Have we not been training for this?
Yes. Yes, we have. We have been training for this moment. We have been preparing.
(each all caps is a link to a previous post - click through if you missed them)
THE ONLY EASY DAY WAS YESTERDAY We knew harder days were coming. It’s how this works. Every day a treatment works means a day closer to when the treatment stops working. Today is gonna be tough and tomorrow tougher still. That’s the hand we were dealt. I got 21 months on that line of treatment (with some whackamole radiation added on top). Each month was pretty much borrowed time. No surprises here.
GET COMFORTABLE BEING UNCOMFORTABLE Change, upheaval, uncertainty, new side effects - it’s all sand in our undies. Expect it. Oh sure some would say embrace it, but I think it’s enough to just accept it, to say yup, that’s how it is. Screw embracing it, just nod and move past it.
DON’T RUN TO YOUR DEATH No need to put things in fast forward. They’re ticking along at their own pace. Don’t make stupid mistakes, keep your head, remember your strategy and your tactics. Whining is fine but at some point it’s a waste of time and energy. As is wallowing. Put a limit on the wallow.. I wallowed a fair bit between Wed and Friday (including during my Zoom metastatic support group meeting). Now the time for wallowing is over. (your wallowing time might be shorter or longer - you get to decide that. Just be sure it doesn’t become an indefinite thing....)
HAVE A SHARED SENSE OF PURPOSE For me it is: keep kicking this can down the road. The length of time I spent on first line of treatment of Tecentriq/atezolizumab + taxane has meant that a whole brand new drug reported out trials and actually got through Canada’s very slow tortoise-like approval process. I’ve told my oncologist I’m interested in aggressive treatment and clinical trials. I am a bit sad that my regular oncologist is away. I like her locum but we simply do not have the history and there’s so much trust required in this relationship. And for all that we all walk around touting evidence based medicine, so much of this comes down to judgement calls. Do you wait for another scan, make a call now? Push for a trial, use standard of care, try to go out of the box? I believe she and I are on the same page but to an extent it’s something I won’t know for sure until a bit more time passes...
Alas, we’ve possibly hit a small snag - on Friday I had a follow up phone call with the oncologist who was feeling less confident that Trodelvy would be quickly approved for me. There’s an issue with that one biopsy last year which showed faint estrogen positivity. Everyone still considers me triple negative (& for that matter, this drug is actually in trials for ER+ pts & showing some good results too so it’s not as if that means it wouldn’t work for me, even if all my tumors are faintly ER+. That said, the current Health Canada indication is only for triple neg metastatic breast cancer) but that biopsy might complicate approval. Funding is apparently also more complicated than she anticipated. She filled out a bunch of forms on Friday & now we wait and see.
If it all goes sideways, we have some options.
-appeal the decision.. We have an oncotype test from 2018 which categorized me as triple negative which we could submit.. We could do a repeat biopsy and hope for a clearer triple negative result.
-this drug is also available in the US and I know at least one Canadian woman who accessed it in Bellingham.
-move to another chemo and worry about sorting out this one as a 3rd line.
We make the plans, make the notes and flowcharts
& then we let go of what we can’t control.
& get back to reading good books
Book recommendation today is Lori Foster’s A Perfect Storm