Finally, we have a treatment plan!

The week after my actual diagnosis I had an MRI, PET scan, pre-op blood work and an EKG done since I was going away for a week to Greece. My mom and I had this trip planned from when I was in Rwanda, but luckily we were still able to go with my doctor’s approval. The timing worked out just perfectly so that upon my return I would immediately start preparing for treatment.

Taking this trip meant that some decisions needed to be made quickly though, primarily about fertility preservation. I was given the option to freeze my eggs prior to chemo since the treatment is known to negatively affect fertility. However, this would require a 1-2 week delay of treatment, which didn’t sit well with me. It was hard knowing I had cancer growing inside my body yet I hadn’t received any treatment yet. Feelings of urgency overwhelmed me. 

When I considered fertility preservation, I thought about my life and what I wanted. I was currently 25 and single, and had spent the past few years living in different countries. I was by no means settled down and I was on the fence about having children in the future. Sure, I grew up thinking that I’d go to college, get a job, get married and have kids like society says we should. 

But from years of travel, my mindset started to shift and I realized I didn’t have to do that if I didn’t want to. I loved traveling, I loved my freedom and quite frankly, I couldn’t imagine settling down at this point. I still had plenty of time to figure it all out. Was I willing to write it off completely? No way. But was I willing to delay cancer treatment to ensure I could have children? In the end, I wasn’t. I didn’t feel that I had time to spare and I wanted to get treatment as soon as possible.

With that decision being made, my doctor offered another option to take Zoladex injections. This medication is used to temporarily ‘turn off’ your ovaries during treatment, in hopes of preserving their function in the future. It was an injection in my abdomen that I’d get every 4 weeks throughout chemo, which seemed easy enough and felt like a good middle ground.

So, with those decisions being made, my mom and I embarked on our trip to Greece where we decided to pretend I didn’t have cancer as best we could and to simply enjoy. I think we did a pretty decent job at that until I had a flight cancellation that would impact my entire treatment schedule. From the lobby of our hotel in Greece, the night before my flight was supposed to leave, I was panicking on the phone with my dad trying to have him sort out the canceled flight situation from the US. It was the first time I used the cancer card and of course, with good reason.

Thanks to my dad and whomever he spoke with that took pity on me, I was able to get a different flight and make it home in time for my first Zoladex injection and my IV access port surgery the following day. I felt instant relief.

The basics of my treatment plan at this point, according to my hematologist-oncologist, were to have 5 months of chemo, then surgery and possibly radiation after. We learned that I did not test positive for any BRCA mutations, which means I do not have a known genetic component and we simply have no idea why I got breast cancer at such a young age. It could be a genetic mutation that my maternal grandmother had that isn’t able to be identified yet, or maybe not. We just don’t know.  We also learned from the PET scan that my cancer had not spread beyond my lymph nodes, phew! Stage 2 confirmed.

My first chemo A/C (Adriamycin plus Cytoxan) would be every 2 weeks for 4 rounds and then we’d switch to Taxol once a week for 12 rounds. They chose neoadjuvant therapy for me, which means the chemo comes before surgery. The benefit to this approach is that we could tell if my body was responding well to the chemo or if they needed to make any changes to my treatment plan prior to surgery. Another benefit to this, for me personally, was that I had time to decide what surgery to get. I wanted to make as few immediate decisions as possible because it was already such a whirlwind. After surgery, I would most likely have radiation, but a few factors would come into play with that. 

So all in all, I imagined I’d have about 10 months of treatment at the most and could start to mentally prepare myself for that. My mental preparation was mostly me just telling myself that this is all temporary, 10 months, and then I can go back to normal life. While it helped tremendously to tell myself that during treatment, it certainly didn’t turn out to be true. Temporary is relative and there was nothing familiar about my ‘new normal’ after treatment ended, but I’ll get into those details down the line.