Cancer Recurrence – Part 1

Taken before starting the chemo cycles all again to remind me fight all over and not give up

In my current situation, I have to Fight like Hell and experience not only physical pain but also emotional pain by having to drag my near and dear ones into this ordeal with assumably more cloudy days. It’s a tough battle to fight alone; you need an army to battle it, and I have mine. It’s priceless to see them cheering, celebrating, praying, laughing, and crying with every good and bad news coming my way. 

For someone who has always lived life on my own terms, it makes me think – I am alive; it’s a life filled with richness; I am stronger than I thought I was and have so much more in me to fight this battle. Importantly, I have learned to prioritize, which boosts me to rock most days. 

The way everything unfolded was a heart-wrenching time for my family and me. There is a reason this is such a delayed blog – I never thought in my most wild dreams that I would have to write about my cancer recurrence so quickly. While with the triple-negative breast cancer diagnosis, one is prepared for recurrence, I was not ready to face it within a few months. 

The first line of treatment with a combination of 16 chemo sessions, double mastectomy, 33 radiations, and 12 immunotherapy sessions to kill the cancer cells and avoid any recurrence with sustaining treatment ended in May 2022 – a Euphoria moment!!

Morning of Mothers day goofing with my girls

Feeling on top of the world. 

Walking on air would be an understatement because I felt nothing could stop me now. I met with my surgeon to schedule taking out the port (used for chemo treatment) at the earliest. During my visit, we also discussed breast reconstruction, but I was interested in flattening it further instead of going for reconstruction immediately. After double mastectomy and radiation treatment, the breast area on the right side (my cancer side) is still tight, and there is a little fat settled towards the armpit area on both sides. The fluids in the body settle in that way after a mastectomy. So I wanted to remove this fat area and flatten it evenly to make it easier with clothing. Since he is a general surgeon, he recommended I meet with a plastic surgeon, and of course, they could time both surgeries together. 

Remember, I was still in a blissful state, so I got the appointment with the plastic surgeon as quickly as possible. Looking at the doctor, it felt like the hero from my childhood, Mills & Boon books, just walked in. It was nothing short of a movie-like experience meeting a to-die-for handsome doctor. I am sure I was awestruck for the first few minutes of the meeting just admiring his handsomeness and fit body. Now that you imagine everything you possibly can about this guy, come back to reality because everything from here went downhill for me. Yes, it started when we discussed my cancer and treatment plan, and of course, I bragged about my Peloton rides and milestones. I was just finding ways to impress and distract him from my scars. He is a Peloton user, too, and at the stunning moment, I forgot to ask for his username or a picture. LOL !!! Sorry, I am constantly distracted thinking of his looks even while writing this post. 

I had already changed into the hospital gown with the front open but holding on to the laces as if I was holding my life because I did not want him to see my mastectomy area. By the way, Robin was in the room somewhere in the corner, completely ignored, and I might have refused any association with him. Then, it was time for the doc to check, and there was this giant mirror in the room to stand examining surgery options. After much discussion, we decided against the surgery – he felt the skin on the right side needed more time to heal from the radiation. If I were his wife, he wouldn’t recommend any changes to it for another 6-9 months till the skin heals completely – that’s what He Said:) The body also slowly absorbs the fat, which I can see happening. He also suggested using the fat on both sides for reconstruction. 

Standing in front of the mirror suddenly took my focus away from my breast to my tummy. I felt it looked bloated, and in no shape or form it represented someone working out every day. The distended look stayed with me even after the appointment. That embarrassed me a lot, and I again brought up the topic of Peloton and being a diligent user. 

One of the side effects of chemo is weight gain, which, due to how cancer patients are depicted in movies, most people miss out on. They expect you to look weak and fragile – which happens during the treatment, but once the chemo sessions end, many see weight gain.

After this appointment, it all brought back to scheduling the surgery only for port removal. I was looking forward to this surgery because this would mean a nice cherry on top to end my treatment. 

Abdomen Swelling and Port Removal Surgery 

With the surgery scheduled, I took a quick work trip to Seattle. It is important to note ( and you will learn more in the blog why) that I attended all-day meetings, including team dinners, for two nights and walked about 3-4 miles daily. This was also my first flight trip after 2 years – with COVID and cancer treatment, I had not traveled after march 2020 and the entire of 2021. 

We suddenly lost a very dear friend at the end of May, which completely shocked Robin and me. I owe my cancer recurrence diagnosis to her – while she did not get a chance to fight, she gave me another chance to fight and find more time with my family

Knowing she had some abdomen pain, I focused now more on mine. With the chemo treatment, I was in the post-menopausal phase, and one of the side effects of it was abdomen bloating. One of the common side effects of immunotherapy is Colitis – which is also feeling bloated. My mind was debating between the two but more inclined towards Colitis. The more I read about it, I was convinced that it was not from my post-menopausal but Colitis. Added to this bloating, I was also experiencing weird lower back pain.

abdomen bloating

A pain that would bother me only at night and not during the day, working out, walking, standing, or sitting. It did trouble me a lot at night, though. Initially, I thought because my stomach had bloated suddenly, that was why my back was hurting. However, being a google doctor, this led to me self-diagnosing with spinal cancer. My doctor did not doubt anything at this point in time and wanted me to wait and see. My lovely physiotherapist decided to help me relieve the back pain and, during the lymphedema sessions, taught me some home exercises. I was not getting much relief from the pain. Robin thought I was overanalyzing my situation and getting stressed and shouldn’t presume spinal cancer. Under normal circumstances, yes, no one thinks of spinal cancer with back pain, but I was almost certain something was not right with my breast cancer. This was going on probably for 4-5 days, and I felt my abdomen bloating was increasing. 

One evening, the discomfort increased, and we went into emergency immediately. After the blood work, urine test, and CT scan – it was confirmed that I was not dealing with Colitis or any tumor. All the reports came clean, except they found a tiny amount of ascites (fluid collection in the abdomen). It usually forms if the liver is damaged but in large amounts. After the discharge from the emergency around 1 am that night, Robin and I came home and started reading about ascites but chose not to sweat too much with the online information as it looked pretty scary. 

The next day during the appointment with my oncologist, she explained that the ascites formed is too little to come to any conclusion. With the blood work and CT scan coming clean, she also spoke with my GI specialist, and he also did not suspect anything. At this time, we did not have any conclusive results for my oncologist to create a treatment plan. So she suggested additional blood work, checking for my liver and kidney enzymes, doing an abdomen ultrasound, and draining the ascites to send for biopsy. 

The ultrasound appointment got scheduled in a couple of days, and I started burping a lot in the meantime. It would be an understatement if I said a lot and ended it – I would burp for hours together. Sometimes the burp would get stuck, causing uneasiness until it was released- some online reading helped figure out how to remove it. That Sunday evening, I burped continuously from 6pm to 3am, causing discomfort and pain in my esophagus. It just wouldn’t stop. 

In the ultrasound appointment, they measured the fluid to be 10cc, which is difficult to drain with that low quantity. The doctor was convinced that this low amount of ascites usually gets absorbed by the body. The extended enzyme and blood marker test results came out to be normal. A couple of marker tests were pending results. With all of these tests, my port removal surgery had to be canceled. 

Unsure of what was developing, I had not shared anything until now with family and friends. My Peloton workouts continued all these days. 

The port removal surgery got rescheduled for the following week. This is one of the best surgeries because everyone around you in the hospital is glad to see you cancer free. The walking on cloud nine feelings were back, and the drive home from the hospital was filled with positivity for Robin and me. 

Meeting with the Gynecologist and was it Ovarian Cancer? 

During the next appointment with the oncologist, we got the results of the pending Ovary marker test. The numbers were higher than the expected range, but the blood work and CT scan were clean, so on a precautionary basis, my onco wanted me to meet with the gynac to get this off our list of worries. 

My onco, Robin, and I did not doubt anything related to cancer at this time, but during the drive back from the clinic, Robin cried inconsolably just knowing that we dint have answers. He, in fact, took me half an hour early for the appointment as he was feeling very unsettled at home – which is exceptionally unusual of Robin. 

I went alone for the gynac appointment, not suspecting anything. However, the gynac was concerned it could be ovarian cancer with the ascites seen in the ultrasound again. I drove home with this disappointing news and kept rehearsing continuously in my mind how I would break the news to Robin. All that went waste because I crumbled as soon as I saw Robin. After that, it was disheartening for me to see my family and friends crying. Although nothing was proven, the possibility of having to deal with cancer again disintegrated Robin entirely, and we decided not to share anything with my parents. 

FaceTime with parents and its difficult to hide things from them

My gynac wanted me to go to the hospital again to see if the ascites could be drained and tested. We found that the ascites fluid had decreased from the last visit; while the news was encouraging, the gynac still felt that with the ovary marker number, I should visit the gynac oncologist and plan my next steps. 

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