Living with breast cancer - year three

For those new to my blog, I was diagnosed with Stage 2 Grade 3 Invasive Pleomorphic Lobular Carcinoma of the Breast that is HER2- and hormone receptor-positive in August 2019.

Different types of breast cancer

Stage 2 means the tumour is larger than 20 mm and has not spread to the axillary lymph nodes.

Grade 3 means faster-growing cancer that is more likely to spread.

Invasive applies to cancer that has spread from where it began in the breast to surrounding normal tissue.

Pleomorphic refers to how the cells appear under the microscope - multiple shapes and sizes. The cells display abnormal cores and irregular cellular division.

The term lobular speaks about where the tumour originated - in the breast's milk-producing glands or lobules. 

HER2 is the acronym for the protein called human epidermal growth factor receptor 2. The HER2 receptor has a vital role in normal cell growth and division. In HER2-positive cancers, the cells have extra copies of the gene that makes the HER2 protein which causes out-of-control multiplication of cancer cells.

When cancer is hormone receptor-positive, the body's naturally-produced hormones feed the cancer cells and make them grow faster. 

The first two years

In the first year after the diagnosis, I had seven or eight surgeries (I stopped counting) and underwent chemotherapy. The surgeries caused me pain, and I lost the functioning of my arms. The chemotherapy resulted in extreme fatigue, brain fog, water retention, and increased appetite (leading to weight gain). I took a sabbatical, not realising it would last two years.

I started rehabilitation exercises for my chest and arm muscles during year two and commenced treatment to block the HER2 receptors. I also began treatment to stop my body from producing estrogen. Oncologists call these treatments adjuvant therapy. 

Going into medically induced menopause overnight was an unpleasant experience. I suffered severe hot flashes, night sweats, brain fog, and unmanageable depression. Furthermore, I developed hypertension (high blood pressure) and hyperlipidemia (high blood cholesterol levels).

The third year

Although the many blood tests, x-rays, and ultrasounds every three months for the first three years now indicate no evidence of disease, I must continue adjuvant therapy for breast cancer for the next seven years. Unfortunately, I developed osteoporosis, one of the side effects of hormone-blocking treatment. 

I gradually started working again, settled into nutritious eating habits and paid attention to my mental health, but I've neglected physical wellness.

The stresses and anxiety also put pressure on my marriage. Me and my husband's relationship dynamics have changed gradually since the diagnosis. It is common for couples who have experienced trauma - in our case dealing with cancer and COVID-19 lockdown simultaneously - to encounter strain in their relationship. 

Acceptance and hope

It took me three years to reach the seventh and final stage of grief - acceptance and hope. I have accepted the new way of life and have a sense of possibility about the future. 

After making it through the first three years, the next goal is to reach the five-year mark without recurrence. During the next two years, I will go for six-monthly check-ups, continue adjuvant therapy, and receive treatment to minimise the risk of fractures brought about by osteoporosis. 

I plan to establish an exercise routine focused on strength training to preserve skeletal muscle and work on less target-driven projects (i.e., less execution and more strategy). 

I don't expect a future filled with sunshine and rainbows because I am, after all, living with breast cancer.