Yesterday, mom was officially diagnosed again with triple negative breast cancer (this time, metastatic) that has spread to her lungs, lymph nodes, and bones. It has been a month or more getting to this diagnosis, and we've had a lot of time to process each new revelation as we got closer to the official diagnosis that we received yesterday from her oncologist in ATL. As you can imagine, a lot of tears have been cried but we are at a point now where we are ready to tackle this cancer again (for those that don't know, she was originally diagnosed and treated in 2017 for a lump in her breast, treatment was completed April 2018). Her oncologist was surprised her cancer had returned so quickly, as her type of cancer typically returns (if it does) around the 2-3 year mark. She last had a mammogram in September, and a physical exam in March, which of course came back clear, and still is as far as we can tell. It's really a shame that scans, other than mammograms, aren't approved by insurance for cancer patients. I can't help but wonder if this could have been caught sooner. But honestly, her insurance recently denied coverage for that mammogram, saying it was unnecessary. Talk about infuriating..
Anyway, if you know anything about metastatic breast cancer, you probably know that it is advanced and not curable, only treatable to extend quality of life. You are also likely wondering about life expectancy and survival rates. Honestly, those statistics are not good (generally speaking). However, everyone is different and we just don't know anything specific regarding that. In my eyes, there is no sense in dwelling on an estimated time frame that we may or may not have. For now, mom is feeling good, but just has a hard time moving around, since she has shortness of breath very easily. We found out this morning from the pulmonologist here in ATL that only treatment will help to ease that breathing problem. BUT we did find out that there seems to be only a minimal amount of fluid in her lungs since the fluid extraction (1.5 liters!) on April 23rd. This is good news for now, since that means another extraction is not needed at this time, and the fluid buildup is very slow going.
Treatment for stage 4 triple negative breast cancer is a little complicated at the moment. We had hoped that our trip down to ATL this week would have resulted in immediate treatment. However, her oncologist is working hard to find out if she has a certain biomarker, called PD-L1, that would make her eligible to receive a new treatment for triple negative breast cancer, called Immunotherapy (it was just approved by the FDA in MARCH!) It would actually be combined with chemotherapy... 3 weeks on, 1 week off and then repeat another cycle. They will then take a CT to see how everything has responded after the 2nd cycle, and repeat as necessary. If the cancer responds well enough, mom could take a break from treatment and would be scanned again in 3 months to see where things stand, unless symptoms ramp up. If the cancer looks to have progressed, then the cycles start again to try to control and maintain, and hopefully shrink what is there. This will likely be an indefinite process.
On the flip side, if the testing comes back negative for PD-L1 and she is not able to get the Immunotherapy, she will just have chemo. I'm not sure if she would follow the same or a similar schedule with just the chemo alone, or if it would be different. We are just hoping she gets the Immunotherapy and we'll cross that bridge when we get to it, if she can't. Unfortunately, that comes with more waiting and we have learned a lot about patience these last 3 weeks. When I typed that it's been 3 weeks, I said to myself, "Has it really only been 3 weeks?!" It feels like it was an eternity ago since I went with her to the doctor that Tuesday, right after we returned from Italy. Her Wilmington Pulmonologist was about 90% sure she had cancer again, at least in her lungs and lymph node between her lungs. When I
Unfortunately, cancer was preliminarily confirmed that Friday right after an endobronchial ultrasound and biopsy, but we still weren't sure if it was the breast cancer that had spread or if it was new lung cancer that had also spread. That was what was confirmed yesterday - in her lungs and lymph node and a PET scan prior to the biopsy also highlighted another lymph node, and a couple bones. Those areas were not biopsied.
So, here we are. Scared about the uncertainty and it's implications, but more than ready to get this process rolling so we can continue going to Vegas and wherever else she wants to go, as treatments allow. If you know my mom, not much slows her down when it comes to her travels. During her initial treatment cycle and after one of her chemo appointments, she went to Vegas to visit family (and to go to the casinos, let's be real) and she was a trooper! She has plenty of scarves to keep her looking fly (she loves that term, for some reason💁), and she feels confident in that she halfway knows what to expect with regard to chemo. She is tentatively set up to go back to ATL around June 11/12th to either start treatment or map out next steps, and closely monitor her COPD (so that there isn't confusion between cancer symptoms and COPD symptoms).
Mom is in pretty good spirits, considering what's going on. She's still the same Anne Marie though, so don't get all mushy and say nice things because that makes us cry. Making us laugh to the point of crying is preferred and also appreciated. 😊
