1st Hair Cut

Saturday, I visited a beautiful new spa that opened in the area for my 1st post chemo hair cut.  I had forgotten how much I truly enjoy getting my hair done.  Before chemo, I was a regular 6-8 weeker and always looked forward to my appointment.  It was not unusual for me to tell my stylist to do whatever she wanted or make a drastic change and chop off my long locks.  My most recent drastic change (aside from complete hair loss) was early in my pregnancy when I donated my hair to Locks of Love and went the shortest I had ever been.  That was a fun visit to the salon.  Since my hair was very thick and curly, the pixie cuts were a fun change and so much easier to maintain.  I was definitely excited for my 1st post chemo cut, and I had the added bonus of enjoying the brand new spa.  It was like being on a resort.  It's truly a beautiful facility.  I highly recomend checking it out if you live in the area.  I can't wait to check out other spa services in the near future at Spa On The Boulevard.

The stylist was great and recommended a few things that will help my hair to grow out.  We talked about style and color.....................................so fun to have these options again.  I will say this "new" curly hair is totally different than the big bouncing curls I had before.  My "new" curls are tight and tight some more.  I know over time they should loosen up some and may change completly.

We discussed my plans to donate my locks once they are 8-10 inches long again and buzz it all off.  This is something I definitely want to do as a reminder to myself and others that your hair is not so important in the grand scheme of life.  It will be a great awareness reminder for me ,so I never forget what other individuals are going though during treatments.  For me, my hair was another accessory.  I was always changing the color, length, straight, curly, etc.  Now that I have gone without it, I will do it again as a reminder to myself what's truly important in life and keep things in perspective.

I thought I would share some of the hair styles I have had over the years.

7-2007

6-2008

8-2009 (on our honeymoon)

10-2010

12-2010 (My God Daughter, and check out my cleavage)

7-2011 (6 Months Prego)

3-2012 (a few weeks before chemo)

7-2012 (With my younger sister)

9-2012 (Last day of chemo)

10-2012 (With my soul sister Erin O)

11-2012

1-2013 (After 1st hair cut)

From the back - Curlicues

       

Research Studies (Metformin and Longitudinal Database)

I have been asked to participate in two research studies being done at Hopkins.

1. Phase III - Randomized Trial of Metformin vs Placebo on Recurrence and Survival of Early Stage Breast Cancer - I stopped this study in April 2013 after I continued to lose weight and was unable to maintain a normal level.  I will no longer be participating in this study.  

This study will help determine whether Metformin can decrease, or affect, the ability of breast cancer cells to grow and whether this drug will work with Tamoxifen to keep cancer from recurring.  Metformin is currently being used to treat diabetes.  This study will help determine if it is better to receive Metformin with usual treatments of breast cancer.  Half the participants in this study will receive Metformin in addition to other treatments, while the other half will receive a placebo.  Previous studies of Metformin have shown that it may decrease the growth of different types of cancer cells.  Meformin lowers the level of insulin, a hormone found in the blood that can be associated with worse breast cancer outcomes.  In addition to taking Metformin, blood samples are also taken at specified times during the study.  This is a double-blind study, meaning that neither myself or my doctors will know if I am taking Metformin or a placebo.

• Common side effects (likely)
• Diarrhea
• Nausea
• Vomiting
• Abdominal bloating
• Gas
• Loss of appetite
• Less likely
• Loss of taste or metallic tastes
• Minorweight loss
• Reduced appetite
• Rarely
• Rash, redness, or itchiness
• Decrease of B12
• Anemia
• Inflammation of the liver

I will start taking either the Metformin or the placebo on 1/11 when I start taking Tamoxifen.

      2. Breast Cancer Program Hormone Therapy Longitudinal Database

This study is being done to learn more about the side effects of breast cancer hormone therapy and if a person's genetic information may help to develop a way to predict the side effects a patient may have and how best to treat them.  It will also help the researchers to look at how the side effects of hormone therapy influences a participants willingness to continue hormonal treatments.

I will be filling out questionnaires periodically that will ask spesific questions about how I am feeling, if I am taking the medication regularly, and any changes to my medication list.  I completed a base line and will fill out one at 3, 6 and 12 months.  This is all computerized, so I will be able to see what has changed and it will highlight things that are out of range.  My oncologist and myself will have access to the results, and they can be used to facilitate conversation about any issues I am having.

Tamoxifen 101

Some types of breast cancer need estrogen in order to grow.  These cancers have receptors, or sites, to where estrogen attaches, promoting cancer growth.  These are known as estrogen receptor-positive cancers.  Tamoxifen blocks the estrogen from binding to these receptors, preventing the breast cancer from growing.  For women with estrogen receptor-positive breast cancer (like mine), taking Tamoxifen for 5 years greatly reduces the rick of recurrence and the risk of dying from breast cancer.  Tamoxifen can reduce the chance of getting breast cancer by nearly 50% in women who are at higher risk.

Like with all medicines, this one comes with a long list of potential side effects.  Below are some of them.  

• Common
• Hot flashes (whats new - my special friend for the past 6 months)
• Vaginal dryness or discharge
• Mild nausea
• Weight gain/loss
• Bone pain
• Dizziness
• Less Common
• Risk of blood clot in the lungs or the major veins of the legs
• Uterine cancer
• Eye problems

There was a recent study that 10 years of tamoxifen is better then 5 years.  study-ten-years-of-tamoxifen-better-than-five.  I discussed this with my oncologist who said that the recommendation to continue for an additional 5 years will be on a case-by-case basis.  For me it's really too early to say how long I will be taking this.  The possibility of having my ovaries removed in the next 5 years would change the duration, since I would replace Tamoxifen with a different (post menopause) hormone therapy.

Most of the women I have talked to about Tamoxifen all say they hate it.  Hopefully, my side effects will be minimal.

I will be starting this on 1/11/13.

Radiation - 100%

I have finished 28 rounds of radiation.  I had my last treatment 12/28 and was able to ring in the new year with 100% of my treatments behind me.  Aside from the inconvenience of daily radiation, I did great and my skin even held up well.  Dr. A was a little disappointed I did not have more of a skin reaction to the radiation.  But, she didn't suggest more treatments, which was great news.  Aside from a slight irritation and what looks and feels like a sunburn, I have not had any major issues.  I expected to experience fatigue, but it has not been bad.  Compared to the extreme fatigue I experienced with chemo, I was able to take this in stride.

We can now move on to filling the expanders, which I took a break from during radiation.  Today I received my first fill of 25 cc's in the right (300 cc's total), and 50 cc's in the left.  The left had been completely deflated prior to starting radiation.  It still has a ways to go before it will match the right side, but she wanted to go easy this time around.  Next week she will fill the left all the way back up.  Because my skin held up so well, it looks like we will be able to continue filling the right.  This is great news since radiation can cause tightening of the skin that would not allow for additional fills.  I have some muscle tightening under my armpit and try and do lots of arm stretches during the day to keep the muscles limber.  This also helps keep the muscle behind the expanders from getting tight, which can cause reconstruction complications.   

Next steps - Continue with the fills and start Tamoxifen

My fills ended shortly after this post and, unfortunately, we were only able to do very minimal filling of the expander for the radiated side.  Looks like a small size B is what we will get.  The surgeon did ask if I was ok if she has to go smaller once we get to surgery, so we will see how things pan out in June.