Cancer Years

It’s been a while. The holidays are in the rearview and the new year has begun. Since the last post I have had a recovery period from chemo, undergone surgery, and have resumed infusions. Consultation with a breast cancer radiation oncologist will be coming up in a few weeks.

I’ve been wondering if dog years might relate mathematically to cancer years. The first year of a dog’s life equates to roughly 15 human years. It’s been five months since I learned I had cancer, and I could make a case for saying the interval from August to today feels all of six years long.

Being weak, fatigued, and frail during the shortest and darkest days of the year, coupled with weeks of social sequestering to avoid illness, then recovering from surgery, made for what I hope will be a one-off holiday season. We appreciate those who gifted us with meals and holiday treats to enjoy, as well as the many messages, calls, and cards.

Surgical pathology results hit the MyChart inbox at 0047 yesterday, 19 days after surgery and just hours before meeting with oncologist Dr. Beckwith. There was no residual tumor seen in the breast tissue, and the sentinel node was normal—the best news possible. This means that I will receive infusions of the immune therapy drug trastuzumab (Herceptin) until mid-October instead of combination chemo and immune therapy.

Cardiotoxicity—defined as heart damage caused by drugs or treatments—is a well-known and serious side effect of Herceptin. This being monitored by symptoms I report, as well as with EKGs and regularly scheduled cardiac echocardiograms. So far, so good, on that front.

Radiation therapy will begin later this month or in February. With left-sided breast cancers, there is a very real danger of . . . drum roll . . . cardiotoxicity. The damage caused by radiation to the heart is serious and can reveal itself in the short term and/or months and years later. With traditional photon radiation therapy, there are breathing techniques that can be used to move the heart as far out of the way as possible while radiation is being delivered.

I’ve also been researching proton beam radiation, which greatly decreases damage to healthy tissues by treating a much more targeted area than traditional photon radiation. This is available at only 45 cancer centers in the United States, Mayo being one of them. Dr. Beckwith wasn’t encouraging about BCBS covering the more expensive proton radiation therapy for me. If, during my consultation with the M Health radiation oncologist, I don’t receive assurance that every available measure will be taken with “traditional” radiotherapy treatments to protect my heart, I will seek another opinion with one of Mayo’s breast cancer radiation oncologists and see where that goes.

Something I was planning to ask Dr. Beckwith about yesterday was Signatera—a blood test that detects circulating tumor DNA. The test is customized to each patient from a tissue sample obtained from one of their biopsies. Dr. Beckwith brought it up first and asked if I was interested in having this done every six months. Positive results indicate recurrence or metastasis being detectable in an average of 10 months from the time of the positive result. She said with respect to breast cancer, there isn’t yet a consensus or standard of care in place for what to do with a positive result. Image the patient? Wait for symptoms? Arbitrarily treat with chemo/immune therapy? I told her I would like to have Signatera testing, as the negative tests would, at the very least, provide me with some short-term peace of mind. She placed the order, with the caveat that my insurance provider may decline coverage. That is a tired chorus I’m so very weary of hearing.

My hair is beginning to grow back, but my eyebrows and eyelashes did me dirty and fell out weeks after my last chemo infusion. To add insult to injury, they often landed in my eyes. The drippy nose and running tears side effects of Herceptin never went away and will presumably be with me for several more dog/cancer years. Truth in advertising: I’ve discovered that lotion-based tissues really are gentler. There has not yet been improvement in the neuropathy caused by the chemotherapy I already received, although there remains a possibility that it could get better over the upcoming months.

In November, Russian spambots began flooding my blog comment section, a problem I am not yet sure is gone for good. Google translates Cyrillic script just fine, and fortunately the content is nothing worse than ads for trucks, autos, and countryside inns. If I need to make any major changes, I will let you know. A few random things: the northern lights have been out again recently and the ice on East Rush is 15 inches thick. I hear tell the fish have been elusive. In the words of my son-in-law Chris: the only thing being caught out on the lake is a buzz.

Stay warm and be well.