Treatment: 12 of 12 – All Done!

How treatment went

It’s hard to believe this day has finally arrived! I can now say that I have successfully completed a 12-week program! The day was a bit long, we didn’t get out of the unit close to 4 pm. It was mostly owing to the fact that my infusions started closer to 11 AM as a result of my bloodwork not coming back until almost 10 AM. My Herceptin started first at 10:50 AM. The specific medication I receive is called Kanjinti, also referred to as Trastuzumab-anns. Why do I receive Kanjinti instead of Herceptin? Insurance reasons. Kanjinti is referred to as a biosimilar of Herceptin. That is not the same thing as a generic. Generic drugs have to prove they are biologically equivalent to the brand drug, or that there is reason to believe they would act similarly to the brand drug. Biosimilars need to actually prove that they have the same effectiveness and safety as the brand drug. Biosimilars tend to be more complex chemical structures than generics. They don’t have all the same clinical trial requirements as the original, brand drug so they are slightly less expensive from a research and development perspective. Generics don’t have the same burden to prove they have the a similar level of effectiveness. If you want to read more, you can check out the FDA’s guidance on this.

Sean came with my to my last chemotherapy. He was there for the first two and it seemed fitting to have him come to the last one. He was very supportive, went and procured a delicious lunch bowl from Dooby’s and kept me up-to-date on the Hurricane Ian status. He also performed the all-important service of helping me to assemble my ice packs on my hands and feet! Finally, he kept reminding me this was my last chemotherapy and that I had made it after all of these weeks. And he also told me my hair looked great. You can see my frosty hair picture after I removed my cap. From this vantage point, I think you can tell that I’ve lost some of my hair’s thickness.

I’m so excited to know that I don’t need to travel with a pack horse (no offense to all of my helpers!) to my infusion appointments anymore. Currently, I take a duffle bag, a pillow, a cooler with my ice packs, my Paxman Cooling Cap bag, my lunch/snack bag, my backpack and my purse to every infusion appointment. My duffle bag holds my blanket, Tylenol, hair towel and my socks/mitts. For the rest of my infusions, that will now only happen every 3 weeks, I will only be receiving the HER2-targeted therapy (Kanjinti). No more pre-meds or Taxol. That means I don’t need my cooling cap, socks and mitts anymore. I won’t need to bring a towel to wet my hair and I won’t need all of the ice packs. Basically, I will probably only need to bring my backpack, purse and lunch/snack bag with me. I will go to these infusions alone since I will not require as much support during my sessions.

The journey continues

I consider chemotherapy to be the hardest part of my journey, at least physically. I see my cancer journey broken down into the following phases (I love making lists!):

• Diagnosis [DONE]
• Surgery [DONE]
• Chemotherapy [DONE]
• Radiation
• Targeted Therapy
• Hope

The diagnosis and surgery phases are already behind me and they weren’t too physically terrible since my procedures were minimally invasive. I still have my radiation phase ahead. I know that won’t exactly be a walk in the park, but I don’t think it’s going to wreak as much havoc on my body systemically as the chemotherapy did. The targeted therapies – Herceptin and Tamoxifen – will be the final phase of my active treatment journey. I will take the Tamoxifen for 5-10 years, but I don’t know at this point if it will be 5 or 10. Then I like to call the final phase the “Hope” phase. It’s the part of my journey where I’m no longer in active treatment, I have done everything I can do to prevent this from coming back and I just have to hope and trust it won’t come back.

That phase will probably be very emotionally and mentally difficult. Diagnosis was pretty hard emotionally and mentally as well, but it’s behind me and it felt finite because we found something bad and we needed to do something about it. We quickly transitioned into an action-oriented mindset to approach the surgery, chemotherapy and radiation phases. The hope/trust phase overlaps with a couple of the last phases for me because as each form of active treatment is completed I get closer to running out of “things” to do to attack the problem. The Tamoxifen is only expected to be marginally beneficial since my tumor was only very slightly ER/PR positive. A lot of survivors say this is the hardest part because everyone else in their life sort of goes back to normal and, through no fault of their own and probably because they are trying to keep it positive, people around you forget that things will never be completely normal for the survivor again. Even for the luckiest people who have little to no lasting side effects of their treatment, they are reminded of what they went through but more importantly what could come back every time they see their scars, they get a surprise bout of fatigue or they go for their surveillance scans.

I don’t bring this up to say that people need to treat me differently. To me, it just reminds me that every time you interact with someone you can’t always see the baggage or burdens they carry with them. You never know what anyone is going through, so we should all give people a break. What I know will be hard for me is that everyone always knows that I have a lot of energy and that I’m a happy/smiley person. It’s very obvious when I’m not in that mood and people will even comment on it. The experience has changed me though and I’m not sure I will be quite that same person. Maybe I will be more like my normal self, but every experience we have changes us and shapes us. I don’t think this means I am doomed to be an unhappy person, but I carry more with me now and I know I just need people to understand that.

In other news

While I was at the hospital, Sean told me that Katie Couric shared today that she recently was diagnosed and treated for Stage 1A Invasive Ductal Carcinoma. Many people remember how she experienced the tragic loss of her husband from colon cancer when he was only 42. She unfortunately has an extensive family history of cancer. Her mother had non-Hodgkins lymphoma and her father had prostate cancer. Her current husband also had a tumor on his liver that he had removed. She has been incredibly passionate about colon cancer screening and cancer screening in general. I think her recent diagnosis will help her to become more passionate about breast cancer screening and the disparities that we see in our own country despite the availability of screening options.

On a non-cancer related topic, when we got home my mother-in-law had made us a pot roast and picked up a delicious peanut butter cream pie from Dangerously Delicious! The pie was very good, but I am a peanut butter dessert connoisseur so I have thoughts. We have surprisingly never ordered this pie, despite the fact that we have tried many of their pies. They don’t normally keep the peanut butter pie in the case for individual slices, so it was always going to have to be special ordered. The pie was still a bit frozen when we cut into it, so I think that played a part in it not being the absolute best experience. They paired it with a graham cracker crust, which was excellent. They drizzled peanut butter on top. Somehow it was just not peanut-buttery enough. And it was surprisingly not very sweet. It could have been just a bit sweeter. I’m wondering if they used unsweetened peanut butter on top and in the filling. Overall it was good and worth eating, but I think we will stick to our favorite dessert pies from there including the Mobtown Brown, Lemon Chess and Key Bridge Lime Pie. Their Cowboy and Cowgirl Quiches are delicious as well as the Steak, Mushroom, Onion and Gruyere (SMOG) pie – our absolute favorite savory. Their Crab Quiche is another very good option.

We have been staying up to date on the hurricane status and expect to get the rain from that this weekend. We will probably have rain starting Friday and all day Saturday and Sunday. I’m hoping everyone in Florida stays safe and people don’t get too much catastrophic flooding from that, especially down in southern Florida where the storm surge will be the worst. We’ve already see some crazy photos and videos on Twitter.

Just keep swimming

I’m glad to put this phase behind me and I look forward to an October where I can heal a bit and let my body regenerate from all of this chemotherapy treatment. I have a bit of neuropathy in my right hand, so hopefully that goes away. I will prepare for my radiation in November, but I will use this time to try and process what I have gone through so far and the challenge ahead. I will definitely keep blogging and I will be able to do it a bit more. These last couple weeks it has been harder because I just hit a wall at about 4 PM everyday. I’m too tired to do much other than watch some TV or read a book, but I really just want to go to sleep. Also, I get a lot of “Mommy! Mommy!” from Maddie at night where I get requests ranging from “Can you cover me up again?” to “Can you put these pants on my Auntie Anna?” Auntie Anna is the name she has given to her Barbie, not my actual Great Auntie Anna! It’s really funny how many times the word “naked” and “Auntie Anna” are associated in sentences in our house. I’m sure Auntie Anna would be pleased to know that!

Now I plan to just keep swimming… but probably riding since it’s a bit cold for swimming outside!