Thursday, January 29, 2009
Yesterday, I was again filled with anxiety as I opened the folder that contained the results of my CT Scans. My hands were trembling but I'd rather see it then and there than wait for my doctor to announce the bad news if there is. I scanned the document for a few seconds and decided to sit down so I can clearly grasp every word that's written on this precious document. First few paragraphs had a lot of medical jargon written on them but I understood what they said.
My heart leaped after I saw the words clear and unremarkable. My lungs and liver are clear! Woooo-hoooo!!!! I wanted to ran back home and hug Maia. But then, I immediately gathered my composure since it's never going to be final unless my doctor says it. It has to come from her.
When I reached the clinic, I cannot hide the smile on my face. She asked me if I've seen the results. I said yes. "So how was it?" I said my understanding is that I'm clear. "Ok. Let's take a look" So one by one she took out the films. By the time she's done with the last film, she also had a grin on her face. I was soooo happy. Then she just said..."that's it. So far we're okay. You can relax now. Basta just to don't be lazy to see me regularly ha? Don't be like the others, they disappear after sometime." I just nodded my head. Of course I will be there. I will not miss any of my appointments. I will remain a very good and obedient patient (hehe).
Getting the scans done was not easy for me. It was one of the most painful procedures I've gone through besides the surgery (but then I was asleep so this is still the winner) in this lifetime. The scanning procedure itself was just easy breezy. What was painful was I had to be injected with 50cc of IV contrast (iodine solution one of the nurses said) so the technicians can get a clearer picture of my organs. My veins were however too tiny and too narrow to handle the instant injection that for a minute, I felt like my arm was going to explode. I was not allowed to move so I can only cry out in pain. After that my body felt like hot water was being poured over it. In a few seconds it was replaced but a cold sensation. All these I guess was so stressful for my body that I was not able to stop myself from throwing up. I'm a nightmare for nurses. Haha. But all that felt like nothing now...the sacrifice was worth it... the scans are clear that's all that matters.
Again, thank you to YOU who never forgets to include me in your everyday prayers. Thank you to YOU who never failed to cheer me up when I am on the verge of giving up. You are right. God is Good.
I know I'm still not safe from this monster. Cancer is still cancer. But I will continue to fight. I will continue to stay positive that eventually, somebody will come up with a cure for this disease that I have. For now, I have the optimistic attitude, the lifestyle change (go organic! gulay na lang!), the diligence for my monthly check ups and all your prayers as my weapons. I believe these should be enough get me through this storm.
Tuesday, January 27, 2009
I am again scheduled to visit my doctor today. I pray that you give me enough strength to face and accept whatever news she has for me. I was telling my sister early today that we've had so many surprises already this month and I am hoping that it stops here. I know this is just to much to take already and my family is only trying so much to hold their individual selves together for me.
I would like to thank you for blessing me with so people who cares and loves me. Despite of the distance, friends are there to cry with me when I need to vent out all my worries. I thank you for giving me people to talk to when I need somebody to perk me up and take my mind off the anxieties that have been building up since we received the bad news. I thank you for friends and family who never get tired of asking me how I am doing. Having them around always make my day a lot brighter.
I thank you most especially for helping me find a support group. Linking up with people who are going through the same experience as I am is very comforting. Knowing that there are people who survived this disease for years gives me a lot of hope and optimism that I will win this fight.
Lastly, I thank you for giving me my daughter. She always gives me the enthusiasm to wake up and live the day as if I have nothing to worry about.
Sunday, January 25, 2009
So anyways, as I was going through the previous post, my initial fear that there's really no defined treatment for PT (Phyllodes Tumor) patients has been confirmed.
When we were informed that the tumor was malignant, we immediately asked my doctor what treatment options are available for us. She told us, for now, chemo/radiation therapy is the last resort. But that's only when there's metastasis already. For now, we just have to closely monitor my body through regular check ups. What we should be looking out for is the incidence of a recurrence. I was telling my family that this whole thing does not really scare me. But what I cannot handle right now is another surgery this year. I don't think my body can handle another surgical invasion after a mastectomy.
Later today, I am hoping to finally finish the CT Scan so we can get a clearer picture by the end of this week. We've been praying really hard that it stays clear so we can at least set aside our worries for the meantime.
Friday, January 23, 2009
Before Mommy had you, she was a cry baby in every sense of the word. She would cry over small stuff and would cry harder when things get tougher. But that does not mean that she's weak, that's just how Mommy expresses her emotions when she's sad, frustrated or disappointed. Once the tears ebb down, the worries go with it. Then Mommy's all better. Nevertheless, people around Mommy especially Daddy, GrandMa and GrandPa does not like it when Mommy cries. So Mommy vowed to control the tears when Mommy was already carrying you. Guess what, you did help Mommy on this mission. From the moment you were born till about a month ago, she's finally mastered the art of crying.
But it seems all that was temporary. When Wednesday's news sunk in, the tears came back. You know why? Because Mommy kept thinking of you. Of how small and young you are yet. You do not deserve to be deprived of her love and attention just yet. Mommy did not cry when she received the news but she cries when her thoughts are flooded by you.
Mommy is now praying for strenght to fight this fight so she can spend a longer time with you. When Mommy's all better, she will take an advocacy to help others just like her. And she will do it with you. Because you are her inspiration for taking on this fight.
Mommy vows to be around to witness many of your firsts. I love you very very much baby. You are Mommy's world.
Wednesday, January 21, 2009
While the hubby was looking forward to hearing my doctor deliver a positive note, I had a nagging feeling at the back of my mind that it might not be as pretty as we would like it to be. To be on the safe side, I prepared myself for the worse.
Turns out, my instinct was correct.
The tumor is malignant. But unlike the time when my doctor told me my left breast had to be taken out, this one did not shock me anymore. I guess my preparation paid off after all.
So while we discuss the further actions that we need to take in order to prevent or maybe combat the worse that's yet to come, my mind floated to the confines of our bedroom where our little Maia spends most of her time playing, cooing and giggling. My heart felt like it's being crumpled to pieces. Surprisingly though, I never shed a tear. The lady who used to be a crybaby did not shed a single tear! I guess, this whole experience is indeed starting to toughen me up.
Now, in the next two weeks or so...I will undergo more testing just to ensure that the malignant 'cells' (i don't know if that's even the correct term for it) has metastasized to my lungs and liver. But now, I feel there's a light at the end of the tunnel. God seems to be telling me to hold on a little longer and keep the faith going. The should be an end to all of this.
As we leave my doctor's clinic, I took the hubby's hand and squeezed it reassuringly. We will get through this.
Tuesday, January 20, 2009
This is from www.answers.com:
What is Phyllodes Tumor?
Cystosarcoma phyllodes (CSP) is a rare type of breast tumor. It is categorized by the National Cancer Institute (NCI) as a tumor subtype that occurs within the breast but is not considered a typical cancer. Its name comes from two Greek words that mean "fleshy tumor" and "leaflike," because its internal structure resembles a leaf when the tumor is cross-sectioned. The term phyllodes tumor is considered preferable to CSP as of the early 2000s because most of these tumors are benign. Phyllodes tumors are also known as giant fibroadenomas of the breast.
Phyllodes tumors develop only in the breast; they are never found in other parts of the body. They are formed within the stroma (connective tissue) of the breast and contain glandular as well as stromal tissue. Phyllodes tumors can grow noticeably within a matter of weeks, causing the overlying skin to become semi-transparent or reddish and warm to the touch. They do not, however, usually involve the nipple or areola.
A phyllodes tumor can be moved freely within the breast when the doctor performs a manual examination. The tumor has a firm, smooth texture, can be easily distinguished from the surrounding tissue, and may grow to be quite large and bulky. The average size of phyllodes tumors is about 2 in (5 cm), although tumors as large as 11.8 in (30 cm) have been reported. These tumors do not cause pain when touched. For reasons that are not yet understood, phyllodes tumors are more likely to develop in the left breast than the right.
There is some disagreement among specialists regarding the number of phyllodes tumors that prove to be malignant. Although figures of 16–30 percent are commonly given, some doctors think that the actual incidence may be higher, as more cases of malignant tumors have been reported in the early 2000s.
Phyllodes tumors account for less than 1 percent of all breast tumors. Almost all occur in women, although a few cases have been reported in men. Phyllodes tumors have been identified in women in all age groups but are uncommon in adolescents. They are most likely to occur in women over 35.
As far as is known, phyllodes tumors occur with the same frequency in women of all races and in all parts of the world.
Causes & Symptoms
The cause of phyllodes tumors is not known as of the early 2000s.
The symptoms of a phyllodes tumor include the rapid but painless growth of a smooth, bulky mass within the affected breast. The patient may notice that her entire breast is enlarged and its shape distorted. The skin over-lying the tumor may feel warm to the touch and develop a shiny appearance; it may also become translucent.
The diagnosis of a phyllodes tumor may be made when the patient notices a rapidly growing mass in her breast and consults her doctor. After palpating (feeling) the mass and evaluating the appearance of the overlying skin, the doctor will order imaging studies and an open breast biopsy. Although a mammogram or ultrasound study may be useful in evaluating the size and location of the tumor, these tests are not reliable in distinguishing among benign phyllodes tumors, fibroadenomas, and malignant phyllodes tumors. In addition, fine-needle aspiration does not usually confirm the diagnosis; an open biopsy is considered the definitive diagnostic test as of the early 2000s.
There are no tumor marker or other blood tests that can be used to diagnose phyllodes tumors as of 2005.
Clinical Staging, Treatments, and Prognosis
Phyllodes tumors are not staged in the usual sense; they are classified on the basis of their appearance under the microscope as benign, borderline (or indeterminate), or malignant. The pathologist makes the decision on the basis of the cells' rate of division (mitosis) and the number of irregularly shaped cells in the biopsy sample. In one series of 101 patients with phyllodes tumors, 58 percent were identified as benign, 12 percent as borderline, and 30 percent as malignant.
Surgical excision (removal) is the usual treatment for phyllodes tumors, whether benign or malignant. In the case of benign tumors, the surgeon will usually try to spare as much breast tissue as possible, generally removing about 1 in (2 cm) of normal breast tissue from the area around the tumor as well as the tumor itself. If the tumor is very large, however, the doctor may remove the entire breast.
Although radiation therapy has been tried as follow-up treatment after surgery, phyllodes tumors do not respond well to either radiotherapy or chemotherapy if they recur or metastasize. In addition, malignant phyllodes tumors do not respond to hormone therapy.
The prognosis for benign phyllodes tumors is good following surgical removal, although there is a 20–35 percent chance of recurrence, particularly in patients over the age of 45. Recurrence is usually treated with further surgery, either another local excision or a complete mastectomy.
The prognosis for patients diagnosed with borderline or malignant phyllodes tumors is more guarded. About 4 percent of borderline tumors will eventually metastasize. A Mayo Clinic study of 50 patients with malignant tumors found that 32 percent had a recurrence within two years after surgery; 26 percent developed metastases, and 32 percent of the group died from their malignancy. The most common sites for metastases from malignant phyllodes tumors are the lungs, bones, liver, and chest wall, although metastases to the lymph nodes have also been reported. Most patients with metastases from a malignant phyllodes tumor die within three years of their first treatment.
Alternative and Complementary Therapies
Women who have had surgery for removal of a phyllodes tumor appear to use CAM therapies as often and for the same reasons as women treated for breast cancer. According to the Behavioral Research Center of the American Cancer Society, breast cancer survivors are highly likely to use some form of alternative or complementary therapy during cancer treatment or within a year or two of completing conventional treatment. A survey of 608 longer-term (8 years or longer) breast cancer survivors reported in early 2005 that the majority were still using CAM therapies. The survey respondents gave four reasons for using alternative treatments:
- To maintain an active role in recovery from cancer.
- To reduce their stress level.
- To reduce the risk of recurrence.
- To maintain hope.
Specific CAM therapies mentioned by the women in the ACS survey included exercise, humor, self-help books (bibliotherapy), prayer or spiritual practice, vitamin treatments, relaxation exercises, and support groups. Dr. Kenneth Pelletier, the former director of the program in complementary and alternative medicine at Stanford University School of Medicine, lists hypnosis, visualization, naturopathy, and journaling as other alternative approaches that breast cancer patients find helpful. Acupuncture is frequently mentioned as a useful method of pain control.
Coping With Treatment
Coping with the aftereffects of surgery for a phyllodes tumor is similar to coping with the effects of surgery for breast cancer. Patients who have had a complete mastectomy may experience pain, limited range of motion or weakness in the affected arm, scarring, or swelling. Exercises, outpatient physical therapy, and massage help to relieve these side effects of breast surgery. In terms of follow-up, most patients treated for phyllodes tumors are scheduled for a postoperative visit with the surgeon 1–2 weeks after surgery, with periodic checkups thereafter.
The National Cancer Institute (NCI) is not conducting any clinical trials involving phyllodes tumors as of 2005. There is, however, an ongoing study at the Dartmouth-Hitchcock Medical Center in New Hampshire of the effectiveness of radiation therapy in preventing recurrences of borderline or malignant phyllodes tumors in patients who have been treated with local excision of the tumor. Women who have had a borderline or malignant phyllodes tumor removed within the past three months may wish to consider participating in this study.
There is no way to prevent phyllodes tumors as of the early 2000s because their cause is not yet known.
Questions to Ask Your Doctor
- What are the chances that my phyllodes tumor is either borderline or malignant?
- What are the chances of a recurrence?
- Would you recommend a total mastectomy rather than local excision to minimize the risk of recurrence?
The special concerns of patients with phyllodes tumors are similar to those of patients diagnosed with breast cancer, particularly concern about disfigurement, physical weakness, or recurrence if the entire breast has been removed.
Friday, January 16, 2009
The past few days felt like the 4 longest days of my life and I am just very, very glad to be home again with Maia.
Wednesday went by like a blur. I was woken up by my nurse at 5am to inform me that I need to take a bath already so I'd be all cleaned up when the people from the OR fetch me.
I am emotionally ready. I have already thought of the worst possibilities I might encounter while on surgery and have already put my trust on my surgeon. I know she will do what she thinks is best for me.
But despite the mental preparation, I felt really clammy when I was wheeled in. I guess it's a pretty normal reaction considering that it is my first time to be in an operating room and definitely my first time to go under the knife. But I was telling myself to think happy thoughts. I thought of Maia's face when she giggles and it made it all better.
I was a bit shocked when my surgeon came in and told me she's doing the incision biopsy with me on local anesthesia for 30mins. Our discussion earlier during the week was that I will be put under general anesthesia from start to finish and hearing that I sort of felt panic. But I regained composure almost instantly. I recalled my earlier thoughts and decided that again my surgeon would know what's the best thing to do.
So for the first 30 mins of my scheduled 3-hour surgery, I was lying there both arms tied on the side waiting for the surgeons to finish taking samples of the tumor. Once they were done, I had to wait for 30 more minutes for the frozen section results. I kept the sunny disposition and decided to chat with the intern who was looking after the incision that was made earlier. We started laughing at my tumor since it was moving in all directions while the intern was applying pressure on the wound. It felt like I had a ball running wild inside my left breast.
Thirty minutes went by and my surgeon came back...sort of gloomy faced. She immediately announced that the labs proved the tumor was phylloides and patted me on the shoulder and told me they have to move on with the mastectomy. I just nodded my head and got myself ready for the show. It took just a few seconds for them to put me to sleep.
...after 2 hours, I woke up in the recovery room with a throbbing pain. It felt more intense than the pain I had when I gave birth. I immediately asked for pain relief and they signalled to the IV drip above my head. The nurses told me to just do breathing exercises so battle the pain. I guess I sort of felt asleep again because the next time I woke up, I was already being wheeled out of the recovery room. It was still very painful and the sight of Mommy and Tibs gave me an excuse to cry out the pain.
Thirty minutes after I was settled in my room, the pain finally went away. And my old bubbly self is back. To all who offered prayers, I could never thank you enough. I know God never left me all through out the surgery. I know because I would never have the strength I had without his help.
To everybody who made time to visit despite their busy schedules, I am very grateful because you made me feel really loved and you definitely lifted my spirits.
I may be left with only one breast at 30 but I have my friends and family to compensate for the loss. And despite knowing that it was my pregnancy that triggered the tumor to grow aggressively up to the size of a tennis ball, I have no regrets for choosing to get pregnant and have Maia. And if I had to, I will readily give up my other breast without skipping a beat, for her. Motherhood is something I will never trade for the world.
Monday, January 5, 2009
Two days before Maia turned two months old, I went to see a surgeon at PGH to have the mysterious lump on the exterior part of my left breast checked. I had complained about this to my OB-Gyn during my routinary post-natal check up but I was instructed to just apply hot compress over it. My OB-Gyn was saying it was probably just due to lactation and it will go away once I stopped breastfeeding. But just to be sure she says, she'll schedule me for a mammosonogram once I ceased milk production.
But then my Mom and sister kept on prodding me to seek other doctor's opinion. To give them peace of mind, I gave in to their plea. It turns out however, the lump was indeed a tumor. One large tumor - measuring 4x5 cm - that had been sitting there for sometime and growing by the minute. Doctor's theory was, the lump had always been present but was left undetected.
Due to a family history of lumps and tumors (both of my maternal grandparents succumbed to cancer) plus undergoing hormonal treatment for my irregular menses earlier on and an intensive hormonal medication during my pregnancy, the lump's growth became aggressive. Thus, resulting to large mass like this one in just 5 months.
Due to the lump's size, I was not required to get a mammosonogram anymore. Instead, the doctor suggested a biopsy of the breast mass. But the guys at PGH were going to make small incision on my breast so my family and friends suggested that I seek another doctor's opinion before I had my breast sliced.
So I again went to see a different doctor, this time at the Makati Medical Center. But she only confirmed the previous findings. Only three days have passed since my PGH trip but the mass has now grown to 5x7cm. It's growing really fast! Good thing though, she did a fine needle aspiration biopsy so no incision was made. She told me we needed to rule out malignancy of the tumor before we go a step further on the treatment.
But since we were approaching the long holiday break, I had to wait on the results for 2 more weeks. Yesterday, I went back to discuss the biopsy results. I was hoping it would be nothing. And indeed, the biopsy findings were nothing to be alarmed about. What was alarming though was that the lump continued to grow. Now it's 5x8cm. The conversation became blurry to me after that. It was only after I met up with Tibs that it sunk in. Then I just cried.
Diagnosis was the lump is a phyloides tumor of the breast. It definitely has to be taken out. Due to its size, the doctor cannot do it under local anesthesia. I have to be put under general anesthetia and while I am 'sleeping' they will check the tissues from the breast mass to rule out phyloides. But if it turns out to be phyloides, they will take out ALL of my left breast. It was hard hit on me. It never crossed my mind that I will be left with just one breast at 30.
At this point though, I am more worried for Mommy than for me. She did not get any sleep last night. She's really scared I might end up like my grandmother. I was not able to get a decent sleep either but I vowed to stay tough. I kept looking at Maia and thinking how small and fragile she is. I need to stay healthy for her. Then I just prayed. Felt better after that. I thought, one breast is better than cancer. At least it's not cancer (--yet). But with all the support from family and friends, I know I will get through all this. God just wants our family to be a lot more stronger that's why he keeps sending us these challenges.
So this week, when I'm finally cleared for surgery, I will try my best to stay tough. I have prayers to guide me through. And my Maia to give me strength.