Today I had my first MUGA, or multigated acquisition, scan. This is also know has a nuclear heart scan. Yes, that’s right, nuclear.
I do believe this one took the cake. The nuclear cake, that is. Not only did the nuclear medical technologist draw my blood and mix it with a radioactive tracer, she then pushed my hot blood back into my body. I positioned myself under something that looked liked an inside-out Tie Fighter; this was apparently a gamma -ray-shooting camera. The gamma rays picked up the radioactive tracers as they rocketed through my body. This all somehow let the radiologist know that my heart can handle chemo.
I am now supposed to drink a lot of water and urinate frequently to rid myself of any remaining radionuclides. As with the PET scan, holding babies is out of the question. Again, hide your children.
(Do you think Professor X would go for the mutant name “MUGA”?)
CLICK HERE for more information on MUGA sans.
Good news and confusing news from the PET scan.
Good news: I do not show signs of cancer anywhere other than my left breast.
More good news: I’m still convinced that I have super powers.
Confusing news: According to the PET scan, I do show signs of cancer near or on lymph nodes close to the tumor. I asked if this was the biopsied area that came up benign, and Dr. Kantor said maybe. Apparently the PET scan shows areas and not specific sites like the MRI. Apparently the biopsy results could be false. Apparently the PET scan results could be off. Apparently I no longer need biopsies, and I should decide when I’d like to start treatment. Apparently there was a reason for my last lymph node biopsy that I should apparently understand, but I don’t.
Obviously, I am confused.
I am quickly learning that this whole breast cancer business contains many maybes. Those of you who know me well know that I do now do well with maybes.
Any advice? I know that I should have been more direct with Dr. Kantor when he told me this news, but I didn’t realize my confusion until after our conversation. I plan to ask some specific questions the next time we speak, but I don’t really know what to ask.
The one thing I do know is that this is an appropriate time for another sweet Power Ranger picture:
Yesterday I had my first MRI to determine if I will need more biopsies and to confirm that my cancer has not spread to other areas. I wasn’t really concerned about this appointment going in, and I was surprised by how emotional it was for me. As the technician stuck me in four different places for an IV line, I realized that this was the first of many unfamiliar and uncomfortable procedures. That realization took me by surprise while I was there, and there were many tears.
As I lay face-down on an uncomfortable table, the nurse pulled my breasts through two large holes. She then held them as she clamped them into place. Looking back, it was actually quite humorous. In fact, there is a fantastic picture of this process in the Breast Book:
I realized at that moment that my body won’t really be my own for awhile. It was also incredibly loud and bizarre sounding; I imagined I was in the middle of some sort of science fiction construction site. The smooth tunes of Kool 105, Denver’s Classic Hits Radio, certainly helped; I don’t think the song Tainted Love will ever sound same!
I will know the results of my MRI Monday, and I will go over them in more detail with my surgeon and the oncologists that I meet on Tuesday.
Thank you all again for your interest and support!
Thursday I met with a genetics counselor to discover if my cancer is hereditary or spontaneous. This will help determine what type of surgery I will want after treatment. My genetics counselor went over the basics of cancer genetics for over an hour. And then, I swished with Scope and spit into a cup. Silly me for dreading needles all day!
Essentially, we all have BRCA1 and BRCA2 genes. A pair of each, to be exact. These genes are tumor suppressors, so when they are functioning normally, they control abnormal cell growth. If there is a mutation in one or more of these genes, then a person is more likely to grow tumors and, therefore, more likely to have cancer.
BRCA1 and BRCA2 are both significantly tied to breast and ovarian cancers. If I have a mutation, then I will have a much higher chance of getting cancer again. Given my family history with cancer, this is quite likely.
To find mutations, they start by targeting certain parts of each gene that commonly have mutations. Three such mutations are frequent among the Ashkenazi Jewish population, which is a population out of Eastern Europe, particularly Poland. It’s likely I have this mutation given my heritage. I also discovered that young women with triple-negative cancers are more likely to have one or more of the Ashkenazi Jewish gene mutations.
For a more extensive yet very comprehensive look at cancer genetics, CLICK HERE for a great resource.
My prognostic panel that analyzes the cancer’s responsiveness to specific hormones came back “triple negative”. I need to look into this more, so please comment or post information if you know or find anything about this.
From what I understand so far, there are three hormones to which the cancer might respond. If it is responsive to one or more of these hormones, there might be treatment options other than chemotherapy. If a prognostic marker report comes back “triple negative”, then chemo is the only way to treat it. Although, researchers are looking into other ways to treat this type of cancer, so please post anything that you find, particularly treatment options and studies.
Only about 10% of women with breast cancer have this type. Unfortunately, it’s more aggressive and more likely to spread; however, it’s more likely to respond to chemo than some of the other forms. I think. . .???
Below’s what I’ve found so far:
BreastCancer.org on Triple Negative Breast Cancer
National Breast Cancer Foundation on Triple Negative Breast Cancer
John Hopkins Medical Center Info
I have not yet seen my pathology report in person, but this is what I was told over the phone. I will update this if anything changes.
Diagnosis: Invasive Ductal Carcinoma
Size: 3.8 cm
They are still waiting on hormone response and lymph node risk.
CLICK HERE for a good resource for reading and understanding pathology reports.
My next step is to meet with some surgeons to receive, analyze, and choose treatment options. I meet with Dr. Elizabeth Brew at the Red Rocks Medical Center on Monday.
Dr. Juhi Asad at Red Rocks also looks like a good choice, so I will see if I can also get in with her.
I am probably going to meet with Dr. Jodi Widner at the Littleton Multidisciplinary Breast Cancer Clinic on Tuesday.
I have to miss work for both appointments, so I’m trying to decide if Dr. Widner’s worth the visit, or if I want to try to find another who can meet after work. What do you think?
I am also going to look into University of Colorado’s Young Women’s Breast Cancer Program.
Any other suggestions?? I want to act as fast as I can, but I also want to be careful about choosing the right team of doctors. I’d like to see as many as I can this week so that I can hopefully start my treatment plan by next week.
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The boob is now home to invasive ductal carcinoma, which is the most common type of breast cancer.
Read more HERE if you would like to know more about it.
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