Radiation ahead followed by oral chemo

On February 9, we met with Dr. Coral Quiet, my radiation oncologist. She was happy with how I was healing and my range of motion after surgery. She said that as soon as my last drain came out and my expander was filled to where we wanted it, we could begin radiation treatments. She set up a CT scan for the February 16 to outline my anatomy and begin a mapping process of all the areas they will hit with radiation and for how long. She wants to do six weeks of treatments, everyday M–F. This is just one more week that she would have done if the breast surgeon had found no cancer in my breast and lymph node. 

She plans to radiate the lymph node area under my arm, the chest wall where any breast tissue may remain, and the lymph nodes along my sternum. Side effects from radiation will include brittle ribs, fatigue, and burning/irritation/peeling of the skin. I will also have a possible risk of short-term or permanent lymphedema, which is swelling of my arm from a lymphatic system blockage. When we asked what we could do to prepare for radiation she encouraged me to keep walking so that my skin would be well oxygenated and to continue to eat food high in minerals and vitamins. Once I start treatment, I will start applying a steroid cream along with an aloe vera gel to heal damage to my skin.

I have continued to struggle to get good sleep the past few weeks because the drains and expander are very uncomfortable and require me to stay elevated on my back but things are slowly feeling better and I try to rest as often as I can during the day. Each day, I do some light physical therapy exercises to help regain my range of motion. I follow up with my PT on February 26 to see how everything is looking.

On February 16, Dr. Matatov’s medical assistant removed my last drain. I was so happy to be “untethered” and to be able to wear something other than a button-up shirt with pockets to hold my bulbs. :) That afternoon I had my CT scan and we set up an appointment for verification on March 1. This will basically be a “dress rehearsal” for my first treatment the next day to make sure all of my markings line up and Dr. Quiet is happy with the radiation mapping that has been outlined by the technicians.

Today, February 19, I had an appointment with my oncologist to discuss the biopsy results of my surgery and I was also scheduled to get another Keytruda infusion. I was disheartened when Dr. Curley said he felt like we needed to change my treatment plan to include more chemotherapy. Because the pathology still showed cancer in my sentinel lymph node and three areas in my breast (1.8cm, 2cm, 0.8cm in size), I only had a partial response to the chemotherapy. Dr. Curley is recommending that following radiation I begin an additional 6-8 cycles (about 6 months) of an oral chemo called Xeloda. One cycle would consist of 4 pills every morning and every night for 14 days followed by 7 days off. Ideally he would like me to have 8, 3-week cycles but a minimum of 6 cycles depending on my reaction to the drug. The side effects of Xeloda are not typically as bad as the infusion drugs I got but often include diarrhea, mouth sores, fatigue, hand-foot syndrome (skin rash, swelling, pain and peeling of the palms of hands and soles of feet), low blood counts, and elevated bilirubin levels. I won't have any more Keytruda treatments since they're not giving us the results we had hoped for. Dr. Curley feels that by adding this additional chemo I can decrease the percentages of cancer reoccurrence. 

Glen and I knew there was a chance I might need oral chemo after we got cancerous biopsy results from the mastectomy but I was not expecting six more months, so it's been a difficult pill to swallow, no pun intended. We will bravely carry on and trust “that God will deliver us, insomuch that he will speak peace to our souls, and grant unto us great faith, and ... cause us that we can hope for our deliverance in him.” (Alma 58:11) Embrace the Future with Faith - President Nelson