In July Theresa noticed a few large lumps in her right breast. She went for bilateral mammograms and bilateral ultrasounds. She was found to have three fairly large benign cysts in the right breast and a few in the left. Nothing concerning was seen on either test and were reassured. She was told she could have some discomfort and pulling in her breast as the cysts regressed. All was fine at that time.
Two days before Christmas she had pretty severe right breast pain and then her right arm pit enlarged and she couldn’t keep her arm down without something between her arm and chest because of the severe arm pit pain. Her lymph nodes seem to enlarge over night and touching them was severely painful to her. Because cancer usually presents with painless lymph node swelling and infection with tender lymph nodes, we tried an antibiotic for a few days without improvement. About 5 days after the start of the axilla pain, it improved significantly so she could put her arm down again. Only touching the area was uncomfortable. We set up a diagnostic mammogram and ultrasound for January 7th, when I could take her up. The mammogram and ultrasound were obviously much different this time. (mammogram category 1 is benign – which was her first one, category 5 is cancer – this time). There was a 4-5cm right breast mass and multiple enlarged lymph nodes, one being 4cm in size. The radiologist was generous to facilitate my request for biopsies the same day, as my impatient driver side came out. That afternoon he did multiple biopsies, lymph node biopsies and aspirated one of the cysts. Friday afternoon about 4pm the radiologist called Dr. Lisa with the results of the biopies. I came home from work, after stopping to see a patient at an assisted living facility, and told her the news, she not only had cancer but the lymph nodes were replaced by the cancer. We wept together and prayed together in our bedroom. I also had to ask forgiveness for not protecting her. She was sure the news wasn’t going to be good, and was in our bedroom wrapping the boys birthday presents for their March and April birthdays, not knowing if she would be around for those occasions or in good health and have energy for it, for she had started to lose weight and was getting fatigued easily.
After some time, we got our kids together and told them the news and the emotions were raw again. We had been transparent with them from the beginning and they knew there was a concern for cancer. Again we cried and prayed together. Our daughter, 11 years old, struggled the most. My parents came over and once again the raw emotions prevailed and we prayed with agonizing pain, yet also thanked God for his sovereignty and goodness.
The radiologist had set up an appt with the surgeon on Monday, but over the weekend I talked with the surgeon and oncologist. This time I was willing to use my Doctor influence to push ahead as fast as possible. The radiologist had given me his cell number, so over the weekend I set up appointments for CT scans of the chest, abdomen and pelvis after talking with the oncologist and giving the cell number to the oncologist so he could talk with the radiologist. She had her CT scans Monday after we saw the surgeon. The surgeon had recommended a lumpectomy and lymph node dissection if she was stage 3, which was most likely at the time. I was feeding Theresa the oral contrast for the CT scan, during this visit, so we could get it right afterwords. More bad news. The CT scan showed that all three lymph node chains had cancer and the liver had some concerning areas. That evening after getting the news and talking with the radiologist, he set up a liver MRI the next morning. Despite Theresa being claustrophobic, she had no trouble sitting for the 40 minutes in the tube. She explained that God had been gracious to her and had taken her away to Disneyland (her happy place) and she was in Space Mountain going through the narrow tunnels and riding in the dark. More bad news. The MRI showed more than 15 metastasis to the liver. She now had Stage 4 breast cancer, the worse case.
That Thursday, a week after her biopsy and not quite a week ago, we met with the oncologist. The news again wasn’t good. There are three receptors on cancer cells that they look for and if present, they have medications that can block those receptors so the cancer can’t grow and then die. The receptors are estrogen, progesterone, and HERS2-neu. If the estrogen and progesterone receptors are positive then she can be put into menopause to suppress the cancer and if the HERS2-neu receptor is positive then there is a newer agent, Herceptin, that really works well. If all three receptors are negative, then they have to use toxic, indiscriminate chemo and the outcome is significantly worse. In addition they look for how much of the cancer is active at the time. Most cancer have between 5% and 25% of the cells in active growth phase. The lower the number the slower the cancer growth and the more time you have, but also the longer you may have to have chemo, since inactive cells don’t take up the chemo or blockers. Well her progesterone receptor is negative, the estrogen receptor expression low at 15%, HERS2-neu receptor indeterminate, and her growth rate at 68% (which explains the rapid aggressive change). Her path report was as bad as it goes. The clarify the HERS2-neu receptor status, other tests are done but each take three days to complete. The next test to clarify her HERS2-neu status is a FISH test, which also was indeterminate, the next – I don’t know what the name is, but the results will be given to us this Thursday when she gets her first Chemo course.
Back to the saga…We saw the surgeon on Monday, had the CT scan Monday and the MRI Tuesday and she went to the hospital to have a Chemo port placed on Wednesday, last week. There was a 5% chance of a pneumothorax (puncture of her lung), and as you can guess, she got a pneumothorax and had to be admitted to the hospital. As the events have occurred, her pneumothorax got worse, she had to have a chest tube placed, the lung took a while to seal and the chest tube leaked a little. She got her chest tube removed today after having an 8/10 painful sleepless night due to the chest tube irritating the inside of her lung cavity. She was told that taking the chest tube out would be painful, and she told God she couldn’t stand anymore pain. As they were taking out the chest tube, she felt Jesus saying He was here, He took the pain, and she didn’t feel anything and then her pain immediately dropped to a 2/10. She spent 7 days in the hospital in pain and yearning to be home with the kids and I. But this morning I brought her home and now she is in bed sleeping. While in the hospital I was able to serve my beautiful bride, by bringing meals in, massaging her feet, helping her take showers with her favorite shampoo, pray and read Gods word together, and work through the emotions and decisions together. I had a dear friend who has been here before, sit with her a couple days so I could get some things done at home. While I was at the hospital, family stepped in and helped with the kids and house. We are blessed.
God has given us peace about this whole process and has been present throughout.