Breast Cancer Month: A Jamaican Lesbian’s survival story …………….

(WARNING – some photos contained may be unsettling)

On the evening of October 19, 2011 at the Couture Oasis’s Open Mic Open Soul Wednesday night discussions series we were asked to invoke the presence of a Jamaican same gender loving breast cancer survivor who from the moment she opened her presentation had all wondering if she was really going through this struggle and complications with this awful disease. The picture of doom and gloom mixed with uncertainty and doubt as often marketed with cancer victims of all sorts was clearly missing from this vibrant soul. Her resilience had audience members in awe and deep appreciation and other stories from the transfixed persons came flying out as well at some points leaving many in the small air conditioned room teary eyed.

“Judy” as I shall call her for purposes of this post is in her late twenties or early thirties from as early as 2010 said she started to notice strange things happening with her right breast and especially at or around the nipple. There were leakages at some points with what appeared to be water and blood as the residue from it and this she thought was maybe she had scratched her nipple area. After seeing this for some time she decided to have a check up done but doing the tests including a mammogram nothing was found , she had repeated tests over time but still there was neither any lumps or any blots on her X-Ray results to indicate there was trouble or via self examination the few times she attempted them. It was not until a new doctor she consulted went further than just the breast itself and focused also by her underarm to her lymph-nodes and realised that her nodes had overgrown onto her breast tissue, it was then she was finally diagnosed on November 26, 2010 after repeated calls from the doctor’s office up to her due checkup date that she had Breast carcinoma, For solid tumors, stages I-IV are actually defined in terms of a more detailed staging system called the “TNM” system.

N classifies the amount of regional lymph node involvement. It is important to understand that only the lymph nodes draining the area of the primary tumor are considered in this classification. Involvement of distant lymph nodes is considered to be metastatic disease. The definition of just which lymph nodes are regional depends on the type of cancer. N0 means no lymph node involvement while N4 means extensive involvement. In general more extensive involvement means some combination of more nodes involved, greater enlargement of the involved nodes, and more distant (But still regional) node involvement. M: Metastasis M is either M0 if there are no metastases or M1 if there are metastases.

As with the other system, the exact definitions for T and N are different for each different kind of cancer. As you can see, the TNM system is more precise than the I through IV system and certainly has a lot more categories. The two systems are actually related. The I through IV groupings are actually defined using the TNM system. For example, stage II non-small cell lung cancer means a T1 or T2 primary tumor with N1 lymph node involvement, and no metastases (M0).  She was kind to provide me with some photos of the courses of treatment she underwent. (photos published with permission)

short time after surgery and stitching

 Herceptin treatment course

day 1 of draining

 day 2 of draining to remove excess liquid around the area

She took it in strides much to the surprise of her family, close friends and then partner while they in turn had great difficulty emotionally in dealing with the news, many were surprised how she was calm and in control which in the long run made the road to recovery easier for all in knowledge of her illness and drew on her strength. Her mother and father in particular were deeply affected by the news according to her. Surgery was the next move and in preparation for that she dove into attending as much entertainment gigs as possible just weeks before going under the knife then came the faithful day of December 9, 2010 where she underwent her single mastectomy and a new set of problems presented themselves almost from the get go post the breast removal, the LMA – Laryngeal mask airway was apparently absent during the session so she was not fully drained the remaining tissue area where the breast was before leaving the hospital, as in most surgeries of this nature there is the issue of liquid gathering around the area where the tissues were and she had to make repetitive visits to do the drainage procedures with some side effects such as numbness, pain from where the needles were implanted and some lethargy but the nurses and medical team again expressed surprise and some elation at how she took it, she was even considered as a model patient to others who were also doing their own courses of treatment. In April 1, 2011 she commenced chemotherapy as of course one of the first things to go was her hair but one wouldn’t recognize that it was the fault of cancer or chemo but more just her natural style. Her personality superceeds all other underlined issues  thus helping her to cope. At this point economic factors to navigate the sessions presented themselves as she required 17 injected doses of a particular treatment known as Herceptin HER2 test to determine if your cancer is HER2-positive before taking Herceptin, as benefit has only been shown in patients whose tumors are HER2-positive and there was some concern about other side effects such as the hardening of her veins and repetitive phlebotomy exercises leaving her skin marked and difficult to find new areas to puncture. Worsening of low white blood cell counts to serious and life-threatening levels and associated fever were higher in patients taking Herceptin in combination with chemotherapy when compared with those who received chemotherapy alone. The likelihood that a patient will die from infection was similar among patients who received Herceptin and those who did not.  Herceptin treatment can also result in heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure). The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline). Because she was diagnosed with a form of Metastatic Breast Cancer here are some quick facts about the drug/treatment/side effects.

Metastatic Breast Cancer

Herceptin has 2 approved uses in metastatic breast cancer:

• Herceptin in combination with the chemotherapy drug Taxol^® (paclitaxel) is approved for the first line treatment of Human Epidermal growth factor Receptor 2-positive (HER2+) metastatic breast cancer
• Herceptin alone is approved for the treatment of HER2+ breast cancer in patients who have received one or more chemotherapy courses for metastatic disease

Taxol is a registered trademark of Bristol-Myers Squibb Company.

Some Infusion Reactions include

• Some patients have had serious infusion reactions and lung problems; infusion reactions leading to death have been reported
• Symptoms usually happen during or within 24 hours of taking Herceptin
• Your infusion should be temporarily stopped if you experience shortness of breath or very low blood pressure
• Your doctor should monitor you until these symptoms completely go away
• Your doctor may have you completely stop Herceptin treatment if you have:
  • A severe allergic reaction
  • Swelling
  • Lung problems
  • Swelling of the lungs
  • Severe shortness of breath
• Infusion reaction symptoms consist of:

• Fever and chills
• Nausea
• Vomiting
• Pain (in some cases at tumor sites)
• Headache

• Dizziness
• Shortness of breath
• Very low blood pressure
• Rash
• Lack of energy and strength

One other issue she faced was her own constant movements during some of her sessions as this can auger negatively for any patient and can lead to punctured or damaged skin that may itch or get infected if not properly monitored. She now does her Herceptin treatment every three weeks and has subsidized the costs through insurance and other state healthcare benefits under the National Health Fund and some help from Jamaica Reach to Recovery. Treatment can run in the millions literally locally as her initial run was budgeted for over $2M. Her type of cancer as you may have gleaned is rare as her family history does not have many persons who have or had the disease, she was alone on this front. Four other members of the audience expressed their own stories of losing loved ones and are presently under pain from some sort of cancer, but mostly that of the breast, clearly there are issues of closure for some persons with cancer of any sort. Judy’s case however is a testament to survival and proof that strong will and determination can help to overcome the odds, her sister who was present in the discussion paid testament to that as she said she sometimes draws strength from Judy even though it is Judy who is ailing and she still wonders how does she do it?. Applause rang from the audience and commendations as to how she dealt with the whole ordeal and for openly sharing the information the audience ended the session which was followed by the floor opened to poetry.

God Bless Judy.

Peace and tolerance

H