the short and long of it

To say I've learned a lot about cancer (in general and breast cancer specifically), treatment options, etc, in the past 1-2 months would be... an understatement. I've been surprised by a lot of the information I've learned. One of those surprises is that I had this idea that, ok, cancer sucks, and going through chemo and surgery sucks, but if you catch it early then you just you fight it, beat it, and move on, right?

Well, yes and no. I've been surprised by the many much longer term affects that will stay with me for a long time. An obvious one, of course, will be losing one or both of my breasts. Once I get through active treatment (my 3-4 months of chemo, surgery, plus probably continued chemo/targeted therapy infusions of some sort for several months after that), then I'll go on hormone therapy for 5-10 years after that, launching me into early menopause and all the fun things that come along with that. Breast cancer surgery often involves removing some number of lymph nodes, which depending on how many will put me at risk for lymphedema in my arm and hand for years afterwards.

Also, most cancers, if they're going to recur, usually do so within the first five years, which is why 5 year survival stats and disease-free anniversaries are such a big thing. But ER/PR+ and HER2+ cancers like mine can also recur later, even 10-20 years in the future. It will be a much longer timeline before I'd be considered "in the clear" (if ever).

Now, it may turn out that none or few of these things even affect me. The usual recurrence and survival statistics are outdated because many of them were collected before many of the newer drugs and targeted therapies became common (Herceptin and Perjeta are, apparently, quite the wonder drug for her2+ cancers and has dramatically improved outcomes. One review I found showed that recurrence rates without targeted therapies for HER2+ cancers were 30-50% in the first 10 years, and with them it goes down to 25% or lower depending on different factors). I feel pretty confident about my odds of going through treatment and emerging cancer-free at the end of them. That said, while recurrence rates are relatively low, they're still a bit high for comfort. It's hard not to feel like I'll spend the next few decades looking over my shoulder waiting to see if it will come back.

I'm grateful that we caught this early. I have a lot of reasons to feel hopeful and optimistic. And yet, it's a bitter pill to swallow to accept that not only is breast cancer turning my life upside down for the next 6-12 months, but that there's also a list of ways that it will stay with me for years and decades to come.