And here we are...

Still keeping it quiet, but also putting it out there.

So. Some people (many people?) don’t know that in August of 2020 we found a lump on the side of my breast and it was very quickly determined to be suspicious.

Mammogram → biopsy → scans → lumpectomy and sentinel node removal → Tamoxifen → 4 weeks of radiation

The lump was small, there was no lymph node involvement, the margins were clear, I didn’t have to do chemo. These were all good things.

Doing all of this in the middle of the beginning of the pandemic was a thing all to itself, and that’s a conversation for another day.

And now here we are, almost 2 years to the day of the beginning of this whole mess. My boobs are fine, but the same cancer (ER/PR+, HER-)* has decided to take the party elsewhere. Routine checks are key to this tale, and I have to say, my doctors here in Portugal have been on top of things.

I get bloodwork done every few months to keep an eye on an assortment of things because Tamoxifen sucks and makes you feel bad in different ways. Its job is to block hormones because hormones are what feed this cancer. But when you don’t have hormones, you can have other problems. So routine bloodwork, routine ultrasounds on parts of your body, a mammogram every so often.

There is a thing they can look for in bloodwork called a tumor marker, and there are various schools of thought on the value of using this measure. Well, I’m a big fan of this measure. One particular tumor marker has been going up steadily over the past few months, and a slightly questionable ultrasound from a while back led my oncologist to request another ultrasound.

Lots of stress later (but actually not much time because they can actually get shit done here when they need to) and here’s where I’m at:

Ultrasound → bloodwork → PET scan → liver biopsy → 27mm lesion on my liver

That sounds scary, doesn’t it? Yup, it is. But now we have a bit of a plan and I feel a little less terrified but still really anxious.

Here’s what it means:

I have what is referred to as Oligometastasis which is when you have metastasis in less than 5 isolated sites. This is the "good" kind. The plan is to do localized focal treatment if possible (likely) alongside systemic treatment (hormone suppressing poisons medications). For two months I’ve been getting Zolodex shots to shut down my ovaries and that will continue, the Tamoxifen has been changed to Anastrazole, and Ribociclib (a cyclin D1/CDK4 and CDK6 inhibitor) will be added. Plus probably some other injection to protect my bones, because no hormones, mo’problems.

I’m having an MRI on Monday so they can get a better detail of the little monster** and after that, I’ll meet with the oncologists (I’m lucky to have two!)*** and then an Interventional Radiology Specialist to discuss the focal treatment options. Those options are less invasive than surgery and use either targeted radiofrequency or microwave (ding!).

So. Everyone wants to DO SOMETHING TO HELP.

And that is hugely, lovingly, sincerely appreciated. But can we be as normal as possible? I need to do my best at being as normal as possible. This is going to be a bit of an invisible illness… I might be super tired, or cranky (no hormones, y’all) or have all sorts of body aches and pains, but there isn’t going to be a lot to DO.

Send me letters, podcasts, pictures. Tell me what crystals you think I need. You know me, I love a present (joke, that is NOT an ask). I know some of you want to start baking and you’re frustrated because distance and Portuguese customs won’t let you bake for me. Send me the recipe and we’ll do it together. But when it’s less hot. I CANNOT turn the oven on right now.

I’ve talked to friends who have/had cancer and doctor friends, and doctor friends who have/had cancer, and the one thing that everyone agrees on is that this is really fucking crappy and really fucking scary but it’s on the good end of the scary spectrum, and the treatment plan is solid.

I’ll post my updates here. And probably some thoughts here. And most likely pictures of all my little self-care projects. And maybe some thoughts about being a therapist during an ongoing global health crisis while having an ongoing personal health crisis.

Feel free to ask questions and reach out. I’ll try to tell you what I need.

Lots of love,

Jenn

(ER/PR+, HER-)* - this mean that the cancer lover estrogen and progesterone, but is HER negative which is really good

little monster** - y’all wanna name it? Leave suggestions in the comments

(I’m lucky to have two!)*** - I have two oncologists because this crap started in Lisbon and then we moved to Faro, and they are being awesome and working together to keep me whole.