The Diagnosis: Part 2

From the moment I heard the word “cancer”, everything happened so quickly. Like someone hit the fast forward button and couldn’t figure out how to turn it off.

Carlos and I had a flight booked to go to Hawaii for a week on August 2nd (for my 27th birthday) and I had no idea if I would be able to go. They rushed my first appointment with my oncologist for this reason. I met with her on July 31st and she told me the tentative plan for treatment:

  • 8 rounds (~4.5 months) of chemotherapy (expect hair loss, nausea, fatigue, and bone pain… yes BONE pain)
  • Nightly injections in my stomach to boost my immune system during chemo (expect more bone pain)
  • 1 year of targeted therapy (this is toxic to your heart so regular heart scans are needed)
  • Surgery (preferably lumpectomy with lymph node dissection)
  • 20-25 rounds of radiation (every Monday-Friday for 4-5 weeks)
  • Hormone therapy (oral pill and monthly injections) for possibly 5 years (this keeps your body in chemical menopause so that no estrogen can make the cancer grow, expect hot flashes and mood changes)

As someone who once fainted at the optometrist when I found out that I needed glasses, you can imagine how I handled this information.

When I asked about the trip to Hawaii, she explained that delaying treatment by a week wouldn’t make a difference and that I should go ahead and enjoy my vacation before I begin treatment.

So that’s what we did! It was a little taste of paradise to hold on to before I entered… well, not paradise.

The Road to Hana, Maui
RIP hair. It should be noted that I resisted EVERY temptation to not shave my head in Hawaii. Having to detangle it from salt water and wind every day was extra tedious knowing it would all be gone in a few short weeks.

I know it’s hard to believe, but I actually had an amazing trip. Sure, there were times when it all hit me at once, but changing my environment was the best possible thing I could have done for myself. On my birthday I rolled around in the sand, splashed around in the waves, went to a movie, and ate the most delicious fish tacos I’ve ever had in my life. It was perfect.

Having cancer sometimes makes being alive feel like you’re touching a live wire. It’s like all of a sudden, everything is amplified. The highs are so much higher, and the lows are so much lower. You start seeing beauty and joy in so many places you never saw before. This trip let me experience that and it kept pushing me to live in the present moment. When everything is new (new sights, sounds, smells, foods, activities, etc.) it invites you to fully absorb the present moment, which is exactly what I needed.

When I land back in Vancouver, it’s go time. Here’s a brief timeline of what happened:

August 14th: I have a port surgically put under my skin on my chest so that I could get treatment and blood work more easily (you can read about that here)

August 16th: I have a PET scan in order to find out exactly what stage I am.

August 17th: I start chemo (ew).

August 18th: Me and my amazing friend Charli get pixie cuts together to prepare me for hair loss.

August 21st: I go with Carlos and my sister Lucy to meet my oncologist for my first follow up appointment after chemo. My oncologist also has the results of my PET scan (warning, this is where shit gets real). Her voice gets a bit somber. She says “The good news is that it’s not in your heart, your liver, your brain, or your lungs, but… we did find two small spots on your sternum, I’m so sorry Sarah”.

My mind went completely blank. I instantly crawled up into a ball and just kept turning towards Carlos and looking at him with a complete look of panic. I couldn’t even cry. I was completely shell shocked. I couldn’t look at Lucy. I could see her in the corner of my eye with her head between her knees and her hands on her head. My oncologist continued, “So unfortunately this does make you stage 4 and you will be considered a cancer patient for the rest of your life“. I basically combusted into a ball of anxiety and panic. I didn’t have anxiety, I transcended and BECAME anxiety personified. Even though she followed this up with “but I don’t view you as a stage 4 patient because you have such a minimal amount of disease in your body”. And “There is a very good chance you will make it through this”.

So let me just clarify, no I’m not dying. The cancer did metastasize to my sternum in a small area (which technically makes me stage 4), but I’m not considered terminal by any means. My oncologist explained that I am what is considered “oligometastatic” (a new term, and very rare). Oligometastatic means the cancer has spread to a different part of the body, but it has only spread to one area and in a very small amount. What does this mean? It means I have a shot at a “cure”, meaning I could live a long life without this ever coming back. The other good news is that my mets (metastases) are in the bone, and women with bone mets have better chances of long-term survival. Bone mets also respond really well to radiation.

Let’s fast forward to present day for a second: The GOOD news is that I responded insanely well to chemo. After my lumpectomy, they analyzed the breast tissue and 7 lymph nodes they removed and found ZERO cancer cells. In the cancer biz, this is called a complete pathological response and it’s the best case scenario. Although I haven’t had a follow up PET scan yet to confirm all the cancer is gone, my doctors tell me it is HIGHLY likely that the mets on my sternum are also gone.

So am I cancer free?
The answer: we think so, but it’s not yet confirmed. But trust me, when I know for sure I will scream it from the rooftops!

I expected my treatment plan to completely change with this new stage 4 label stamped across my forehead, but it didn’t. What did change is that my oncologist added an extra drug into my targeted therapy regime. Instead of just receiving the drug Herceptin for 1 year, I was now going to receive Herceptin and it’s sister drug Perjeta to better attack the cancer cells. She also explained that instead of just doing targeted therapy for 1 year, I should now do it for 5 years. However, since I had a complete pathological response, she thinks that maybe it won’t be necessary (it’s something we’re going to discuss in the future).

In case you don’t already know, the survival rate for metastatic breast cancer is extremely discouraging. But, I am not going to let it bring me down. I’ve responded incredibly well and I’m going to keep fighting every day to live a happy and healthy life for as long as possible. I never understood the concept of “fighting” cancer until I had to fight it myself. It’s more than a physical battle, the real fight is choosing to take back your life every day and live it to the fullest, despite your circumstances. So that’s what I’m going to keep doing. It’s hard as hell and I didn’t expect to ever have to do this, let alone do it in my 20s, but it’s really the only choice I have.

I don’t know why I suddenly feel like writing a thank you speech, but I honestly cannot put into words how much I love and appreciate all the people in my life who have been there for me or supported me in one way or another. I have the best partner, family, friends, and coworkers anyone could ever ask for. My heart feels so full and I’m so excited to beat this with all of you amazing people by my side.

xx

Sarah