Category: Here we go again

I met with the local surgeon for my first consult. I wasn’t sure what kind of biopsy we would be doing. She informed me that we are treating this like a local recurrence of breast cancer. That is most likely what we are dealing with, so the initial treatment plan is based on that.

In the next couple of weeks I will have a bone scan to ensure that there is no cancer in my bones (which would indicate bone metastasis, and change things to stage 4). In addition, there will be a surgery to remove my axilla lymph nodes. This is what they would have done had they found cancer in my lymph nodes when I had my initial cancer diagnosis. It will likely mean some form of chemotherapy and radiation therapy. Ugg!

I now to get learn another medical system – the cancer system in Nova Scotia. Since they are assuming it is breast cancer, everything will be forwarded to my existing oncologist, who I like. I haven’t seen him in person since shortly after arriving in Nova Scotia, as all my follow up appointments have been over the phone. I’m curious to see if the next appointment will be by phone and when it will be scheduled.

The surgeon commented that she needed to meet with the radiologist and would review my CT scans together later this afternoon. That would allow her to figure out her surgical plan. I expect to hear from her office soon. In the meantime, I’m thinking of it as a local recurrence and figuring out what all that means.

What I can expect with a local recurrence is radiation because it is in my lymph node. This would happen in Halifax. And a switch up in endocrine therapy, as the 5mg of Tamoxifen clearly didn’t work. Fortunately, there are several options on that front. There might need to be more chemotherapy (yuck). One thing that I didn’t have with my previous cancer was an oncotype nor a mammaprint. I’m now wondering what types of genetic scans are available in Canada that might help inform the next path for treatment.

And so now, I wait. I’m planning to keep myself busy painting and visiting the ocean – both things I enjoy doing.

I am surprised at how calm I am – how I’m not totally stressed out or in panic mode. It is so different from the last time.

I found out on Thursday that the swollen lymph node in my right axilla is cancer. We don’t know yet what type of cancer, we just know that it is malignant. I will have a consult with the local surgeon on Thursday to talk about the next steps. It will be a biopsy of some kind – just not sure if it will be a needle biopsy or a full excision (where they remove the offending lymph node).

I was lucky to have the weekend at StanFest – a folk festival up in Canso, Nova Scotia. It meant that Scott and I were on our own, and I could think. I could also control the messages I was sending out – informing people that I felt needed to know or should know, without feeling like I had to talk to anybody about it. It meant I could send a text with some information and then let them process it before we talked about it (if we talked about it). That way, I didn’t need to deal with the awkwardness of telling people that I have cancer again! But also that I don’t know yet what kind of cancer or what I’m dealing with from a treatment perspective.

My thoughts have been about what the results might show: (1) breast cancer, or (2) lymphoma. If it is breast cancer, then the next step would be to determine if it is anywhere else in my body. If it is limited to just my right axilla, then as I understand it, it is not considered stage 4. This would be considered “locally advanced” as it has spread from the breast but only to the first set of lymph nodes, which were not removed nine years ago when I had my first treatment.

One of the challenges this presents me is that it is in my right arm. My right arm is where I have been getting all my injections and IVs since I had lymphedema in my left arm. I’m complicated.

All that to say, what is surprising me is how calm I am about the whole thing. For the most part, I am sleeping through the night. I’m working hard during the day, with painting at Treehouse Village, exercise, and playing with my puppy. I know that there is very little point in doing any research yet, as I don’t know what I’m dealing with. I did ask a friend about treatments and what the current least sucky option is. I’m told that abemaciclib is something that is currently being used – and I validated that it is available in Canada.

No matter what it is, it is going to suck. What is not going to suck is that we are living in a place where we have a lot of community support – unlike the last time when we were mostly alone. Here we have our Treehouse Family – some of whom are currently living in our house while we wait for their unit to be ready for them. It has been so nice to not be alone and have the support of other adults in the house – and the fun of a child too. My puppy and the one-year-old in the house are so cute together – and I’m so happy that they play well together. Being part of this community also means that my hubby also has support – something he didn’t have when I was initially diagnosed in California.

Another thing that I’m grateful for is that I don’t have to have a Facetime call to tell my mother that I have cancer again. It was one of the hardest things I had to do the first time around. Since then, I’ve lost both of my parents. That is sad, but at least I don’t have to tell them that I’m sick because that just sucks.

I’m thinking now about the things I want to be doing with my time. I have paid attention to that ever since my first diagnosis. This time, I ask myself, what am I doing right now that I want to be doing? What I don’t want to be doing? I enjoy painting and fixing drywall and being part of the construction team at Treehouse. That feels really rewarding; however, it is also taking too much of my time. I need to find time to get back to the beach. I would spend more time swimming in lakes and the ocean if I could. Unfortunately, the exceedingly heavy rains have made the local lakes unsafe for swimming, and the ocean isn’t always an option either (it depends on tides, but also on wind direction and recent weather, as the storms can make the water murky and not great to be in). The water is abnormally warm for this time of year – it feels like swimming in the tropics! It is rather concerning.

For now, I’m calm and trying to be patient … better to spend the day enjoying myself and not being a cancer patient yet. That can wait until I know more. I’m not in a rush to take on that identity yet.