Two years ago, I completed a long sixteen-month process of ridding my body of cancer. From the beginning, I did all I could to learn about what I was going through. I learned what each chemotherapy agent does specifically and all of the side effects. I learned about all of the possible long term side effects and nerve damage. I went as far as looking up the history of the chemotherapy drugs as well as targeted therapies. Knowledge is power and I was not about to let cancer take everything away from me.
Not all breast cancers are the same. We know the statistics, one in eight women will be diagnosed at some point in their lives. Of that 1 in 8, 20 percent of those women will have an expression of the HER2 gene, most women who are HER2 positive are also hormone receptor positive. Not me, I’m in the tiny subset of strictly HER2 positive.
Not all breast cancers are genetic either, mine certainly wasn’t. So, how did I get it? HER2 breast cancers are NOT inherited. It is what is called a somatic mutation, happening some time after I was made. In other words, my cancer came from a gene mutation that was not inherited. Not only did I not get height from my family, but I didn’t get cancer either.
I used to think breast cancer was just one disease. It’s not. It’s an umbrella term covering may different combinations and what drives them. HER2 stands for Human Epidermal growth factor Receptor 2. HER2 is a protein that helps cells grow and divide. My cancer cells had a gene mutation that made too much HER2. This causes the cells to divide and grow rapidly and creates tumors. When this happens, it is called HER2 positive cancer. HER2 positive cancers are more aggressive but there’s an arsenal of chemotherapy and targeted therapy that can be utilized.
Treatment is a long one, lasting over a year and can include surgeries, chemotherapy, targeted therapy and radiation therapy. There are different approaches based on preferences, tumor sizing and node involvement. My tumor (remember Felicia?) was smaller than anticipated but I was surprised with a positive micro node. I had a double mastectomy as the first step of my treatment plan. It is different for everyone. Mine was what’s known as adjuvant therapy. This is when chemotherapy is given to destroy any remaining cancer cells after a primary treatment for cancer. My primary treatment was a double mastectomy and has since been used as my date for when cancer had vacated my body, along with my boobs. Dammit, they took my boobs! It’s all good, I’m bionic with new ones, they’re bigger, better and spectacular! Where was I? The other course would be neoadjuvant, where chemotherapy starts the treatment to hopefully shrink the tumor and allow for more surgical options.
There are different protocols for chemotherapy. I was offered a choice of TCHP or ACTHP. The first choice would be given once every three weeks for 6 cycles. That’s eighteen weeks of Taxotere, Carboplatin, Herceptin and Perjeta. Option two was a little more complex. Adriamycin and Cytoxan every two weeks for 4 cycles followed by Taxol every week for twelve weeks with Herceptin and Perjeta given as well on the third weeks. Once either of those treatments were done, I would continue Herceptin and Perjeta for a total 18 cycles every three weeks. TCHP would be over in a year while ACTHP would take 14 months. I chose ACTHP.
Herceptin and Perjeta are NOT chemotherapy. They are NOT immunotherapy. They are considered a target therapy. They work together to block cancer cells ability to receive the signal to grow. Herceptin is a monoclonal antibody that blocks the ability of a cancer cell to receive growth signals. Perjeta works on the inside of the cell. They tag team. Monoclonal antibodies are laboratory made antibodies from a living organism that help the immune system fight cancer. Together, Herceptin and Perjeta keeps the cells from growing and kills them as well. Herceptin and Perjeta were like diet chemotherapy. It was a welcome relief. There were side effects, nothing as brutal as chemotherapy.
If you are ever thrown into this hellish cancer world, read. Get to know your cancer subtype and what drives it. Understand the chemotherapy drugs and what they do. If you’re HER2 positive, I hope this helps clarify what drives our cancer and how we fight it.
We get one shot at life and sometimes it is dark and ugly for a bit, and that’s ok. I put my life into the hands of doctors that I trusted and who clearly knew more than me. I learned as much as I could from them and followed their advice. I still do. I’m a scientist by education and profession as well as an educator. That helped me tremendously.
So, Here I am, two years out. Tinnitus, neuropathy, aches, pains and a demented sense of humor were my parting gifts, as well as a headful of salt and pepper hair (with a little teal and fuschia for now) and I am grateful. Cancer changes us. It has to. You don’t come out of cancer and treatment the same way you went in. Sometimes I think the experience never truly leaves us. The road cancer paves for us is a rough one that no one wants to travel. It is hard but it was doable. The aftermath it leaves behind is equally as hard and again is doable. We somehow muster up strength we didn’t know we possess and do all the hard things, not exactly willingly. Somehow, I do believe that my experience has changed my life, for the better. Now I’m not saying that life is always rainbows and unicorns after cancer. Some days, those unicorns take a crap on my day and it’s ok. The darkest of days are behind me. Life goes on whether we are ready or not. Somedays, when I’m feeling great, I jump into those unicorn days and just throw glitter everywhere I go because life is meant to be beautiful.
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