Fight Like a Girl - Inevitable

With my family history, getting the news that you have cancer just seemed like following tradition, there have been 13 people over 4 generations, on my mothers side of the family that have had cancer. The first time I remember witnessing cancer was when I was 12 and my maternal Grandfather was terminal with prostate cancer. He was 80 but the rapid deterioration was still shocking because he was a very tall, strong man that seemed to be shrivelling away, along with his pride and independence. It was hard to watch the loss of our patriarch, and the heartache it caused my family, but sadly I never expected him to beat it. The word cancer seemed synonymous with death, and old or unhealthy people if I'm honest. It wasn't until my uncle (mother's brother) was diagnosed with Breast Cancer, and beat it, that I took more notice. Through his diagnosis it was determined that he had a variant in the BRCA2 gene. This is hereditary and subsequently other immediate family members elected to be tested, my mother and one cousin were found to have the variant as well. At the time I elected not to be tested, I was in my early 20's and I was under the understanding the only thing 'knowing' would do would be to subject me to more frequent mammograms and worry. I decided to live my life making healthy lifestyle choices to give myself the best odds. I still did regular self exams and was aware of the increased odds of getting breast cancer and hoped that was enough. In retrospect I still think that was the right choice for me. Had I known I might have been eligible for preventative surgery, including my ovaries, I may have made other choices which would have dramatically changed my family as it is now.

Having the variant type I do in the BRCA2 gene predicts the shortening and consequent disruption of the normal function of the BRCA2 protein, and causes an estimated increased risk of multiple cancers, Breast: 69% or greater (by age 80), Contralateral Breast: 26% within 20y of 1st diagnosis, Ovarian: 17% or greater (by age 80). In males this increased risk is Breast: 7-12% (by age 80), Prostate: 19-34% (by age 80). There is also increased risk in other cancers including pancreas, oral cavity, stomach, gallbladder, bile ducts, melanoma and possibly colon cancer. My genetic counsellor shared with me that research into BRCA2 started in Iceland because with the population being more isolated it was easier to track hereditary history and since then so much has changed! Since my boys both have a 50% chance of inheriting the same variant I am really pleased with the progress, especially the increased inclusion of men in the research and hope that there will be more effective screening processes by the time they are adults.

Because of my increased risk of a new breast cancer within 20yrs, it is recommended that I have a bilateral mastectomy. I met with my surgical oncologist as well as a breast plastic surgeon over the last couple weeks. We need to be aggressive with the surgery since the cancer was 'poorly differentiated' which means it wasn't originally in a neat little package making removing it more tricky, but the surgeon is very happy because at our appointment he could no longer feel any abnormalities. I'll have an MRI to get a really clear picture though. As far as reconstruction I've opted to have implants. I'll be having radiation after surgery and because of the skin tightening that can happen, the surgeon will place tissue expanders in during the same surgery as my mastectomy. These will be filled weekly with saline to gradually stretch my skin so that the implants will fit but the actual implants won't go in until 6-12mo after, to allow for me to be best recovered from the chemo and radiation. I also have an appointment in the works to discuss having my ovaries removed next year because of my increased risk and the lack of effective screening for ovarian cancer. I'm not looking forward to early menopause but I am looking forward to not having the same worry for the rest of my life.

Today marks my second last chemo treatment. This drug has been easier emotionally but harder physically. My routine is mostly the same with the first weekend being rough but the following week feeling more normal. The bad parts are really painful though, two days after treatment I'm the Michelin man with bloating and it feels like my entire body is bruised. There isn't really an explanation for it and no treatment options, so its a great day to lay still on the couch with a few walks around the house to keep my circulation moving and help get the excess fluid out. The next days are full on bone and joint pain, I've likened it to the feeling you get after a brutal high intensity workout, where you feel muscles and joints you could normally ignore, coupled with the amped feeling you have during the workout, but sustained consistently over 2 days. I've noticed the most pain is in anywhere I've perviously injured, such as a badly sprained ankle, courtesy of high school rugby, its so much fun to relive those moments....not! The pain kept me up and made finding a comfortable position pretty much impossible so this round I've been prescribed some T3's to see if they help. I also get nailbed pain and some numbness in my fingertips which is more annoying than anything since it makes doing up buttons, or any fine dexterity things frustrating. There is also a chance I could lose my nails so fingers crossed that doesn't happen!! Overall it makes for a really sucky couple of days but for the last week I've felt great!! I have to keep perspective and honestly it helps me appreciate when I feel good, there are so many little things that I've taken for granted that I hope I won't going forward.

I'm excited that I should be feeling good for Christmas and that I will be officially done Chemo treatments this year! Of course I still have surgery in early February, followed by 5 weeks of daily radiation, and continue Herceptin every 3 weeks until early November, but I feel the worst will be done this year and we can go into the new year with renewed vigour.

I wish you all a very Merry Christmas and hope you can spend some time with those you love.