6. Treatment Plan
So, the day eventually arrived; the day that would determine the next few weeks for me, depending of course on the treatment. Paschal came with me as a support, but more importantly to be a second ear for me, to listen and pick up any details I didn’t catch. I felt fortunate that Paschal was willing, and wanting to come to appointments with me.
This was the start of our new road, not only for me and Paschal, but also for Bella. This was the first time we were going to have to leave her on her own for a few hours. As we left her that morning, I felt a guilt knowing this was the way it was going to be for her over the next while, but still not knowing how long. I could only imagine this to have been difficult for her; she was only beginning to get to know us and already there was uncertainty around. As we didn’t want to leave Bella for too long on her own, and as yet I hadn’t told anyone outside the family about what was going on, my mum and dad came to the house to look after her for a few hours while we were away. It was a relief knowing they were going to be with her, we didn’t have other options so this was a big support to us.
I was armed and ready for the meeting or so I thought. I don’t know if you can ever really be fully prepared. I had my questions written down, however there really was no need. When you’re diagnosed with cancer it’s all you think about, well at least it was all I thought about. Over the course of the treatment questions you have change, however, any question I had at this stage was firmly planted in my mind.
We arrived at the breast screening unit, a place I was going to become very familiar with. I went through the same routine as at my first appointment, making them aware at reception I’d arrived, sitting, nervously waiting. Only this time it was with Paschal. The same routine, I was brought down to the changing room, where I put on a pink wrap around jacket and then went to the waiting room, where we sat and waited. It was quieter that day. Although there were still quite a few women and we both noticed one girl who looked to be very young. Breast cancer doesn’t just happen to the middle aged or old, it’s also a very real possibility for young girls / men also. And we waited making some light hearted remarks to each other, that’s what we do to keep things easy going! And then I was called.
In I went to the same small office I had been in previously. The consultant and my breast care nurse were present. There were a few pleasantries and then the consultant began to tell me the results of the biopsies. He confirmed there was a big lump, 2.5cm and growing from this there was a cluster of cells that are known as HER2+. He said this was 0.5cm and was of great concern. He explained that HER2+ was a very aggressive cancer that can quickly grow. He told me aggressive was good though, because this meant the cells didn’t have time to embed but rather just kept spreading, which meant there was a better chance of the treatment killing them. He continued that HER2+ had a new targeted treatment drug, developed in the last 10 years, that has a very high success rate. So, the type of cancer I had was treatable. So far, not so bad! My head was spinning! Good news and some concerning news, it’s treatable, but it’s aggressive. I’d heard about cancer stages, it didn’t really mean anything to me, but I asked what stage it was at. He said stage 1. A sigh of relief that it was in the early stages. My next question had it spread to my lymph nodes, I had heard that wasn’t good if it had; it hadn’t. The other two lumps that were biopsied were clear and not of concern. I was told had I not discovered the bigger lump, the lump that was 0.5cm, and of great concern, was so small I wouldn’t have felt it at this stage. Oh my lord, thank god I asked the GP to check the lump I found, otherwise this could have been a whole different story. Ok, so the news so far, not so bad!
Next the treatment plan. I was going to have 6 cycles of chemotherapy, alongside this I was going to receive an anti-HER2 targeted treatment which would start at the same time as chemotherapy and continue for a complete year. Following chemotherapy I would have surgery, either a mastectomy or a lumpectomy (now referred to as breast conserving surgery) and then I would have radiotherapy. After this I would have hormonal therapy in the form of tablets for a further 5 years. The heaviest part of my treatment would be complete by Jan 2024. That was a lot to take in and process, a lot of treatment there, should I be concerned as it’s only stage 1? On the other hand, I wanted them to give me everything as I wanted to make sure they got this cancer out of me.
I know now how limited my understanding of treatment was, I clearly didn’t know a thing as I again asked about work. I noticed the consultant look at the breast care nurse and he was very diplomatic, as he said, I could see how I was feeling between treatments but with chemotherapy it’s better not to be in crowds. I decided I wouldn’t be returning to work for a while. I asked about losing my hair and was told this would happen usually about the second treatment. Deep breath, ok! In years gone by my hair, and maintaining my hair, was a big deal for me. It was one of the things I looked after. Some people went for massages or facials, I religiously went to the hairdressers about every 5 weeks. That was pre-covid. Since COVID I’d been doing my own hair, cutting and colouring it, so thankfully it wasn’t as important to me at this stage. I was ok with the fact I was going to lose my hair, to be honest it was irrelevant at that time, just get on with it I thought!
After the meeting with the consultant, my breast care nurse brought us into a room to clarify I had received and heard all the information. She realised I didn’t know a lot about chemotherapy treatment as when she asked what I knew all I could say was I knew it would be hard on my body, I didn’t actually know what that meant, but I knew I was ok with that. As I saw it I didn’t have a choice. I’m strong willed and I knew I’d be fine, there was no doubt in that for me. I asked about food and was told I could eat as I would usually, I didn’t have to follow any specific plan. As the targeted treatment could impact the heart I had to have regular echocardiograms (AKA Echo) to monitor heart function throughout the treatment. That was to be arranged. The breast care nurse gave me a folder full of booklets and leaflets and also a copy of my diagnosis. On the form showed I had ductal and DCIS, Grade 2 HER2+ cancer (i.e. Grade 2 invasive ductal carcinoma of the breast). My next appointment would be at the cancer centre, with my oncologist, in three days time. Everything just moves very fast from here.