Not What I Planned

My plans came to a halt today. Jarring words, spoken quietly, left me stunned.

This is stage 4 metastatic triple negative breast cancer. Rogue cells have moved into the pleural fluid around my lungs. No curative treatment exists. There is only palliative care (life extending, symptom control). An optimistic prognosis is for one, maybe two more years.

The treatment plan, if Medicare covers it, is Trodelvy, which is a newer targeted immunotherapy for triple negative breast cancer. Intravenous infusions lasting 5-6 hours are on a 21-day schedule. Here’s how the cycle plays out in October: infusion on October 2 and 9. Rolvedon injection (to help produce white blood cells) on October 10. Take a week off and then start the cycle again: doctor appointment and labs on October 22, infusion on October 23 and 30, Rolvedon injection on October 31.

How long will the treatment last? For the rest of my life.

Multiple nasty side effects are possible. Naturally, I hope they will be minimal so that I can some quality of life. If the side effects are too rough on me, a lower dose can be tried. Eventually, I may have to decide on quality versus quantity of life.

I am still in shock. My only hope is in Jesus. I count on him to sustain me through the hard times, as he has in the past. I still believe Jeremiah 29:11. My ultimate hope is in eternal life with him.

                                                                             “For I know the plans I have for you,” declares the Lord,

“plans to prosper you and not to harm you, plans to give you hope and a future.”

Jeremiah 29:11

 

Still Learning

I learned something yesterday. Actually, two things.

Since the thoracentesis, I have not been nearly as breathless as before. Thus, I thought I could handle shopping at Aldi. (You see, before the thoracentesis, when I was very breathless, I had shopped at Walmart, and it completely wore me out.) So, I did, and guess what? Though not out of breath, I became very fatigued, to the point that I had to rest all afternoon. This was a surprise since in my previous cancer experiences, I did not get fatigued so easily until after I started treatment.

And the second thing, which perhaps I had simply forgotten: Shopping not only wore me out physically, but mentally as well. I was too tired to do the paperwork I had planned to get done. I kicked back in my recliner and dozed or played easy solitaire games.

I will say that this is discouraging because I wanted to get more things done before my treatments begin.

But this morning I was able to deliver the sermon I had prepared, and I am grateful for that.

Just When

 September 25, 2025

Just when I began to hope that the pleural effusion was due to my bronchitis, reality stepped in with the brief statement from the initial cytology report: “Right pleural fluid, thoracentesis - - Positive for malignant cells. - Metastatic carcinoma, compatible with a breast primary tumor”

Now I wait for today’s PET scan results.

September 26, 2025

That was quick! The PET scan was negative, meaning that no growths or tumors were found. That’s a Hallelujah!

Next week I have two appointments with my oncologist. On Monday, I’m going in for a consult. I want to find out what kind of treatment he plans to do, if it is curative or palliative. Then on Thursday, I may have a six-hour treatment (an infusion). I don’t know what follows that.

In the meantime, I’m breathing much better due to the liter of pleural fluid taken out on Tuesday.

. . . And Again?

 My second four-month cancer check-up did not go as planned. Dr. Moussa has ordered a PET scan and a thoracentesis.

Let me back up for a minute. I’ve had a terrible bout of acute bronchitis since the end of August. I’m on my second round of antibiotics, having just finished a six-day pack of oral steroids. Because of abnormal lung sounds, my primary care physician ordered a CT scan with contrast of my lungs back in August. That revealed mild to moderate pleural effusion on the lower right lobe, so she ordered a second scan to take place at the end of September.

In the meantime, I had another follow-up appointment with her (Dr. Frances Horn) last Wednesday, though I felt better than before. I was surprised when she listened to my lungs and immediately said I needed the second round of antibiotics. She asked if I would like to listen with her stethoscope, so I did and was shocked by what I heard: low, loud rumbling sounds that mimicked my stomach when it is busy digesting food. I go in this Wednesday for another follow-up.

So, when I had my vitals taken by a nurse before I saw my oncologist, Dr. Moussa, last Thursday, I was sure to tell her about the scan, and she looked it up for him to see. His concern was immediate. Did I have chest pressure? Yes, on my right side, and I had assumed it was from the mastectomy. Fevers or chills? No. Coughing? Yes. He looked at my arms and said he saw mild edema in my right arm, which neither I nor my physical therapist had noticed.

He said he wanted me to have a PET scan and a thoracentesis ASAP. (Of course, insurance must approve first.) The PET scan will be at OCSRI (Oklahoma Cancer Specialist and Research Institute) in Tulsa, hopefully yet this week. The thoracentesis will be done tomorrow at St. John’s in Tulsa.

Just in case you don’t know what a thoracentesis is: a long needle is inserted into the pleura, which is a lining around the lungs, to extract some of the fluid. Then the sample will be sent to a lab to test for cancer cells.

On Friday, my blood work results were posted on my patient portal. Two of them are not encouraging: my platelet count and tumor antigen count are high.

Is there a silver lining to this story? Well, only that I won’t need the second CT scan since I will be having a PET scan.

I’m still numb with shock. Here are the three scenarios that I can think of, from best to worst:

1.       1, The pleural effusion is caused by the infection in my lungs.

2.     2.  The pleural effusion is caused by lymphatic fluid ending up where it shouldn’t. (Yes, that swelling in my arm is lymphedema.)

3.       3.The pleural effusion is caused by cancer recurrence.

Number 3 is the worst-case scenario. Survival rates for persons whose breast cancer has metastasized into the lungs tends to be measured in months, not years.

Pray with me. Pray for me. Pray for my children, who are devastated by this news. Pray that we will be upheld by the Holy Spirit. (And a p.s.: we are not yet telling the grandchildren.)