Month: June 2019

My apologies for the delay in posting an update – life seems to have been very busy, which is a good thing.

Last week I received a very nice letter from the Consultant I saw first back in November last year, who is now semi-retired. He has continued to follow my progress and was very pleased to read my histology results. He said that only about 25-30% of patients who receive chemotherapy up-front like I did get an “all-clear” at the end, so I should feel very secure about the future.  

We met with the Consultant Clinical Oncologist and the Breast Cancer Support Nurse in the afternoon of Thursday 20th June. Unfortunately, earlier that day, while applying makeup, I accidentally stabbed my right eye with an eye liner pencil and pierced the white, which immediately bled!  I felt pretty stupid about it and I didn’t tell Colin until we got to the hospital for my appointment!  It wasn’t sore, just rather alarming. 

After seeking general advice about my self-inflicted eye injury(!) I asked about the results from the two scans I’d had the week before.

My MUGA heart scan result was much the same as last time, meaning that there has been little or no adverse effect from the continuing three-weekly Herceptin infusions.

The bone density scan result showed osteopenia of the femur (I already had a pre-condition) and my spine is just slightly into the osteoporosis spectrum. So, no surprises; and there is now a baseline for future monitoring.

You may remember that the bone scan was done because Herceptin treatment can reduce bone density so I am to have infusions of bisphosphonates. These infusions will be at a frequency of once every six months for three years, but they take just fifteen minutes each time. I don’t yet know when that regimen will start. 

The Consultant Clinical Oncologist also gave me the first prescription for the Letrazole tablets which I am to take daily for at least five years and maybe for up to ten. He went through the possible side effects (which I mentioned in my last post) but said that I may not get any of them, or if I do they might just settle down given time.  I have now been taking the tablets for a week and haven’t noticed anything so far – long may that continue!  

So, immediately following the appointment with the Consultant Clinical Oncologist I phoned our local optometrist for a triage appointment. Fortunately I hadn’t done any serious damage to my eye although it was very red and bloody. That was just over a week ago and I am happy to say that with regular use of antiseptic eye drops it has now completely healed and my eye is back to normal. What a silly thing to do! 

To celebrate being cancer-free and to mark my birthday (belated, from April) we went to The Ivy the same evening for a lovely meal with Mark and Amy. Red eye and all!

Now back to the subject of this blog… the next stage for me is radiotherapy.

Until about six months ago they used to put permanent marks on the skin to make the machine setup quicker and more accurate – that would have been my first tattoo!. Now they scan the area to build up a 3D map of the body to use each time for targeting the beam. It will just be for my breast; my lymph nodes don’t need this treatment.

I went for the radiotherapy scan on Thursday 27th June. There was a lot of form filling; a detailed description of the radiotherapy treatment to come and finally a CT Scan.

The first of the fifteen radiotherapy sessions will be on Monday 8th July, then it will be every weekday for 3 weeks until 26th July. A “free” return taxi ride from home will be provided for me each day. Not free at all of course, it’s undoubtedly included in the overall treatment cost which our medical insurance company will be paying.

Each daily radiotherapy session will take about thirty minutes in all, but only fifteen minutes for the actual treatment, the rest is getting ready and setting up. Apparently my skin may become red and sore – much like sunburn – and it’s likely I will become more tired, especially towards the end of the three weeks.

I was advised not to use any cosmetic products that contain metallic ingredients, particularly aluminium. Typically these are anti-perspirants and highly pigmented eye shadows and eye-liner – I didn’t even know there was aluminium in them!  

After my last radiotherapy session I will see the Consultant Clinical Oncologist again to assess any reactions to the treatment.

So there you have it. It’s almost 4 weeks since my lumpectomy. I still have a blue boob and am a little tender but all the wounds have healed really well and I don’t seem to have any fluid build-up which is for many people quite common. I have generally been feeling pretty well… just a bit of a rash on my face and itchy forearms which is most likely to be a side effect of the Taxol, even though that treatment finished 8 weeks ago. The time seems to have passed so quickly. 

I will post again after the end of my radiotherapy treatment, so around the last weekend in July.  It seems like summer is here at last, so if you’re in the UK get out and enjoy the wonderful weather!

Thank you again for keeping in touch and for the many cards and lovely messages I have received, they are so much appreciated.

I realise that the title of this post sounds like something I might have written on a student’s academic report when I was teaching at Guildford College, but please read on!

After my lumpectomy procedure last Monday I am happy to say that I have not really been in any pain although I have had a little discomfort around my right armpit (from where the three lymph nodes were removed).

I have been carrying out the physical exercises I was given and Colin and I have been quite active with gentle local walks around RHS Wisley and the National Trust property, Hatchlands Park. I have been quite tired each day but have paced myself carefully and taken regular naps.

Yesterday we saw the Consultant Oncoplastic Breast and Skin Cancer Surgeon who gave me the result of the biopsy of the breast tissue:

“The tissue that was removed was found to be “pathologically inactive”. In other words, no remaining cancer could be found; the tumour has been completely eradicated by the chemotherapy treatment”

I was absolutely delighted and (to say the least) very relieved that there is no need for a further procedure to remove more tissue. Indeed, the Consultant doesn’t need to see me for another six months, which takes us all the way to December. Also I do not need to have another mammogram until then.

Of course the planned radiotherapy treatment will still go ahead in a few weeks’ time, daily for three weeks. Belt and braces, just to be sure.

Also, the three-weekly antibodies treatment (Perjeta and Herceptin) will continue until next February as originally planned. This is protective treatment.

After giving me the wonderful news, the Consultant then removed all the surgery dressings and he was very pleased to see that the cuts have started to heal quickly.

He told me to stand in front of a full length mirror to see how my right boob looked compared to the left one. I was amazed to see that despite the surgery they looked pretty much the same as each other (well, as much as they ever were!) apart from the right one still being a quite vivid shade of blue from the dye he used. It will probably stay that colour for up to six months which is going to be very weird!

So again, no need for any further surgery to correct “the look”.

Apparently the type of cancer I had was slightly “oestrogen positive” and there are drugs which I will take for up to ten years to prevent a reoccurrence. I will start on Letrazole, which may have some short term side effects, such as hot flushes (oh joy!) aching limbs and digestive issues. It’s most likely that these side effects will abate after a month or so but, if not, there are alternative drugs available to try (such as Tamoxifen or Arimidex) until I find one that suits me.

For many years I have had osteopenia (a bone condition that can lead to osteoporosis) and since one of the long-term side effects of the continuing drugs regime is a reduction in bone density, I went to the Imaging Department for a bone density scan to set a baseline for future monitoring.

I am also due to have my next heart scan since you may recall that the antibodies treatment can adversely affect this vital organ. It’s called a multi-gated acquisition (MUGA) scan and it creates video images of the lower chambers of the heart to check whether they are pumping blood properly. It shows any abnormalities in the size of the chambers (the ventricles) and in the movement of blood through the heart.

Hopefully the result of the MUGA scan will be normal.

So there you have it, everything’s looking much more positive and the forthcoming treatment should be pretty routine, if lengthy. We are starting to plan for the future again.

As always, I will only post here if there is anything significant to say… I might be getting better but please don’t stop your lovely messages of support!

The publicity surrounding the 75th Anniversary of the Allied landings on the beaches of Normandy at dawn on 6th June 1944, always referred to as D-Day, got me wondering what the “D” stands for.

The simple answer is that the “D” stands for “Day”. That sounds a bit daft until you realise that the day before D-Day was D-1 and the day after was D+1 so today, 3rd June, is actually D-3. The date set for Avril’s lumpectomy procedure.

D-3 for Avril and me meant a very early start, but not nearly as early as it was for the troops in France all those years ago. We set the alarm for 06:00 so that we had plenty of time to get ready for our 07:30 arrival at Mount Alvernia Hospital.

The hospital room was lovely with a magnificent view over the Surrey Hills. The staff was very welcoming and we both felt relaxed and comfortable very quickly.

The morning was quite busy for Avril with lots of forms to complete and sign; many questions about her medical history; formal consent to the procedure proposed and, most importantly, what was her menu choice for dinner tonight?

Having donned her rather fetching hospital gown, compression socks and slippers she was taken down to the Nuclear Medicine Department. First, a radioactive isotope was injected into her breast and she then had a fifteen minute scan.

Back to the room and forty-five minutes later she went downstairs again and back into the scanner for another thirty minutes. This scan detected which lymph nodes the isotope had travelled to and localised the area of the sentinel node or nodes (the first few lymph nodes into which a tumour drains) so that they could be removed during surgery later in the day. An “X” marked the spot.

She returned again to the room and a short while later she was taken back down again, this time to the Imaging Department. A local anaesthetic was given and a thin stainless steel wire was inserted into her breast to mark the area where the tumour had been. Then a second wire was inserted near her armpit to mark the area of the lymph nodes.

Back in the room once again, she was visited by the Consultant Oncoplastic Breast and Skin Cancer Surgeon who used a magic marker to draw guide lines and yet more marks. Before doing so he put on surgical gloves because “he always gets ink on his hands”!

Finally, the Consultant Anaesthetist arrived to discuss what would happen before, during and after surgery.

Both Consultants gave us confidence. Any questions Avril? None at all.

At 15:50 Avril walked along to the Operating Theatre accompanied by the Theatre Nurse. Nothing more for me to do so I decided to go home to kill some time (and write the blog so far).

Time passes…

I went back to the hospital at 19:00 as promised and was somewhat alarmed upon entering Avril’s room to find that the bed had gone!  A few minutes later she was wheeled in from the recovery room and all was well.

I won’t add a photo tonight because she is a rather strange shade of blue as a result of the dye they put in!

After reviewing the latest scans the surgeon carried out a slightly different procedure to his original plan, involving less reconstructive work.  He removed three lymph nodes and upon analysis none showed any active cancer.  The breast tissue biopsy will take 7-10 days and he is hopeful that there will be sufficient margin; if not, further surgery may be needed.

The surgeon said he was very pleased with the way things had gone and asked her if she would like to go home tonight, but she preferred to stay… probably so she could have a night’s respite from my snoring. Also she had already ordered her favourite breakfast.

I will post again soon if there is anything significant to report in the short term. Otherwise the next stage will be the result of the biopsy.

Thanks as always for your many messages, emails etc., which Avril has really appreciated.