You Gotta Have Friends

August 27

Breast cancer is not just one form of cancer, but many different "subtypes" of cancer. These subtypes of breast cancer are generally diagnosed based upon the presence, or lack of, three "receptors" known to fuel most breast cancers: estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors that are positive with “anti-hormone therapy” or “anti-estrogen therapy” pills. Mine are in the “lack of” subtype, aka Triple Negative Breast Cancer (TNBC).

TNBC means that the tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative, thus giving rise to the name "triple negative breast cancer." Because of its triple negative status, however, triple negative tumors do not respond to the anti-hormone therapy – usually only to chemotherapy. Depending on the stage of its diagnosis, TNBC can be particularly aggressive, and more likely to recur than other subtypes of breast cancer.

Because of the high recurrence for TNBC, and if I had/have the BRCA hereditary gene, serious thought was given to having a mastectomy on both breasts (bi-lateral mastectomy). I haven't spent time on geneaology since my surgery, but it sure would be nice to find some living relatives to include them in the free gene testing!

Why is TNBC so important? Researchers have identified treatment for hormone-fueled cancers – which is the pill. The research on TNBC is fairly new. Women who were diagnosed with TNBC 5 or 6 years ago have frequent recurrences. Remember, I am not a doctor, but a TNBC person who researches to gain understanding to prepare for discussions with physicians. This is my life, and I need to have a say in it and not just “yes, okay doctor”. Many women who belong to No Surrender Breast Cancer Support and the Triple Negative Breast Cancer Foundation have had to show their medical oncologists information from the web. Why? Because even tho we are sub-typed as TNBC, we are all unique individuals. Some treatment may work well for some and not for others.

I have to remind myself of this – that we are all unique individuals – and respond differently to surgeries and medications. I have not been released to work and have been comparing myself to my co-worker. She had a single breast mastectomy, which to me is much more than the surgery I had. She will not have radiation or chemotherapy and can take the “anti-hormone” pill for 5 years. Yet she was able to return herself to work within 1.5 weeks. I’m not sure if her doctor approved, but given the lack of pay and concern about insurance as she also was a new employee – same as my concerns – she may have felt that she had to go back.

My doctor prefers that I go back to work after I see her next Wednesday. I am trying to manage the pain today with Tylenol. . . .after my morning oxycodone acetaminophen cocktail. So far so good but I’m also staying down and not “thinking” (lol) or moving around like I would at the office. If it goes well today, I will see about returning to work tomorrow or Friday.

If you want to read up on the chemotherapy drugs that I will be taking very shortly – Docetaxel and Cytoxan – here is a good website: www.nosurrenderbreastcancerhelp.com/Chemotherapy.html. You’ll need to scroll down a bit to find the lovely side effects of these two drugs. When people were asked what was worse – cancer or chemotherapy – it’s no surprise that chemotherapy won.

Just as I “geared up” for the surgery with everyone’s prayers and support, we will be gearing up for the chemo portion of this journey very, very soon. The incisions need to heal first, and should more surgery be required, this will be pushed back. I am finding the old hymns that we sung eons ago at People's Church in Fresno come to my brain at each start of the journey. . . What a Friend We Have In Jesus is this leg of the journey’s mantra. But Peter will be with me as well during the infusions.

As Bette Midler's song, Friends, goes:
But you got to have friends.
The feeling's oh so strong.
You got to have friends to make that day last long.
I had some friends but they're gone, somethin' came and took them away.
And from the dusk 'til the dawnhere is where I'll stay.