Monday, November 14, 2022

Breast Cancer Fight: Adjuvant Chemotherapy and Herceptin Injections After Mastectomy


Every time I go to the National University Cancer Institute, Singapore {NCIS} to meet Dr Samuel, it is always so terribly crowded.

My appointment with him on Mon 14 Nov 2022 was at 3pm, so I registered via the OneNUHS app around 2pm, and we arrived there at 2.45pm. Lil Pumpkin came with us this time as she had her science enrichment class in the evening and we wanted to send her to class after my appointment. 

I did my heart-rate and blood pressure screening, then waited until 3.40pm to see Dr Samuel. While waiting, 2 students/ research assistants?? approached me to take part in their respective surveys or research studies on cancer. 

Is this because NUH is a teaching hospital? I had already taken part in a breast cancer research study previously when one of Dr Mikael's students approached me last time and even gave my blood, but these 2 students/ research assistants were not related at all to my doctors, but seemed to already know my name and background of my case... hmmm, I wonder if this will happen frequently whenever I'm at NCIS or the Breast Care Centre.  


My meeting with Dr Samuel gave a clearer view on the follow-up treatment after my mastectomy and breast reconstruction surgeries.

Basically, based on the Surgical Pathology Report, I have Stage 1A left breast cancer. My mastectomy surgery was a success {part 1 and part 2} and since my sentinel lymph node biopsy showed no spread of the cancer, I am currently considered cured and there is no need for radiotherapy

However, as the largest cancerous tumour was more than 1cm {1.7cm to be exact}, and I have HER2+ and ER- {so not positive for hormone receptors making hormone therapy ineffective} grade 3 breast cancer, the cancer is considered aggressive and I need to undergo adjuvant chemotherapy and herceptin injections to lower the chance of the cancer returning, and to improve the outcome of first-line treatment i.e. my mastectomy. 

The total length for this post-surgery part of my treatment is about 1 year. 

Adjuvant chemotherapy is when you get chemo after the primary treatment, usually surgery. Sometimes cancer cells can be left behind after surgery. It’s also possible that cancer cells may be circulating in the bloodstream or lymphatic system so the traveling cancer cells don’t show up on imaging tests. Without follow-up treatment, they can find their way to distant organs to form new tumors. 

Since I have early stage cancer, Dr Samuel planned for me to undergo chemotherapy for 3 months, instead of a longer regimen. 

I will do a TC Regimen, which consists of two drugs - Docetaxel and Cyclophosphamide. This will be given intravenously once every 3 weeks, for 4 cycles. Dr Samuel said each session may take around 4-5 hours, including time to use a cooling cap to help reduce chemotherapy-related hair loss. 

Charlene actually went through the chemo same treatment for her breast cancer {but her surgery and breast reconstruction procedures were different}, and she said her first session took 7 hours! Goodness.. subsequently, it took around 5-6 hours zzzzz The boy said I should bring an iPad to pass the time, but Charlene also said the drugs made her sleepy so can nap haha.. 

Before each chemo cycle, I've to do a hormone shot to make my ovaries "sleep" as the chemo may cause premature menopause, and screen my blood and heart to make sure that I'm fit enough for the chemotheraphy cycle. A day after the session, I have to take a blood booster to help boost my immune system as it will be drastically compromised during chemo. Dr Samuel said the boy can help to administer this at home. 

Other side effects of chemotherapy include allergy, fatigue, increased risk of bruising or bleeding, nausea or vomiting, bladder inflammation, mouth ulcers, body aches or joint pain, numbness or tingling in the hands/ feet etc. 

Oh well. We gotta do what we gotta do. 

Concurrent with my TC regimen chemotherapy, I have to take a Herceptin jab every 3 weeks for 18 rounds. This treatment course is known as “AC➝TH”. 

Herceptin is a HER2 inhibitor targeted therapy. It works against HER2+ breast cancers by blocking the ability of the cancer cells to receive chemical signals that tell the cells to grow.

It may cause severe problems with the heart, lung problems and low white blood cell counts. Other common side effects are nausea or vomiting, headaches, shortness of breath, fatigue, rash, muscle pain, diarrhea, fever etc.     

My oh my. The second part of my treatment sounds really dreadful and makes my surgery experience seem like a breeze?!! I mean... apart from the trauma of losing a body part (ToT)

Really praying for strength and positivity to overcome the next year... please pray for me too.


As I still have my drainage tube zzzz, I've to check with Dr Jane on Wed 16 Nov 2022 if my wounds would have healed in time for my chemotherapy to start on Mon 5 Dec 2022. 

I can only start chemotherapy if my wounds have completely healed, and I clear my heart and blood tests. 

Dr Samuel 3rd visit: S$99.51

*****

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Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries
Surgical Drains Removal After Mastectomy and Breast Reconstruction 
 

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