LifeAsIKnowIt – Page 2 – Life As I Know It

Welcome 2025 🍾

January 1, 2025

As New Year’s Day winds down I write to say hello to all my friends and family, near and far. 2024 was actually a pretty good year for me (unlike 2023) and I’m optimistic this year will be even better.

I had a PET scan in December and the results were “fuzzy.” Well, that is the first word my oncologist used. Let me explain.

He agreed that imaging was not very reliable for me. However, the results showed additional uptake of the contrast in a few areas where I have known cancer (mainly in my spine). On the one hand, other areas seemed quiet and unremarkable. (I want to get a t-shirt that says “I’m unremarkable” – if you know, you know.)

Dr. Andorsky said the most important thing is how I’m feeling. I feel great! Really, I am so grateful for my new hip and my fentanyl patch and other meds, and the fact that I can get up every day and work, exercise, read, paint – you name it. On the other hand, my tumor markers have been slowly rising. They tend to be accurate in terms of whether cancer is active or not.

The other thing to consider is that there are a finite number of treatments so you want to make them last as long as possible. I was prepared to argue to stay on the same treatment and I didn’t need to do that at all! He suggested we stay on Enhertu and revisit in 3 months.

In other news, the tingling in my left arm has gone away. I will attribute it to the blood clot I had under my left collarbone and that by this time it has dissolved and so has my arm tingling.

So, I stay the course which is the best possible outcome. I get an IV infusion of Enhertu every 3 weeks. The cancer center is only 5 miles from my house so I’m able to get there and back quickly. A typical appointment is 3-4 hours for labs, an office visit and then treatment.

The rest of life is going swimmingly. We had a lovely (short) visit with family in Wisconsin. Glen, Maddy and Evelyn have hit the slopes already. Evelyn has been popping home now and again. Maddy has a short break from dance so she is home a bit more as well.

Maddy and I head to Texas to see her grandparents, it will be a short visit – we are looking forward to it regardless. I’ve booked a trip to see my BFF in LA for February and our family is making plans for a few family vacations in 2025.

I hope you are able to approach 2025 with optimism, enthusiasm and peace. I hope to see many of you this year. You are always welcome here – we have plenty of room! Seriously, we’d love to show you around Colorado.

Onward!

Thankful 💖

We are in the throes of fall and the Thanksgiving holiday is less than a week away. For many people, this time of year causes more reflection. For me, it’s mostly gratitude.

I’m grateful that I am able to celebrate another holiday season with my family. I’m grateful that most days I can live my life like I don’t actually have a terminal disease. I’m grateful for friends and family that support me and I’m grateful for science and scientific researchers who are working to find more treatment options for me.

I’m grateful that my oncologist is top of the game and is always a step a head of me. I appreciate that because, as you can imagine, I’m the kind of patient that comes with questions about new drugs and clinical trials.

Speaking of which, I spent all of yesterday afternoon researching clinical trials. Clinical trials.gov is a database of every clinical trial happening in the U.S. As you can imagine there are tens of thousands. Fortunately they have a decent search feature.

Even better are two trial search sites that focus on breast cancer. The Storm Riders site allows you to search for any trial related to breast cancer (any stage). It’s a fantastic resource. If you know anyone with breast cancer I hope you will share it with them.

The other site is Metastatic Trial Talk. This one is focused on stage IV, metastatic disease. In spite of searching and reading through many, many trials, I did not find any that were particularly helpful for the next treatment line. That was a little disappointing.

Last month my oncologist shared a trial with me for my next line that basically compares two different types of IV chemo. While that is fine, I’m really hoping for something that doesn’t require me to go in to the cancer center every week for an IV infusion.

I’m still taking Enhertu and the side effects have stepped up their game lately. Actually, I don’t know if they are side effects or just bad luck with something else.

I have tingling in my left arm that comes and goes. I had a Brain MRI and MRI of my cervical spine. The brain MRI was clear (yay!) and the cervical spine showed that the openings in some of my vertebrae where nerves exit are a bit too small and pinching the nerves, potentially causing the tingling.

What is causing this in my cervical vertebrae? I met with my neurologist and they are convinced that it is not a result of cancer. My oncologist thinks the same thing. What did they say? “This kind of thing can happen when you are 50+.” I don’t buy it. I think there is something going on that is causing it, likely cancer.

I also have a blood clot under my left collar bone. That could be causing the tingling. I’m on blood thinners now to prevent any new clots from popping up.

To top things off I’ve been having episodes of vertigo. My PT did the Epley maneuver and that helped initially. However, the episodes continue.

So, where does this leave me? Good question.

I will have an infusion of Enhertu on December 4. I will have a PET scan the following week followed by a telehealth appointment with my oncologist. My CA 27-29 tumor markers have been rising, so that’s not great. At that appointment we will know if the cancer is quiet or progressing. If it’s quiet, we continue on with Enhertu. If it’s progressing, we change treatment.

In between my Enhertu infusion and scan I will need to travel for work. I don’t mind traveling for work but it’s certainly not fun. It’s harder for me now than before my diagnosis so I try to go only when I really have to.

That’s my cancerland part of life. In the rest of life, I’m still working FT. I’m almost finished with a painting project, I’ve started painting with watercolor, and Glen and I went to the theater to see A Christmas Carol. The girls are off in Vienna now, exploring and having some quality sister time.

I hope that all of you have a meaningful Thanksgiving holiday, whatever that looks like for you.

Onward!

BCAM and Lobular Conference

October 20, 2024

It’s been a busy couple of weeks. The main thing to share is that I feel great and have largely been able to do all the things I’d like to. My main medication (Enhertu) does cause significant nausea and vomiting (yes, that is the reality of MBC) but I have some medication that largely keeps it at bay.

My recovery from the hip replacement is going very well. All restrictions are lifted and I’m working with my PT to get more flexible as well as gain strength and endurance while walking.

October is Breast Cancer Action (Awareness) Month. This year hit differently for me and I can’t pinpoint it. It’s been hard. I did update the blog pages to include my favorite organizations for supporting breast cancer. You can see it here: Organizations to Support. If you are inclined to share some of your hard earned money to breast cancer research you are welcome to donate to my efforts to support METAvivor on this page.

Last month Maddy and I went to Belgium to attend the International Lobular Breast Cancer Symposium. In addition to enjoying the city of Leuven, I learned a lot about the state of research of lobular breast cancer. I have a short write up of what I learned at the end of this post.

Going back to the month of October and breast cancer – please “Think before you Pink” and know where your money is going. Awareness will not help those of us being treated for cancer. Ask questions, if they can’t tell you where the money is going it’s probably not a good investment.

I have treatment again this coming Wednesday. I’m usually at the cancer center for ~4 hours total including office visits, labs and treatment. I use the time to keep up with work but also read – or nap!

Take care of yourselves and your loved ones and enjoy fall.

Onward!

Here is the summary of my experience at the Symposium:

The ILC Symposium, held in Leuven Belgium, was attended by clinicians, researchers, and patient advocates. I attended the 3-day event as a patient advocate. There were just under 190 people in attendance. There are three main points I took away from the Symposium. Imaging for ILC is not very good and needs a lot of improvement. There are new opportunities for understanding an individual patient’s ILC/disease using circulating tumor cell technology. There are many people passionate about ILC and working to move the needle both in treatment and awareness. I found the opportunity to network with other patient advocates to be very good on Monday. We traveled to the university hospital and the time together on the bus allowed for very informal conversations. On the way back from the hospital we discussed what we saw and how the treatment there differs from the U.S. I found the lunch period another good time to network. It was rather difficult though for me personally to manage lunch because I have mobility issues and a cane and there were no tables to sit at. Because of this I ended up sitting elsewhere initially during lunch and then working to join conversations after.

I attended a breakout session devoted to “Imaging primary and metastatic ILC.” Breakout sessions ran concurrently and attendees could self-select which they wanted to join. There were approximately thirty attendees in this breakout session. The overall message was that imaging needs to be improved to be able to diagnose and monitor lobular breast cancer. It was interesting to hear from multiple people on the panel that there is also a shortage of radiologists, causing delays for patients. Patient concerns were shared with researchers and clinicians and among the top concerns were access to imaging, exposure to radiation, contrast exposure and difficulty with IV placement.

The second session I’ll summarize was focused on Tumor Microenvironment, specifically in Metastatic ILC. Here there was a presentation about circulating tumor cells (liquid biopsies) and how that may be a future way to monitor metastatic progression. There needs to be more research and clinical trials into liquid biopsies in various biofluids (beyond blood). This is an area that really needs more focus. Also discussed in this session was to promote research on misdiagnosis and delayed diagnosis in ILC as well as addressing patient-identified concerns through targeted research. I found those two discussions very interesting, and somewhat frustrating. It is clear we have a long way to go when it comes to diagnosing and treating metastatic ILC.

I’ve already had the opportunity to share what I’ve learned. I attended a metastatic breast cancer event the week after the Symposium and shared with other patient advocates what I learned. In addition, I’m the moderator for two facebook groups (one focused on lobular bc) and I shared some information already and will share more in the coming weeks. I also posted on social media during the Symposium, reaching several hundred followers. My hope is not only to educate but to prompt others to become ILC advocates in the future.

All Systems “Go”🚦

September 19, 2024

Hello friends and family! Welcome to fall (almost). The nights are getting cooler here and I’ve seen photos from others that the aspens are starting to change color in the mountains.

I write with good news. My PET scan of earlier this week shows that I’m stable. This is fantastic; it means that the cancer is not growing or spreading. The caveat is that lobular breast cancer sometimes doesn’t show up well on imaging. However, my blood tumor marker number dropped as well! The CA 27-29 gives an idea of how active the cancer is. A number of 38 or lower means the cancer is inactive. In mid-August it was 109. On September 11 it was 93! That was very welcome news!

The combination of the tumor marker dropping and my scan not showing progression means I can stay on the same treatment. I’m currently getting Enhertu every 3 weeks. I’ve got medications to deal with the side effects, overall I’m tolerating it very well.

I also spoke with my orthopedic surgeon this week. My recovery is going very well and he wished me a good time on my upcoming trip. He did mention several times how bad of shape my hip was in. I’m feeling grateful that I no longer have pain and hopefully I will be able to walk unaided soon. I still have some swelling and it’s hard getting used to walking since I’ve been using a cane for 2 years.

Tomorrow Maddy and I leave for Belgium. We are attending the International Lobular Breast Cancer Symposium! I received a travel grant from the Lobular Breast Cancer Association for which I am very grateful.

The symposium is 3 days long and the first day is focused on patient advocates. Maddy will come with me that day. The other 2 days are more research focused. We are excited to go and learn where research is headed for lobular breast cancer. My oncologist was not familiar with this conference and asked me to brief him on what I know. I’m more than happy to do that!

Not gonna lie – we are happy to go to Belgium as well. We should have one day where we can sight see. We will be in the city of Leuven which is east of Brussels. Watch for photos in the next blog post.

Life is good, right now for me life is great. I’m going to take it all in while also making sure I rest and don’t overdo it. Maddy may need to help me with that.

Onward!

My shiny new hip

September 7, 2024

I’m happy to share that my total hip replacement was a success! I had the surgery on Tuesday and was home Wednesday afternoon. My first home physical therapy session was Friday and he cleared me to walk the cul-de-sac. All the pre-habilitation has paid off!

Thank you to everyone who has sent well wishes and flowers and text messages. They are very much appreciated and each one brightens my day.

So, it turns out that my right leg was 1.5 centimeters shorter than my left leg. Over time, with the cancer eating away at my hip, the socket flattened out. The top of the femur also flattened out. It was months in the making so I didn’t necessarily notice the leg difference. It feels weird now to have both the same length – the right feels longer than the left.

He put a ceramic socket in and attached it to the cement/hardware that he put in a couple of years ago. My hip is not strong enough to have the socket attached to the hip bone, like in a normal hip replacement.

The top of the femoral head is metal (titanium I think). When he was putting it in my femur cracked (again, weak bones) and so he had to wrap some wire around it, kind of like a wine barrel. Overall he said the procedure was good and doesn’t expect any kind of complications with the healing.

Ann came out and was my caregiver for which I am extremely grateful. Maddy took the day from school to come to Denver and wait with Ann during the surgery.

The weather has been good and so I’m looking forward to walking outside. My PT comes again on Monday and I’ll be looking to walk longer. The cat is happy that I’m spending a lot of time in the recliner! On Monday I’ll get back to working, probably from my recliner!

I’ll have a check up in 2 or 3 weeks. I’m still planning to go to Belgium with Maddy for a breast cancer symposium later in September. The work must go on!

I also have a PET scan mid-September to see if the cancer is stable or growing. Keep those fingers crossed! 🤞

Onward!

Toward a New Hip

August 25, 2024

Happy end of summer everyone. It’s been a good one for me all things considered. I had some work travel and also some fun personal travel. I was in Wisconsin with Evelyn and Maddy to visit family and shortly after that we took a family vacation to Kauai, Hawaii.

The Nepali coast. You can only see this area by foot, boat or aircraft

Kauai was beautiful as you might expect, it is called the Garden Island! We had a grand time. I was not able to do all the things they did with hiking and surfing. I did mange to read two books and get through a full season of a Netflix series. Those are things that an are tough to do in daily life.

My cancer is still here of course, just hanging out. I had a PET scan in July and it was a bit “brighter” than the previous scan. What does that mean? Could mean that the bones were healing (growth) or it could mean that the cancer is growing. Confusing? Absolutely!

My tumor marker numbers (taken via blood work) have been pretty reliable. The higher the number the more active the cancer. Over summer, they had been creeping upward a bit. But….the most recent blood work saw them drop back down.

So, my oncologist decided we would repeat the scan in 2 months instead of 3. I am scheduled for a PET scan mid-September. After that we will determine if we should switch medication (progression) or stay the course (stable). We talked about what is next….a different kind of chemo. There is the possibility of getting into a clinical trial which I will try to do. More on that later when we get to that point. It is good to have options. As I’ve mentioned many times before, there are limited lines of treatment. Once I run through them all, then that is it. So, we want as many options as possible. Adding in clinical trials is a way to increase the number of treatment lines AND help advance scientific research.

In the meantime, I have this fracture starting in my acetabulum (extending from the socket of my hip) extending upward into my hip. The femur connects with the fracture when I step, causing a fair amount of pain and discomfort. I continue to walk with a cane to relieve the pressure. I actually wore out my first cane and had to buy another one!

Tuesday, September 3 (the day after Labor Day) I will have a full hip replacement. I’ll stay in the hospital for 2 nights and then recover at home. Glen has some international work travel so Ann has kindly agreed to come out and help me. I’ve been told by numerous people that recovery is not difficult. I’ve been working with my physical therapist on some pre-habilitation to make sure I’m in the best possible place. In addition to the PT exercises I continue to walk daily. I’m up to 8000 steps a day which I think is pretty good.

I did learn what it means to have a full hip replacement. If you are squeamish you might want to stop reading here!

They cut off the top of your femur and replace it with an artificial top. It could be metal or ceramic or plastic. Your bone is hollow and so they basically hammer the artificial femur top into your bone so it stays. They also put something in where the socket is. I’m not positive how that will be attached but likely with special cement. Apparently the material of the femur and the new socket are not the same material, it is rare for a surgeon to use a metal-on-metal replacement.

This image shows the various parts and how they fit together.

This image is pretty self-explanatory. The material for the socket and femur head will be TBD. My surgeon said he will be doing a posterior approach which might take a tad bit longer to recover from.

I am cautiously optimistic that this will go smoothly and I will be up and about in no time. My surgeon has green-lighted me to take an international trip 3 weeks after my surgery so he thinks the same thing apparently!

A few fun photos from summer. Missing here is Maddy’s first day of senior year, visit to Wisconsin, and many walks and lunches with friends.

Onward!

Shades of Gray 🩶

July 26, 2024

Like many things in life, medicine is not black and white. I’m reminded of this every time I have a test or conversation with my medical team.

Earlier in July I had a PET scan. This is one of the primary tools my oncologist uses to determine the status of the cancer. According to the PET, there was increased update / brightness on the image, potentially indicating progression or the cancer being active. However, my blood work (tumor markers) show things as steady, no progression. My tumor markers have been pretty accurate in general.

So, we have conflicting data, which makes decision making challenging.

Given that there are a finite number of treatments, the goal is to stay on each treatment as long as possible. Once you move off a treatment you can’t go back to it. The reason for this is that the cancer has mutated and figured out a way around the treatment so it wouldn’t be effective to go back and take the same medication after you have progression on it.

So, I’m in a situation where one piece of data says potential progression and another piece of data says no progression. What to do?

I will stay on my current treatment (Enhertu) but have another PET scan in 2 months, instead of the typical 3 months. This way we are not waiting too long if there is progression and if there is no progression then we just continue on.

This situation is stressful in spite of my trying not to be too stressed out about things. The uncertainty is hard to deal with.

Working in my favor are 2 upcoming months of lots of exciting things including travel. The best – and only – thing I can do is focus on the here and now and enjoy each day to the fullest. I hope you do the same.

Early morning sun on one of my neighborhood walks.

Enjoying Summer ☀️

Hello friends and family!

First, a very big thank you to everyone who wished me a happy birthday. It was an incredible month topped off by an open house for the ages. I felt the love. Thank you, thank you!

Second, I don’t have much to report. Yay! My infusions are every three weeks. I got my tumor markers back and they dropped down a little bit so basically I interpret that as holding steady.

I have a PET scan this week. My oncologist uses the scans to look for progression. I’m feeling pretty good about it because I both feel good and I think my tumor markers are reliable. If they had started to rise I’d be more concerned.

I’m mostly just trying to enjoy summer, my favorite season. I had an epic weekend with family here. I wish they could come more often and stay longer.

Evelyn, Glen, Cara, Rob, Ann, Lynn, Paul, Donna, Maddy, and Nancy. A huge thanks to Nancy for the informative t-shirts with facts about MBC. Glen even got flowers in the MBC colors!

I’m getting out for walks in the neighborhood, aided by audio books. I am working on my stamina and also working with my physical therapist on “pre-habilitation” to prepare for my hip replacement on September 3.

We just returned from a holiday weekend in Steamboat Springs – one of our favorite mountain towns.

The base of the ski hill is where we like to stay in summer too!

Whatever you are doing this summer, make the best of it!

Onward!

June 2024 update

June 17, 2024

Here we are in full swing of summer. Flowers are blooming, the sun is shining and I’m enjoying all of it.

I had infusion #7 of Enhertu last week. It was an uneventful appointment which is always good. I received a bunch of pre-medication (anti-nausea meds and steroids), a big old bag of fluids (for extra hydration) and Zometa (a bone strengthener). The Enhertu itself only takes about 30 minutes but with everything else it comes out to around 2.5 hours.

I typically feel quite good the day after an infusion. The fatigue starts to hit 3-4 days later. I try to take it easy those first few days because it’s easy to overdo it.

My activity is mostly waking outside now on the cul-de-sacs of our neighborhood. They provide good stability and I can lengthen or shorten my walk pretty easily. At least easier than if I was doing a big loop around our neighborhood. I’m walking long enough now that I can easily listen to some audiobooks which is nice. I’ve missed that. I’m currently listening to How to Solve Your Own Murder by Kristen Perrin.

Anyway, I’m doing fine overall.

I did meet with the orthopedic oncologist last week as well. He validated my pain pointing out on my CT scan that a part of my hip has cracked and broken off and there is the fracture extending through my acetabulum. My femur hits that area each time I put pressure on my leg.

My right hip is on the left of the image. You can see the femur head is not round like it should be. This is from hitting the actual hip – which it should not be doing. You can also see a triangle in the lower center of the left side. That is a part of the hip that has cracked off.

The very good news is we have a solution! In early September I will get a hip replacement. I am very much looking forward to this. The orthopedic surgeon is very confident this will solve the problem. I’m looking forward to walking without pain. My family is also looking forward to my being more mobile. My situation impacts them as well so we will all be happy once I have a shiny new hip.

Onward!

🎂 Birthday Month 🎉

June 1, 2024

It’s my favorite month of the year – mostly because it’s warm and sunny and summer; also because my birthday is the 26th. This year I’ve decided to celebrate all month, I deserve it! (Heck, we all deserve it!) I will be 55 this year. Next month is my 5 year anniversary of living with Metastatic Breast Cancer (MBC). 5 of 55 years with cancer. That doesn’t count the 6 months I dealt with it back in 2009.

Anyway, yay! The cancer is stable.

I have had 6 infusions of Enhertu and it seems to be keeping the cancer quiet. I’ve noticed that my hair is falling out a bit more, it’s quite thin. I’m also taking a fair number of medications to keep other side effects at bay.

I discovered that the steroid I get as a pre-treatment actually helps with the pain in my hip. So, for the time being I’m taking additional steroids daily to make moving about easier. It’s helped tremendously. My physical therapist says I’ve made great progress over the past month. Here’s to hoping that continues!

I have an appointment mid-month with my orthopedic oncologist to see if he can help with eliminating the hip pain. More on that later.

My CA 27-29 tumor marker is a way we monitor for progression. I get tested via blood that gets sent to the Mayo Clinic in Minnesota, every three weeks when I have my treatment. My numbers are still hovering around 100 which is not great but I’ll take it. If it is below 38 then the cancer is quiet and not active. I’m still doing wonderful overall though so I’m not too disappointed.

I’m still working full time with a very flexible schedule. My remote work makes for lonely days but a few wonderful friends make time to come by for tea or lunch which makes a big difference. Later in the summer we’ll do some traveling as a family. This month will be fun at home.