Best case scenario.

Holy crap, it's almost the end of March. Time flies when you've got cancer and you're trying to get a baby to sleep through the night.

Last Monday, March 15, 2021 I had my third chemo infusion, hitting the halfway point of this upfront portion - the first of many milestones to come, but a milestone nonetheless. I keep forgetting I'll continue to receive Pertuzumab and Herceptin infusions every three weeks for a year, but halfway through The Big Six was something to celebrate.

These days my idea of a celebration is pizza and ice cream, so that's what we did. I heard it all tasted great but the chemo makes most foods taste pretty meh for the first week after. It's fine, I still ate it and pretended it was delicious because we take every opportunity to celebrate very seriously around here!

After that, chemo knocked me down hard. My side effects this time around seemed more intense than the previous two rounds, so it was a pretty ugly week. Major fatigue, insomnia, nausea, diarrhea - a real hurricane of fun. I'm just thankful that the medicine they advise/prescribe me really helps. In my past life, I started my day with an Orange Theory workout, lemon water and a probiotic. Now, during chemo weeks, I wake up and pop a Compazine for the nausea, an Immodium for the runs, and hope for the best. Cancer will really shake up your morning routine like that.

It took a little longer for me to perk back up but by Saturday afternoon I was finally starting to feel better. The sun was out and we picked up Arnold Palmers from Surdyk's coffee bar, the first thing I'd had all week that really did taste delicious.

***

Yesterday, March 22, 2021, my oncologist had scheduled me for ultrasounds of my right breast and armpit to really see what the shrinkage was looking like. I felt pretty good going in as she had felt a difference in size when she had given me quick exams during my last two visits, but I was still a little nervous about what the ultrasound would actually show.

The same radiologist who had performed my biopsies and read my previous ultrasounds came in once the tech was finished taking pictures. I was both relieved and nervous to see her. She is so warm and kind, but unfortunately we hadn't had a great track record of results together. First time: "It's cancer." Second time: "The cancer's spread." Ugh. What was it going to be this time?

Almost immediately the doctor started commenting on how significantly the tumor had shrunk and my whole body relaxed. She said a lot of things that I can't exactly remember, but here are the highlights that made me cry (again) on the exam table - this time, happy tears:

• The thickening of my lymph node had decreased so much that it looked back to normal.

• The tumor is "much harder to see and looking less and less like a tumor" - it has decreased in size so much that it's now looking more like a linear piece of tissue.

• When I asked her if the new dimensions of the tumor and what they were seeing on the screen was indicative of a good response to the chemo, she said: "A very good response."

She was thrilled with the progress and told me to go celebrate. I was so happy I think I floated back to the waiting room where Joe was sitting and couldn't wait to tell him the good news. Before we left the hospital, I stopped downstairs in the infusion center for my third Zoladex injection (the one that hides my ovaries) - another reminder that I'm in menopause at the age of 35 and what that all means for me, but I didn't even care. Because that day, the radiologist had confirmed my body was working harder for me than it ever has before and I couldn't have felt more grateful.

***

Today, we had a follow up with my oncologist to review the ultrasound results together and she was equally as excited about the progress. The original tumor measured about 2x2x2 cm. Now it's measuring 1.5x0.5x1.5 cm, and she reiterated the radiologist's assessment. She also noted that what they're seeing now may not all be cancer either; it could be scar tissue, etc. I asked her about my lymph node appearing back to normal. Does that mean the cancer is gone? They won't be able to confirm 100% until additional scans are done at the end of my six chemo sessions, so while there's still a chance there are a few cells still hiding in there, "radiographically speaking - yes." And for now, that was good enough.

My doctor said that given these results, she wouldn't be making any alterations to my chemo plan. We'll stay the course with The Big Six and keep marching toward the ultimate goal: a complete response (CR) to the treatment. She said at this point, these results are "BEST CASE SCENARIO." (I'll be hanging on to those words for awhile.) I told her my latest round of chemo had knocked me down pretty hard and she wasn't surprised. She told me the plan I'm on is one of the toughest she gives out and I have to admit, I felt pretty bad ass in that moment. Whatever - as long as we keep seeing results like this, I can take it. Seeing the cancer shrink makes the hardest days completely worth it.

We talked a little bit about surgery and what that might look like given my body is responding so well. She favors a lumpectomy + radiation but we won't make any final decisions for awhile. Next week I have a consultation with a plastic surgeon to better understand reconstruction options if I go the bi-lateral mastectomy route; then I'll connect back with my surgeon to assess the full picture. It will all depend on whether or not I get a complete response to the chemo, and I'm open to whatever my doctors think is the best path forward. It sounds like regardless of the type of chest surgery, I will still have at least a few lymph nodes removed even though it appears that the cancer has cleared. Not ideal, but having a few removed is better than having all of them removed which would increase my risk of long-term side effects like arm swelling, etc. My arms already look like turkey legs (thanks, 30s!) so if we can avoid any additional swelling, well that would be...swell.

Lastly, according to MN guidelines, I qualify for the COVID-19 vaccination and my oncologist recommended getting it as soon as possible. Today I received my first dose of the Pfizer vaccine and it feels pretty cool to be part of such a historic moment in our lifetime. So far the only side effect I'm experiencing is a deep appreciation for science and people who have a hell of a lot more brains than I do.

Tonight our idea of a celebration is champagne and a cheese board - so that's what we're doing. Toasting our best case scenario news.

Chemos 4-6, you're up!