We met this morning with Jennifer, a collaborative care nurse on Dr. Brufsky’s team. My pathology results came in prior to our appointment, confirming that I have triple negative (TN) breast cancer. I also have a very weak ER/PR+ (a receptor), which apparently is not uncommon for TN. Dr. Brufsky confirmed that the plan is still to pursue the chemo treatment mentioned last week. Things may be refined after my visit with the surgeon next Thursday when she weighs in on my treatment.
Results from my PET/CT scan tomorrow should be in Monday or Tuesday. I’m supposed to avoid alcohol, sugar, and carbs today. I’m allowed a light, restricted breakfast before 6 am. Of course my appointment isn’t until 1 pm! Don’t worry, it’s not a complete fast as I get to drink gross contrast. Can’t wait.
I got the go ahead to get the bivalent booster anytime after my scans and before next Friday’s tentative chemo treatment. I heard about a local place that takes walk-ins, so I’m hoping to go tomorrow afternoon. Jennifer said I’ll have to avoid large crowds and be extra careful, since once I start chemo, I’ll be immunocompromised and my white blood count will be low. A high temperature means a trip to the ER.
Jennifer patiently answered all of my questions and explained the chemo treatment. It’s more than I was expecting. Right now, the plan is to get Adriamycin and Cytoxan (A/C) and Keytruda (the new TN drug) once every three weeks for four cycles. Bloodwork will be done prior to each treatment.
Three weeks after the A/C is completed, I will get Taxol and Keytruda once a week for 12 consecutive weeks. Bloodwork will also be done each week prior to treatment.
The Keytruda can affect the thyroid, making it go high or low. I had bloodwork today before leaving Magee, and the results came in already. Thankfully, my levels are normal (for now).
Jennifer mentioned some possible side effects. The difficult part is everyone is different in how they react to chemo, and some people are actually fine. I tend to get weird medication side effects, though. They’ll give me Benadryl during the treatment, so that’ll make me sleepy. The night of my treatment, I’ll take other medications, like steroids. Typically once the steroids wear off, in 3-4 days, is when I’ll feel the chemo effects. The team will help me try to stay ahead of side effects like nausea.
Other common side effects include dry skin, dry mouth, possibly a metallic taste. There’s also loss of appetite, for which she said to snack throughout the day and not to force myself to eat a large meal.
Chemo is cumulative, so the more treatments I get, the more it will likely affect me. But hopefully the break in between treatments will help.
It may stop my menstrual cycles – either temporarily or permanently (I hope the latter!).
I’ve decided not to pursue the cooling cap. It’s not guaranteed to work, expensive out of pocket, and very uncomfortable. It has to be worn before, during, and after treatment – that’s a long time. It may not even be safe for me because of my CI (I haven’t looked at the CI information closely enough but logically, it would be bad to freeze my implant). I’m already going to be dealing with a lot, and it would be too much.
One surprising thing I learned, however, is that not only will I lose the hair on my head, but it could be all the hair. Eyebrows, eyelashes, and anywhere else hair grows if you catch my drift. Since eyelashes keep things from getting in our eyes, she recommended having something like Artificial Tears handy.
After we talked, Jennifer showed us the treatment room. It has little cubbies with curtains that can be drawn for privacy. Each area has its own TV. Only one support person is allowed at a time, but others can be in the waiting room and take turns. The first treatment will be long as they’ll do things slowly. Three weeks later will be my port placement, followed by my second treatment.
Today’s echocardiogram (to get a baseline of my heart) was unremarkable and the tech said he didn’t see anything concerning.
One day at a time, right?