My Cancer Journeys: Sisters, Not Twins

When you hear the word “cancer”, oftentimes there is a misconception that every cancer is the same. And sometimes from the outside, it can look the same. Many cancer patients often have the same symptoms, sometimes our bruises look the same, and sometimes, sadly, we meet the same fate. But while the path many cancer patients travel down is the same, each individual is walking their own journey. Even those of us who have to walk this road a few times, even up having different experiences. And while there is often a LOT of crossover, each cancer excursion is different.

I want to tell you a story of two sisters - they are my previous cancer experience and what I’m going through this time around. I wanna talk about what’s the same, what’s different, and the lessons I learned in my previous experience to make this walk easier. So let’s start with the most basic: the diagnosis then and the diagnosis now.

Breast Cancer can often just sound like one type of thing, but there are actually several different “flavors” of breast cancer. There are basically 2 large groupings: cancer cells that have receptors and cancer cells that do not (it’s a lot more technical than that, but for the sake of this discussion here, it’ll make it easier to understand). Here’s a visual to help:

Basically, as part of the diagnosis process, the doctor will send a sample of your cells to the lab to be analyzed on a cellular level. And what they are looking for is the type of receptors and proteins that are present in the cells. As you can see in the diagram, it is possible to have any combination of Progesterone, Estrogen, and HER2. And of course, there are cancer cells that can have no receptors present at all. In my first cancer diagnosis, it was discovered that my breast cancer cells did not have any receptors on them. This type of breast cancer occurs in approximately 10 - 12% of diagnosed cases. It is an aggressive form of cancer that can have limited treatment options - more on that in a minute.

During this round of diagnosis, it was discovered that my cancer cells were positive for HER2 Proteins. This opens up a wider range of treatment options that what was available before. Because my previous cancer cells did not have any receptors, the treatment needed to be kind of an “all-purpose” - the treatment needed to be broader because there was no specific receptor to latch on to, and this is what I meant earlier by limited treatment options - there were very few treatment options that could be utilized.

Because my cancer type currently leans positive for HER2, it does allow for other treatment options that weren’t available last time. Think about it this way - the cancer cells are getting very specific medicine that is created just for them while leaving other healthy cells alone. This more targeted approach hopefully allows more unaffected cells to remain alive - leading to better outcomes and hopefully fewer overall symptoms. Here is my interpretation of what it looks like:

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That’s the first primary difference between my two journeys and because the cancers have to be treated differently, it drives the difference in the symptoms that I’m experiencing this me around. While I am receiving infusions again, the medications are definitely different. The medication that I’m taking now has to be taken with a sucrose solution, which as a diabetic is concerning. Prior to going through cancer treatment the first time, my diabetes was well managed through diet and exercise and I didn’t need to take any medication. All throughout my last treatment, my blood sugar was continually in flux and because I took a significant amount of steroids, I ended up putting on a fairly significant amount of weight that caused some additional complications. With the amount of steroids that I’m taking and the infusion protocol, managing my diabetes is going to be a bit of a challenge. The good news is that I have the support of my primary care physical also helping me to manage this process.

While worsening diabetes is a big concern, it’s not the only one. My thyroid numbers and liver numbers are also a significant concern. Cancer treatment is by far a full-body experience. It can significantly change your body chemistry, and while it’s not impossible to recover from, it does take a lot of time and management. All of these things have to be closely monitored via blood tests and medication - you know, more doctors and more appointments. These are some of the long-term consequences that I’ll have to keep in mind going forward.

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The last really big area of change actually comes from the symptoms that I’m managing this time around. During my first battle with cancer, my biggest struggles were body aches, joint pain, and generally feeling very tired. I also had a lot of “chemo brain” - I struggled to connect thoughts and became very forgetful in the days after chemo. All of these symptoms I would equate to the worst flu you’ve ever had. Thankfully I had very little nausea, was able to eat relatively okay, and didn’t have much in the way of upset stomach.

This time around, my symptoms are much more like having the world’s worst food poisoning - which in my opinion is worse. I’m struggling with a lot of nausea, upset stomach, heartburn, acid, and that general ick feeling when you eat something that doesn’t agree with you. Because these symptoms are so different than what I dealt with before, the way that I have to manage them is much different. I find that this time I’m taking more over-the-counter medicine to manage some of the day-to-day symptoms. I’m also finding it difficult to eat in the days after chemo, which can make it even more difficult to manage my symptoms.

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As far as lessons I’m applying to my journey this time, here are the top 3:

1. Rest when you can as much as you can - REST is probably one of the top if not the top thing I’m focusing on. It can be difficult to get enough sleep at night, especially when your stomach is really upset or you have a lot of heartburn. In the days after chemo, I try hard not to do much, schedule any intense interactions, or even exert myself beyond necessary activities. Because I struggle to sleep at night, I try to take cat naps when I’m able to keep my energy level up.

2. Plan for the days you feel really sick - Preparation is key for managing your symptoms on your most difficult days. This could include everything from making sure you have snacks ready to make sure that you have enough of your over-the-counter medication ready. Perhaps the biggest lesson that I learned in my cancer journey last time is that food preparation is critical. I opted this time around to do a subscription food delivery service to make it easier for me to meet nutritional requirements and for my caregivers to support me in the easiest way possible.

3. You are going to need help - As a really independent person, this one is perhaps the hardest to accept. The deeper in treatment you get, the more tired, and the less that you'll be able to do. One of the best things that you can do for yourself and for your caregivers would be to outsource what you can. Things like hiring a housekeeper, grocery delivery, and other services like these take so much stress out of your life. And less stress means for focus on healing.

I'm interested to see what other lessons I'll learn this time around and I'm sure that I'll be passing those on to you as well!

Talk again soon!

OLIVIA