I have had the whole weekend to start processing my diagnosis. It still doesn’t feel real.
Friday night was quite drunken, so I slept well. Saturday also involved daytime drinking and a long walk followed by more drinking. Alcohol is fantastic for conjuring a positive attitude from thin air.
I managed to come up with a list of positives that could come from all this:
- I had always wanted to shave my head, just to see what it looks like, I figured that it would be such low maintenance and the hair would always grow back, so now could be the perfect time if I had to go through chemotherapy
- I had always thought about adopting rather than having my own children, due to me worrying about the environment, so that might now also be a more realistic option
- I had always wanted a breast reduction so I guess the lumpectomy would be just that, unfortunately only on one side (Luke said I might finally be able to walk straight if they reduce one side, I laughed and said I didn’t realise we were making jokes about this yet)
- As coronavirus has already ruined all plans for the year, I didn’t have to blame the cancer on cancelling anything fun!
I spent a lot of Saturday telling close friends about my diagnosis, every time I sent out a similar message “Sorry to be the bearer of bad news but…” And every time I had similar fantastic supportive responses. Thank you if you have sent me a message, it really does make me feel loved. Please forgive me if I don’t reply straight away or if my reply is short.
Sunday is when it all hit me, I could not stop crying on Sunday evening.
Monday morning I woke up at 0600. I couldn’t get back to sleep. All I could think about was the results from the receptor tests.
If the tumor had receptors that were positive to oestrogen, then it would mean I could have surgery in just 5 days time.
If the tumor had receptors that were negative to oestrogen, then it would mean embarking upon 4-6 months of chemotherapy before surgery.
Waiting for the phone call for the results was torture. I couldn’t breathe. I was so tired but couldn’t get back to sleep, I was hungry but I felt sick at the thought of food. Tom and Luke tried to distract me with conversation and exercise, but I didn’t want to do anything until I had the results. Philippa sat with me on the balcony and held my hand.
I emailed Laura to tell her that if she was too busy to call me with the results, I really did not mind if she sent them over by email, hoping that that would speed things up.
Email 14:22 01/06/2020Hi Cara
I have been chasing the lab all morning as has Hannah – sorry I know so much hinges on this for you
I promise we will let you know – I am hopeful it will be before the end of the day
I couldn’t take the suspense so went on a walk. The call finally came through at 15:30.
The tumor came back as oestrogen positive. But also HER2 positive.
What is HER2 and what does it mean?
HER2 is a growth-promoting protein on the outside of all breast cells. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than other breast cancers, but are much more likely to respond to treatment with drugs that target the HER2 protein.
In my case, being HER2 positive means that I have to start chemotherapy before having surgery.
Being HER2 positive means that I now have access to two anti-HER2 drugs if I have treatment before surgery (Trastuzamab and Pertuzamab), after surgery patients normally only get single agent (Trastuzmab). Laura tells me that that both agents are better than a single agent.
Laura explained that she had underplayed the HER2 factor when we met because statistically I was unlikely to be HER2+ and secondly it hadn’t impacted in treatment of patients over the past few months due to the alternate coronavirus pathways that they were following. Luckily, although it didn’t seem lucky, they were going back to pre-covid treatment pathways and therefore I would have to start on chemotherapy before surgery.
I felt so angry that this had not been mentioned before and that it had not been explained to me that I was being offered a different treatment plan, due to coronavirus. Anyway that is irrelevant and I have to come to terms with the fact that I am, infact, lucky to be able to receive these targeted drugs. It is not good or healthy to hold on to anger and so I am working on looking for the positives (something Tom helps me with a lot).
Now that chemotherapy is going to be started a lot sooner than we had provisionally planned, Laura said it was important to speed up how quickly I was seen by the fertility team. Chemotherapy comes with the risk of bringing on early menopause and affecting my fertility so if I want the chance of having my own children in future, I would need to undergo egg harvesting and they would be frozen for the future.
Hannah chatted to me on the phone after receiving the results from Laura. She said that she would send over information regarding fertility treatment. I read through the leaflet and I have to say – it sounded shit. Invasive scans, injections to stimulate ovulation followed by a procedure that I have to be sedated for and given strong painkillers. Thanks, but no thanks, was my initial reaction.
As mentioned before, I am not sure if I do want my own kids. I have always thought that adoption is more appealing to me. So the idea of having to go through unpleasant procedures that are going to delay my cancer treatment does not seem like a great idea right now. But I don’t want to burn any bridges at this point in time, especially when I am not thinking straight.
Plan going forward is:
1. Oncology appointment asap (hopefully this week)
2. Fertility appointment asap
3. Discussion about more radical surgical option to avoid chemotherapy