A (wo)man with a plan

On Wednesday I met with my Oncologist, Dr Tsai. She gave me a ton of additional info about my cancer, and laid out the chemo plan going forward. It was a LOT of info, and she made sure I got to ask all my questions along the way.

First thing Dr Tsai shared was more about my cancer. A lot was things I had already learned along the way – the tumor is Grade 3 on a 3pt scale, its triple-negative meaning chemo is the first plan of attack, but should be highly effective at shrinking/eliminating the cancer. One thing I’ve been asked a lot about and didn’t yet have an answer to is “what stage is it?”  … Dr Tsai explained that now that they have all of the scans and pathology, she’s determined that my cancer is stage IIIB (note: the cancer staging guidelines changed in early 2018, so my staging is not apples-to-apples with staging that occurred before 2018 … long story short, because my tumor is triple-negative, I’m basically automatically Stage III, regardless of size or spreading).

Another question I’ve been getting a lot is “did you catch it early?” … I’ve personally been struggling with this question A LOT. Because my brain automatically translates this into “Shouldn’t you have gone to the doctor sooner.” What I’m slowly coming to terms with is that people asking this question are really asking “how bad is it?” or “what’s the prognosis?” but are trying to be diplomatic and not  completely morbid. So thankfully, now I have some stats to share around prognosis and am trying really hard not to snap at people when they ask if I caught it “early” (but what i really want to say is “I DON’T FUCKING KNOW! I don’t keep a daily log of how my boobs feel! Do you?!”)

Anywho… most important from my visit with Dr Tsai, is we now have a detailed plan for chemo treatment. I knew going in that chemo was going to be the first step of treatment, but now I have loads more details. I’ll do two “sets” of chemo drugs. The first set is a drug combo known as CarboTaxol. I will get it weekly for 12 weeks. Once I’m done with my regimen of CarboTaxol, i’ll switch to a drug combo known as AC, one of the drugs in the AC cocktail, Doxorubicin, is known as the Red Devil – because its red and its a real ass kicker (both of cancer cells and the recipient). I’ll do 4 rounds of the AC, but because of its severe heinie-kicking capabilities, the 4 rounds will be spread across 8 weeks to give my body more time to recuperate between rounds. Both of these drugs will be given in the clinic during the day and I’ll be home to recover between rounds. It can take 3+ hours to get the full infusion of the drugs each round, so to protect my veins and make the nurses’ lives easier, I’ll be getting a port implanted before starting chemo so there is ready access to my vein for all the drugs (and all the subsequent blood draws to check my stats). This combo of drugs has a 65% of PCR (pathological complete response, meaning ALL of the cancer is gone) and a 95% chance of some, but not complete response. So – if you haven’t had the chance to feel Ralph’s tumor yet, you’re more then welcome to cop a feel before the tumor disappears completely.  (no, seriously, about 15 of you have taken me up on this offer, and its open to anyone who feels comfortable and is in a safe place to do so – meaning not at work or in front of my dad).

The symptoms of these chemo drugs are pretty typical of chemo drugs – blood cell counts take a tumble, so you feel really tired and are at extreme risk of infection. Add to that nausea/vomiting, your GI tract getting out of whack (that’s the clean version of saying constipation and/or diarrhea), you lose feeling in the tips of your fingers and toes, have body aches and muscle cramps, and get mouth sores … its basically gonna be loads of fun. Oh yeah, and you lose your hair, so say sayonara to the platinum hair for now. Based on all of this my doctor strongly recommended that i take a leave of absence from work to focus on my health, and staying infection free. Thanks to Target’s generous Short Term Disability insurance, I’m following Dr’s orders, and will be taking 21 weeks off of work while I’m undergoing chemotherapy.

Dr Tsai wanted to start chemo as soon as possible – because why wait, and also because my tumor is rapidly growing. But there is a TON of pre-work you need to do before you can start. In addition to getting the port surgically implanted (outpatient procedure scheduled for the afternoon of 8/23) you also need to:

• go to Chemo Class (8/20 – 1:1 class to become a chemo professional),
• get a PET Scan (8/21 – will confirm that cancer has not spread),
• see the nutritionist (8/16 – intended to help you maintain health and weight during chemo)
• get an echocardiogram (8/16 – confirms your heart is strong enough to handle the chemo, and acts as a “baseline” throughout chemo to see how your heart is being affected by the drugs).

Have I mentioned that I close on a new house next week (8/22) and the movers come the following day (8/23)? Long story short, I’m super overwhelmed and stressed out about everything that has to happen before Round 1 of chemo on Tuesday, August 28th (and my last day at work until January 2019 will be 8/27, woof!). So I’m in heads-down, make lists, get shit done, take it one day at a time, until the move is done and then, its CANCER KICKING TIME.

Unfortunately, Chemo is probably going to suck. Big time.

Fortunately, I’ve got an awesome team of doctors and nurses, and a support network the size of a small country to help me get through it. And we will get through it.