Updated letter from my beloved best friend, Mellisa.
She always inpsiring me . She is very strong woman that i ever know.
Hope Her email can inspiring more people, especially people who in the same boat with her. Hope it can make all people more tough and grateful.
Here is the email :
Sorry for the late update.
So, we went to back to singapore on Monday the 15th and did my ultra sound scan and MRI for the breast.
The result as what my onco said was, "It's good news but not the best news"
Basically, most of the tumors have reacted to the TC x 4 chemo, the biggest one is left at 1.2 cm and unfortunately my onco said " she can't moved me to non invansive Cancer or CCR (clinically clear result)"
She had hoped I would be able to get away just with TC x 4 and said "yea you're cured!"
So she said she is in dilemma whether or not she should give me more chemo with A x 4 or skipped the A x 4 and go straight with Hormone Therapy.
A x 4 if it works will give me 4 - 7% additional cure rate, but she doesn't know whether or not it will actually work, it could not work at all, it could maybe only shrink the lump to only an additional 0.1 mm or it could made the whole lump disappear.
We met with several more oncologist and several breast surgeons and the knowledge that I learnt was that the only way we would know if what's remain is still invasive or not is when we do the operation (this is a must no matter what).
So there's a chance after the pathological result of the operation, the remaining lump is declared to be DCIS or non invasive, hence I don't have to do more chemo.
So, I'm taking that route.
In addition, I've also spoken to my breast surgeon and informed him that I really mind and concern about the risk of lymphodema, so he has agreed to first do a sentinel node biopsy where he will first inserted a radioactive capsule into my lymph node are so during the surgery, he can scan and see whether or not any of them are positive. If any are still positive, however, he said he will have no choice but to take them out. Fair enough.
John and I are still negotiating with each other on the additional chemo A x 4. He said another oncologist that we went to see for a 2nd opinion, specially called him just to let him know that she thinks even if after the surgery the tumor is negative, she suggested i should still do more chemo, which is in line with John's thought.
John is worried about the microscopic tumor cells that are in the rest of my body, and since I'm not CCR, he's afraid some may have spread but we can't see them on PET SCAN yet (if we can, it will already be very bad). So, he wants me to still do more chemo, A x 4 after the surgery even if my remaining tumor is negative.
Me on the other hand thought if it's negative, let's move on to hormone therapy because I'm ER (estrogen) and PR (progesterone) positive, highly reactive to hormone therapy.
And there was a new result that came out for hormone therapy: Ariamicyn + OA (Zolidax) given for 5 years give breast cancer patients 83% cure rate.
This is what my onco talked about, with CCR I would be 90% cured. But since I can't have CCR, she's very much inclined with Ariamicyn + OA that will give me 83% instead. No one gets 100% okay =)
The only downside with Ariamicyn + OA is that I will be in menoupouse for 5 years instead of 3 years. Ariamicyn is a drug that's usually given to post menouposal women, but they have had a trial whereby it was given to pre menopousal women by giving them OA (ovary ablation) so the body thinks that it's having menoupose hence the drug works.
Doc said I'll loose some feminine feature and have some mood swings, etc (just like an old lady i supposed *lol*) but if I can't stand the side affect, then they'll just take me off zolidax and give me tamoxifen instead (the original drug for pre menopouse women) which will give me 76% cure rate.
One doctor said, "It's quality of life that we look for not only the quantity (how long)" which I agree.
Anyway, for anyone near me and don't see me everyday, if you see me changing in too much of a negative way, please point it out to me *grin* coz I don't think me or John will be able to tell since we're with each other everyday and both of us tolerate each other and ourselves quiet well *lol*
I do noticed however with the 2 x zolidax that I have had so far (without Ariamicyn) that sometimes I do have mood swings, hot flashes. I feel less confident in some ways but I think this may not directly link to the zolidax, it could just be a normal phase that a cancer person has to go through.
In many ways, I am overwhelmed with a lot of things, but in many ways I think I have also loosen up. Self pity do come across several times but I've managed to brush it off. I can tell you that I feel ups and downs, and to certain extent I think cancer is 50% body and 50% mind / emotions (this one seem to be harder to battle, I'd say =)
My doctor's dis satisfaction of not being able to declare me CCR, stroke the question of "How many of cancer patients actually reached CCR?" The answer to this question was (from several other doctors) that not many breast cancer patient who is ER + PR + and HER 2 - like me gets CCR, usually patients with triple negative cancer or HER 2 + cancer gets CCR after chemotherapy.
But I still have hormone therapy which will definitely surpress my cancer if any remaining is still invasive.
Then my next question was "Does that mean patients who doesn't get CCR has less years than the ones has CCR?" The answer to this question was "Not really"
What the doctors do know is that most breast cancer women lives up to 5 years cancer free some even lives up to 10 years cancer free, afterwards if cancer relapse, then the doctor doesn't talk about cure rate anymore, it's more of controlling the cancer.
So, if you asked me, life before knowing I have cancer, yes it's all a probability, anyone can just die at any seconds from any kind of accidents, diseases, etc. Now with all of these info on hand, yes, I really realized hey i may just live shorter than other average women who is not diagnosed with cancer. Yes, I may outlived anyone who may had a heart attack, or accidents, but compared to any normal person, yes, I guess I'm in hmmm what's the right term...dazed maybe with this fact.
I told John if the pathological result after the surgery is positive, with full power, I will toughen up and do the Adriamycin x 4 and believe with all my heart that it will give me that extra 4 - 7% additional cure rate. The dilemma will only come if the result of my operation is negative which actually be really2x good (but I do understand that it could also mean that it's only negative because of the TC x 4 chemo and good thing that we take it out coz it won't be active in my body again, it's the remaining microscopic if any that John is worried about). Which will led me to ask my onco later, shouldn't my hormone therapy be enough to surpress them?
Next question would be does that mean anybody who had taken a full scope regime of Chemo TAC for 8x actually has a higher survival rate than the ones who didn't do chemo or the ones tho only did 4 x chemo like myself?
Sorry guys if the top part of the email seem to have lots of medical terms or discussions.
Anyway, John and I are leaving for SG on Monday taking 1st flight at 6 am. My parents will join us on Tues, the 23rd also 1st flight. My operation will be on the 23rd in Glen Eagle at 1.30 p.m. My breast surgeon is SC Low and we've decided to go with Dr. Evan Woo as my plastic surgeon.
For the breast reconstruction, I've opted for the Pedicle TRAM (loose 1 tummy muscle, use part of my lower abodemen fat and skin to be transferred as my new breast). The volume will be around 80 - 90% similar to my left one. I hope that's good enough. If not, we can talk about fat grafting later on. But using my own tissues and fat really sound more appealing to me than using silicon and my back muscle.
The mastectomy itself will take about 1.5 hour, the reconstruction will take around 5 - 6 hours. So, my friends around the globe, please pray for us before, during, and after the operation =) *hug* *hug*
Please also pray for the kids and domestic + office workers =) All of whom, we've lifted up to God since we just can't managed to handle and control everything right now.
One of the doctor that we went for 2nd opinion, reminded John and I on this when I asked her to pray for us to make the right decision, she said, "sometimes when we asked God which way to take, He may gives us an answer through dream, vision, or someone, but sometimes He may not and we would be left to make our choice. and when we do make that choice, we should be at peace and believe that His grace is sufficient for us to take that road. we shouldn't have fear. because if we have fear, then that means we have no faith."
I kept on saying I have faith in God, now it's time for me to live that word, and proof it. I won't lie to you and say I have no fear. Sometimes I like to say it maybe or seem to have display or looks like I don't have any, which helped me to get rid of the fear. I have many worries and dis satisfaction with how messy my working table is right now, my closets, the kids toys, kate 's worksheets is all over the place, domestic workers always asking when the old maid will come back so they can go, or asking to leave because their old boss called them and offered them more money (it's not like we don't pay them high enough). I think leaving my kids with the workers worries me. and living here in this house with the workers stresses me out. truly the word can't live without them and can't live with them is so true.
Above is so out dated, when my self confidence is up and when i wasn't diagnosed with cancer, i can just say, "go ahead, if you wanna go pack now" and I can just say, "next..." meaning next one can come in right away too. but now i'm faced with "I can't do it myself anymore" and I can't just get next because I won't be here to supervised them or train them.
Above is also so worldly and just proof how I don't cast all my cares to God. Well, I'm ready to do so, then I wonder is this casting all my care or more of I don't care anymore, let's just get this thing over and done with and move on with life?
I asked one of my best friend this "so...do you believe as what bible said that God gave up His life so that we may have joy in this life or do you believe the Buddhist teaching that life is full of suffering?"
Logically, I think the Buddhist is right life is full of suffering, everyday...and this is easier to accept because we lived through it everyday. it makes sense. then the Buddhist teaching will guide us how to suffer less in this world.
The Christian thinking however, I must say is harder to accept because it starts in the spirit to first believe in Jesus Christ, then the mind control to keep on reminding self that Jesus wants us to have Joy in this life, we must always be grateful and thankful, and strive for that Joy. This is easier said than done.*lol* that's why it's called faith right =)
I have gained 3 - 5 kg these past 3 months. I have lost much of my physical strengths. I have lost some of my self confidence. I have missed my long hair. I felt hot most of the time wearing my wig although this is already the best option half natural and half synthetic. I'm behind in most of my office work. My household is in the survival mode getting things get by.
but my marriage with John has been proven through fire to be really strong, just as I had been strong for him, he has been so strong for me and himself, and for our kids. he's truly my best friend (2nd to my girl friends of course *lol*) j/k. Kate's grade and work ethic has actually improve while mommy is even more hands off on her school. i have had the privilege to have my mom and dad to live together with us in 1 country (my mom mostly reside in US and dad been back here for past 2 years). i'm happy to see that my kids get to have an active grandma figure in their life.
Yes, you will know the people who really cares for you will always care. and the people who doesn't care still won't care anyway *lol* ranges from domestic, office workers, friends, and family.
Why should they separate the term friends and family anyway. My friends are pretty much my family. Family shouldn't just be a title given to us just because we're blood related or marriage related. I personally feel hurt when I'm referred to "she's her friend" when another person whom my friend rarely see or talk to or know about or who has never been there for her is introduced as "she's family"
Why should you who's been there for me and hear my ups and downs, laugh, cry, fight, made up, prayed for me or me on the other side be downgraded compared to family?
The term family also puts a distance when you are not immediate brother / sister / cousin or you are cousin / relatives from mom or dad side, or if you're brother / sister /cousin in law because you just never know where you stand in front of them. You wanted so much to be part of the family but then you're afraid that you're not welcome because you will always have that barrier.
My family are all of you who has been here for me more than just the casual we will pray for you.
Thank you for your time, friendship, thoughts, cares, love, and prayers.
I'll write again once I can start typing again *lol* hopefully no lymph node taken out *cross finger*
Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.