New Pre-Surgery Treatment Combination More Effective For Women With Triple-Negative Breast Cancer

Adding the chemotherapy drug carboplatin and/or the antibody therapy bevacizumab to standard presurgery chemotherapy increased the number of women with triple-negative breast cancer who had no residual cancer detected at surgery, according to results of a randomized, phase II clinical trial presented at the 2013 San Antonio Breast Cancer Symposium.

An increasing number of patients with triple-negative breast cancer are receiving chemotherapy before surgery, a treatment approach called neoadjuvant chemotherapy. In about one-third of these patients, no identifiable cancer cells are found in breast tissue and lymph nodes removed at surgery performed after the neoadjuvant chemotherapy. These patients are said to have had a pathologic complete response and have a much lower risk of cancer recurrence compared with patients whose cancers do not respond this well to the neoadjuvant chemotherapy.

“Our study was designed to find out if adding either carboplatin or bevacizumab to standard preoperative chemotherapy would increase the percentage of patients in whom cancer is eliminated before surgery,” said William M. Sikov, M.D., F.A.C.P., associate professor of medicine at the Warren Alpert Medical School of Brown University in Providence, R.I. “We are excited to report that adding either therapy significantly increased the percentage of patients in whom cancer was eliminated from the breast, and that adding both was even more effective.

“While our results show increases in pathologic complete response rates with both carboplatin and bevacizumab, we do not yet know how large an impact, if any, these differences will have on cancer recurrences or deaths. Although the study is not large enough to detect significant differences in these endpoints, we plan to follow patients for 10 years after their surgery to see if patient outcomes suggest long-term benefits from the investigational treatments.”  Click here ( to read the rest.

The above was taken from an e-mailed article sent through the Pink Ribbon Cowgirls.

The Odd Couple

So, the pain is still fairly prominent.  Since I’ve gone back to work, I’ve resorted to popping Tylenol and Aleve.  The prescribed pain medication makes me way too sleepy.  It’s not just the pain.  It’s the totally bizarre feeling of having to get used to a hallowed, morphed chest when you’ve been used to having boobs.  Not just boobs, but D cups.  The prosthesis doesn’t really mask the oddity of this feeling either.  And it seems just as bizarre to have pain and numbness at the same time.  Since my surgeon left the breast skin envelope, it’s all adhering to the chest wall, only there’s so much that it’s bunching up in places.  She did state this would happen.  It’s most annoying at the sides where my arms brush against it.  She stated that if needed, she could go back and take off more of the breast skin that was left, but leaving it this way for now will likely give me better recon results, so as long as I keep in mind this isn’t permanent, but very temporary, I’m okay.

The good news is I found my wallet.  It was on my kitchen table in a bag of firestarters. :-)

Off to Slow Start, but Back to the Grind

Well, I’m still very much in the process of healing.  Today was my first day back at work and now it’s the end of the day and, man, I am so, so sore.  OUCH!  All I want to do is go home, take a hot shower, maybe build a nice fire and climb into the blankets sprawled across my living room sofa.

What can I say about being back at work–?  Apparently, I think it’s been pretty quiet.  Most everyone has been gone or traveling on business.  Everyone seems to be happy to have me back, although I should have tried for the rest of this week off and came back on Monday.  Oh well! :-(

I’ve been hesitant on starting a rigorous meditation/cleanse/yoga/fitness program just yet, at least not until I’m more healed from surgery.  However, today at lunch I decided to get my healthy eating plan started so I ventured to Trader Joe’s.  I spent my entire lunch hour filling my basket with yummy, organic produce, fresh fish and lean chicken.  I was so stoked on stocking my fridge tonight with all this fresh produce.  But it wasn’t meant to be.  As soon as I got to the register, I realized my wallet was missing from my purse.  No cash, lone credit card or check book in sight.  I was completely without monetary means to buy all the yumminess I’d just spent an hour loading into my cart.  Crap!  I hate it when that happens.  What a letdown!  I just hope my wallet is, like, sitting on my kitchen table or something.  Yikes!

Speaking of fitness programs though, my oncologist’s office has referred me to physical therapy to get more rehabilitated before I begin a more rigorous fitness program.  I’m sure that’s best.  After the year I’ve had, I’d like to ease into the best healthy living and fitness for me.  I think that’s the best approach if I want this all to become full-on changes for the rest of life.  Going at something full-force sometimes leads to failed results and I’m not in a place to be pressuring myself.  I need to take it smooth and easy, at least to start.  I realize I need to start setting small goals, but I’m not about to pressure myself with 3-mth, 6-mth, 1 year deadlines, at least not just yet.  I realize 2014 is all about transition for me.  That’s what I need to pray most about.  Let there be transformation, God!!!!  Tons of transformation!!!!  So much so, that no one will recognize me.  So much so, that I won’t even recognize me!!!!

An End to 2013 and My Crap Year of Cancer!

Yay!  As the year of 2013 comes into its final hours, I sit in my cozy living room next to a roaring fire and drink pink champagne and enjoy the chocolate truffles my friend, Charlotte, made.  A very nice and relaxing celebration to the end of a bad year.  One full of a cancer diagnosis, TONS of doctor appts, a lumpectomy, five grueling months of chemo, a very serious blood clot, three months of blood thinners, and the cherry on top, a double mastectomy.

Yesterday I had a second follow up with my breast surgeon.  I stated I was still having some pain.  She stated it was most likely due to the drains.  She removed the drain tube from my right side but left the drain tube on my left side because it’s still draining a good amount of fluid.  I go back in one week to hopefully have the other taken out.  No infection or anything though.  Good news!

I also had an afternoon appt with my oncologist yesterday.  She was practically doing the jig in the exam room, saying, “yea, aren’t you happy, no more cancer!”  She said she was so happy for me and asked what my plans were now.  I told her I now have to get ready for reconstruction.  She said she was going to refer me to the Star program for rehabilitation to get me on a good fitness program.  She stated she wants to see me more than normal to track my progress in order to get me to my goal.

I was invited to a couple of parties tonight, and down to the lake in my little, lake community to watch fireworks, and even though I have been spending so much time snuggled on my sofa recuperating, I’m quite enjoying this quiet, cozy, pink champagne and chocolate filled end to a dismal year.  I just finished watching Willy Wonka and the Chocolate Factory.  What a classic!

I look forward to 2014 with an excited hope that I don’t think I’ve had previously.  Today was a beautiful, winter day in the Texas hill country.  I stepped outside feeling refreshed.  The day was sunny and crisp and I felt my prospective on everything around me has shifted slightly.  Maybe even much more than slightly.  I pray this next year brings amazing joy, incredible adventure, vibrant health, positive changes and happy gifts of love and life beyond my wildest dreams!  I hope for simplicity, abundant happiness, romance and incredible wealth in all aspects of my life, and for those I love in my life!

One final thought, remember to eat your black-eyed peas tomorrow! ;-)

The dog-deer days of recovery

This is my first post in weeks.  I’ve mainly been couching it recovering from surgery.  My close friend, Beth, came and stayed with me a few days as well as my friend, Kim.  They definitely kept me in good spirits and took wonderful care of me!  I also spent several days with my brother and sister-in-law, where my sister-in-law took amazing care of me as well.  Best part was being able to spend quality time with my 3 year old nephew, Luke.

As for my reference to “dog-deer days,” there is a doe in my neighborhood that was raised by a family here from a baby deer.  Her name is Daisy and she likes to come play with my dogs.  I live in the country and have stock fencing around my backyard.  They run up and down the fence line together and you can tell she playing with them because she’ll buck here and there and thrash her head around and jump and bat the fence with her little hoof.  Definitely play-mode.  My girlfriends, total city-dwellers, got such a kick out of this.  At one point she scratched at her ear with her hind hoof, like a dog would do, so my friend, Beth, started calling her the “dog-deer.” 

daisy dog-deer

Anyway, though I have mostly been sucking down pain pills and sleeping, I’ve definitely had some cabin fever.  Luckily, a friend a couple streets over came and picked me up on Christmas Eve for a nice dinner party at her house.  I indulged in a glass or two of wine, which may not have been the best idea with my pain killers, but then again I wasn’t feeling the pain, which was a good thing.  I stayed for a couple hours and then she brought me home.  Even Christmas morning I didn’t feel I needed a pain pill but the pain definitely caught up to me as the day wore on.  I had Christmas with my family, which was nice and relaxing, but by the afternoon I was feeling the pain and needed to go home and lay down.  Spent most of the day (as with most all days of recovery) in my pjs.

I still have the drains in and have no idea when they’ll come out.  Even though no signs of cancer, my surgeon ended up taking 11 lymph nodes from my left side.  She stated she had to go up further than expected and they were part of the breast tissue.  That side has been producing much more fluid than the other side.  I also forgot about taking the antibiotics after returning home from staying with my brother and sister-in-law, which I realized Christmas night.  My right drain started having a bungent smell, which really started freaking me out.  I found the bottle of antibiotics and started taking it again.  Hopefully, everything is still okay (i.e., no infection).

I had my first follow up with my surgeon one week after surgery.  She stated everything looked good even though I wouldn’t like what I saw, but that it would be fixed upon reconstruction.

I can’t explain the freeing experience I’ve had in going through with the mastectomies.  The monkey on my shoulders has left the building.  I felt a renewed sense of self after surgery.  This was my biggest hurdle.  A massive brick wall that I didn’t jump over, but busted through.  Now I just have to stay on the path and keep going.

Another battle won

pinkbraWell, I’ve survived M-day!  I honestly thought I’d be an emotional wreck, completely devastated, but a funny thing happened when I woke up from surgery.  I was crackin’ jokes and in good spirits.  I have cried a bit, as I think there’s no way around that.  It is a loss and you have to mourn.

I wore my hot pink, push up bra to my mastectomy surgery, which seemed most appropriate.  Other than that I strived for comfort.

I’m still really groggy, pain meds and all.  I told myself I’m never gonna look at my chest again, but then I catch myself sneakin’ a peek.  I can do this!

I can tell you one thing, if you’re ever in need of mastectomies and in the Austin area, St. David’s HealthCare off Red River and 30th is the place to go.  Best hospital I’ve been to and I’ve been to a few.  The nurses are all excellent, the food is restaurant worthy–really good and you kinda feel like you’re at a resort.  My favorite thing is this awesome water bottle/cup they give you.  I’ll be using this sucker like crazy!  Love it!!!  Ah, the things we can be amused by.


December 5th

I drove to San Antonio yesterday and met with the plastic surgeon, Dr. Minas Chrysopoulo at PRMA Plastic Surgery, regarding my reconstruction options with respect to the DIEP procedure under a delayed recon scenario.  I’m still not fully decided on the method I want but I will have time to think on that later.  The consultation went far better than I anticipated.  I was dreading it at first since things weren’t improved for me from my last visit with him, but from the start he was very understanding and compassionate and added I’ve been through quite a lot the past few years and I needed to give myself a break.  He felt I was making the right decision, stating that I was being very logical about it all and that if I were his wife, he’d tell me to do the same thing.

He first stated that reconstructively, particularly with flap procedures, they have no problem working with radiated skin.  However, the benefits of going ahead with the mastectomies and delaying reconstruction, even with more scarring, far outweigh having radiation, simply due to potential, long-term health effects that can be caused by radiation.  He was also very pleased to hear my breast surgeon is breast conservative and reconstructive-friendly and the method she plans to use sounds like a very good one.  The one downside being the fact that I’d have to mentally prepare myself to live in this state for a period of time, which will take some considerable mental and emotional strength, but with a continued understanding that it is just a means to an end–That it all can and will be fixed.

We mapped out options such as utilizing expanders, but in the end, after various scenarios were discussed, we both felt given my understandable fear of surgery and current potential for complications, having the mastectomies alone and making time before reconstruction was likely the best way to go.  He also stated he didn’t have any problem with having my complex hernia repair done at the same time as the revision surgery (2nd stage of recon).  That made me feel better too, as that means one less surgery and he can make everything cosmetically more aesthetically pleasing.  All in all, the consultation went really well and made me feel better about moving forward with my chosen course.

I then made it back to Austin for my pre-surgical testing.  Later I attended my firm’s holiday dinner.  It was at Eddie V’s.  Everything was delish and we all had a good time.

The Countdown to M-day has begun

Just hitting the week mark before M-day – Dec. 10th.  I overscheduled myself with activities this week and find that being busy has occupied my mind enough to settle my fears of the unknown just a bit; however, I have had to deal with the reality of the situation here and there.

Wednesday, the day before Thanksgiving, I had to have a bilateral, diagnostic mammogram and wait for the results.  They stated everything looked fine and that they couldn’t see anything out of the ordinary for a lumpectomy.  This day was also my father’s birthday, and I had completely forgotten.  Totally unlike me but my father said he completely understood, noting that I am going through an awful lot right now. 

Anyway, while there I was sitting in the lounge in the white terry cloth robe they give you to wear waiting for my turn.  I was seated next to two women in their 50s/early 60s.  They stated they gather a group of 3-4 of them and go to have their mammograms done every year.  I commended them on their effort to go together simply for the moral support.  One woman stated to me they had to practically drag her as she saw no reason to have it done since it wasn’t in her family.   

I read an article just a couple of weeks ago that 85% of all breast cancers are completely random, meaning no family history.  We hear it all the time from women, “[I]t doesn’t run in my family, so why did I get it?”  This is one point I think all women, especially younger women, should be educated on.  I realize I’m very special in being in the tiny minority of the already seriously genetically flawed with respect to breast cancer, but too many women believe if it isn’t in their family they have nothing to worry about.  Our genes, cells and environments are changing all the time.  I told the woman she shouldn’t sit so easy thinking it couldn’t strike her as it can hit anyone at random.  Cancer doesn’t discriminate. 

Another reality head-smack happened yesterday when I decided on my lunch hour to venture to the lingerie shop my doctor’s office suggested to look at post-mastectomy garments and prosthetics.  The whole experience felt uneasy and left me a little unhinged.  I cried all the way back to my office and told my friend, Kim, over the phone last night that everything in me just wanted to call the whole thing (i.e, surgery) off.  She said, “what are you going to do then, bury your head under a pillow, and then what?”  I know I can’t do that and that I just need to get past the fear and mental blocks that are swirling around in my head.  I know I need to move forward with getting this done, but I can’t deny the enormity of the situation nor pretend I’m not having a tough time dealing emotionally with it all.  I can say that the part of me saying, “I got this, I’ll be okay,” is getting a little louder.

The Breast Dilemma

So, I’ve pretty much accepted surgery as the logical, smart way to go here; and I’ve resigned myself to the fact it’s going to happen.  In fact, I’ve already scheduled for it.  December 10th.  So close!  I’m already starting to have anxiety about it.  Maybe my friend, Beth, is right, “just rip that bandaid off quick.”

It’s weird, even though I know of my mutation and triple-negative cancer, my brain wants to find any other possible option.  Even with how long I’ve known of this potential fate, it’s so hard to accept, even now, with everything I’ve been through and everything I know about it.  It’s so crazy how much the brain resists, even though I know it’s the right decision and best chance I have.  I guess it is the obvious reaction of the brain, I mean, we are talking about lopping off parts of the body here.  I guess I should still count myself lucky as many women don’t have the choice and/or have to endure both radiation and mastectomies.  Hell, I may still be looking at same depending on how my pathology comes back after mastectomies.  Some woman request radiation even after mastectomies and chemo, and against doctors recommendations because they want to choose absolutely every weapon in the arsenal.  Personally, not sure if this is helpful or overkill if not recommended as radiation can have it’s own significant short and long term effects.

I’ve met with my breast surgeon and feel comfortable with what she’s said, although I still need to consult with the plastic surgeon as well.  I also met with the RadOnc and felt good about the consultation and my brain does see it as the easier route in the short term, but I also feel radiation is likely a treatment to avoid if at all possible.

Fortunately, I was able to get an appt with the plastic surgeon I’ve chosen to do my reconstruction.  I’ve met with him previously, but feel it’s probably best to do another consult to make sure everyone is on the same page pre-mastectomies.  It’s really close to the actual surgery date though, so I hope everything falls in line as it should.

I decided, aside from divine, spiritual guidence and deep contemplation, to put together a little pros and cons list to help me with my decision making.  Thought I’d share here:

BiMx w/DELAYED Recon










Most significant risk reduction for cancer recurrence, 2nd cancer or contralateral cancer of the breast
Loss of breasts for a period of time until recon
Allows me to keep my natural breasts for a longer period of time while I work to become better candidate for immediate recon
Risk of recurrence, 2nd cancer or contralateral cancer still significant
Closer to new boobs (1st surgical step done), which means LESS complications, risks, surgical and recovery times when recon happens
2-3 week recovery time
Approx. treatment time –
5-20 mins max each day, therefore can do before work or on lunch hour
5-6 weeks of every day targeted radiation
Will force me to recognize I am NOT my breasts
Will have to wear prosthetics until recon
No immediate surgery or time off from work
Short and long term effects
Will force me to become fit and healthy
Possible, significant, psychological damage–
On the plus side, may force me to learn to detach from my earthly, egoic mind and deepen my spirituality
Will have to continually moisturize radiated area every day for life
Will force me to re-evaluate my life in its entirety
No guarantee BC will not recur
Limits reconstruction options (size, type of recon, etc.)
More time to get healthy without full worry of immediate cancer recurrence or unrealistic deadlines to contend with
More scarring than with immediate recon, but would have scars regardless
Recon may need to be delayed even longer in order for radiated skin to heal
More time to evaluate best recon options/surgeons – Dr. Chrysopoulo still top of list!
May limit future treatment options
Less surgery at one time, less to be fearful of–Baby steps!
Why add an unnecessary treatment if you plan on doing bimx/recon anyway