Blessings in the Bad

Let me preface this by saying all the news in this post is not bad. There is actually a lot of really good news. However, instead of taking two steps forward, I feel like I've only taken one.

I went back for my post-op appointment and to receive my pathology results yesterday. Back in November, my oncologist told me only 50% of triple negative patients achieve a "pathologic complete response." This means at the time of surgery there are no cancer cells present in the tissue samples. I was up to the challenge (which makes me laugh right now, because I clearly had no control over the situation) and was convinced I was going to be in that 50%.

I'll be honest. I was a bit of a quiet, disheveled and hidden mess this past week. I would not call myself anxious - I truly was at peace with whatever news I would receive. It was more the building anticipation of getting the news. Not to sound dramatic, but yesterday's news was probably the biggest news of my life. Especially considering my future life was dependent upon the results.

In my case, there were five tissue samples: left lymph nodes (5 were taken), left tumor, left fibroadenoma (which was taken because my original pathology report from my biopsies didn't specify which mass was cancerous. My care team decided to take both masses and play it safe.), right tumor, and right sentinel lymph node (only one). In order to achieve a PCR, all five of those samples had to show no cancerous cells.

I did not achieve a pathologic complete response. But I was SO damn close. Like, ridiculously close it hurts. Let's start with the left: prior to chemo, there was one positive node and a 9mm tumor that was only discovered serendipitously. The pathology results showed zero positive nodes (yay!) and the original 9mm tumor is now greater than 1mm but smaller than 5mm. However, the sample showed clear margins, so that is great news!

On the right hand side, there were zero positive nodes and a 2cm tumor prior to chemo. The pathology report showed residual cancer where the 2cm tumor originally was, meaning the cells were scattered throughout the specimen; they were not in a mass of any kind. Furthermore, lymphocytes were surrounding the cancerous cells which is a good thing because it means my immune system is working with the chemo to fight them off. The not so great news is the sentinel node that originally tested negative in the operating room turned out being positive in pathology. Remember - this node was also negative prior to chemo! It's absolutely crazy how cancer can just throw these random surprises at you. However, the cancer in the lymph node is considered a "micrometastasis" containing approximately 200 cells and/or is greater than 0.2mm but less than 2mm. So once again, we're talking tiny. The margins were clear on all the samples, so that's good news as well.

Basically, in summary, everything had clear margins, meaning all the cancer was removed. Anything that was discovered in the specimens is itty bitty. As of now, it is 'safe' to assume there is no cancer in my body...but I say that lightly, because triple negative is a crazy beast, so who ever knows what may be floating around out there!

I believe my mother summarized my news best when she simply responded with, "Well, shit." Yep. That pretty much summarized my initial feelings as well. My other friend in Texas, who is also going through breast cancer, said, "This is basically the equivalent of being ready to graduate college and finding out the day of graduation that you're one credit hour short." Yep...that too.

However, it's amazing what a little bit of time can do for your mindset. Less than 24 hours later I am feeing so much better about everything. However, yesterday at 11:30 was a different situation. I'll be honest - I called Jeff as soon as I left my appointment and got emotional. I was really just disappointed I didn't get the news I was hoping for.

I then went to Trader Joe's and bought my feelings in fruits, vegetables, flowers, and Everything but the Bagel seasoning. #selfcare

BUT, I also realize the news I got is not all bad! At all! It could be so much worse, and I am certain there are thousands of other cancer patients who would be more than happy to trade me places. I have to keep everything in perspective; not to diminish my feelings, but just to remember how far I've come and celebrate the successes. I am truly grateful I even have things to celebrate.

I meet with my radiation oncologist next week and will then get a game plan on that treatment plan. I hope to begin in early June and think I'll have anywhere between 16-18 rounds. I'll then get a short break from radiation and then start Xeloda, an oral chemo. Xeloda is the standard of care when a pathologic complete response isn't attained. I'll take two pills a day for two weeks, followed by one week off. I will do that for eight cycles, so six months. Luckily the Xeloda does not cause hair loss and the vast majority of the side effects can be controlled by reducing the dose. My immune system will also not bottom out like it did on the IV chemos I took. My oncologist also said if we need to cut the Xeloda short due to side effects, she would be ok with that since the remaining cancer cells in the specimens were so miniscule. Basically, radiation is going to kill any remaining cancer cells in my chest/lymph nodes, and the Xeloda will kill any remaining cancer cells that may be lingering somewhere else in my body.

After I've had some time to process everything, I am now at peace with my results. This sounds crazy, but I'm afraid if I'd achieve PCR I would have fallen back into bad habits like not consistently exercising, not drinking enough water, not eating enough vegetables, and either oversleeping or under sleeping. The pathology results have truly kicked me into high alert and made me realize taking care of myself has to be a priority. If I can take time to binge watch Netflix or scroll through social media, I absolutely have time to go for a walk or do a Peloton ride. I just need to actually do it.

These last six months have been a whirlwind, and I know I haven't even begun to process all of it. I've learned so much about myself, and I have also changed. Things that used to bother me aren't even a blip on my radar anymore. My patience level has hopefully (slowly) increased. I take time to notice the small details of my day, like the way the birds sing in the morning, or the way Reid's lips look like they did when he was a baby when he sleeps. I'm learning to laugh a lot more than I used to. I'm exploring new passions and finding fulfillment in being creative. While I wouldn't wish my diagnosis on anyone, there are also a lot of really good things that have come out of it.

Remember that song "Everybody's Free to Wear Sunscreen" from back in the late 90s? The one line that has always stuck with me is, "Don't worry about the future. The real troubles in your life are apt to be things that haven't even crossed your worried mind. They're the things that blindside you at 4pm on some idle Tuesday."

I happened to be blindsided on a Thursday in October, but you get the point.

The emotional earthquake that has ensued has forced me to evolve...and for that, I am thankful. I guess that's how life works. We all have nuclear bombs dropped on us during our time on this planet. None of us are immune to them. Some people choose to be defeated and never make a change. Some people become hyper focused on their new normal and are so fixated on trying to control all the variables that they miss the lessons within. Some people take it in stride, while others deny it all. But change? Real change? That happens when you allow yourself to become vulnerable. Nothing worth fighting for comes easy - it's important to remember that. Just be mindful of the fact there are always blessings in the bad. And that space? That space where it's brutal and hard and uncomfortable? That is where the magic happens. Don't go through life without experiencing it. I promise it's worth it.