Intro + Neoadjuvant or Adjuvant Chemo?

Hi everyone, thought I'd just take a sec to give an update on our situation - it's always good to hear how people are going, so here we go!

We're now just over halfway done with neoadjuvant chemo, having completed all of the AC rounds and 5 out of 12 Paclitaxel rounds. The AC was definitely tougher than the Taxols with more notable side effects like constipation, heartburn a little nausea and obviously hair loss, but Rebecca made it through that OK and is now being treated much less harshly by the Taxols with, so far, no signs of neuropathy or any damage to nails, skin etc.

We had an ultrasound last Monday to check on the response to the chemo and met with our surgical team on Wednesday to discuss the results. I'm very happy to report that Rebecca's primary tumour has shrunk by more than half and the lymph node that was cancerous now shows "normal morphology", i.e., the cancer appears to be gone. This is obviously great news since it now means a much better chance of full recovery with a minor lymph node excision, rather than a full axillary dissection and a lumpectomy instead of a mastectomy, which is where we thought we were heading before we started treatment. In addition, all of the genetic panels have come back negative, so everyone is absolutely stoked. We've now got a surgery date booked in early December and are hoping to have a nice Christmas with radiation done and dusted by mid-February.

I can't thank everyone here enough for all the support we've had, both publicly and privately. We know we're going to get a great outcome and having good people to lean on has played a big part in our success and positive mindset so far. 

If anyone's interested, there are a couple of things we've done which may or may not have helped including:

1. Exercise. Exercise. Exercise - We've been doing daily walks and physio-based training almost every day for the last few months. Sometimes only a short walk of 2-3KMs, but have regularly done 5-7KM walks, sometimes only a day or two after treatment. Obviously your mileage will vary depending on how you're feeling, but I can't emphasise enough just how much of a difference this has made.

2. Diet - Healthy eating and LOTS of fluids - water, fresh juices etc, all go a LONG way to helping the body stay hydrated and able to cope. Lots of salads, veggies and protein (chicken, fish, lentils etc) have helped - we've also cut right down on red meat and processed meats like sausages and bacon 😢 There has been some challenges with loss of taste, especially during the AC rounds, but we adjusted our meal plans to accommodate for that by introducing more flavourful meals.

3. Sleep - Despite the premeds and steroids, our treatment days have been long, with multiple hour commutes to the hospital, so by the time we get back it's not hard to fall asleep. We've aimed for a minimum of 6 hours, but try for at least 8 a night and, for the most part, seem to be managing.

4. Supplements - We've avoided all supplements (as well as things like caffeine, aka coffee, tea, coke etc), except for Vitamin D which gets taken every night, along with some magnesium after a blood test recently showed a bit of a drop there (subsequent tests have been good, so we'll probably stop those once they're finished). Pantoprazole has been a life saver for preventing reflux and heartburn and gets taken almost daily as well, but other than that, given the good blood results we get every week, the nutrition seems to be keeping up.

5. Documentation - We write everything down, from consult notes to treatment timings etc plus a daily log of vitals like fluid intake, temps, meals, side effects etc. None of it has really been required, but it's good to see any patterns emerging before they become an issue. A good example of that was how we noticed Rebecca's skin was getting more itchy over certain days and that helped us manage things with applying more regular moisturising etc.

6. Advocacy - Always speak up in your consults. We've realised that the Public System, as amazing as it is, is massively under staffed and under resourced, so we've had to often act as our own best advocates in asking questions, pushing for scans, discussing side effects etc. There's been a few times where if we hadn't spoken up the doctors would have missed something like a blood test number or similar. It doesn't take much time and if your notes etc are on point you will often be more organised than your consultant.

7. Gadgets, pills and potions - We've tried not to go too crazy with random Internet tips, but some of the things that have worked are definitely soft toothbrushes, regular mouthwashing with a gentle mouthwash, nail strengthener, moisturizer and sunscreen plus just general hygiene tips like weekly bathroom cleans and bedding changes. We've also been using ice gloves and booties during the Paclitaxels (much to the amusement of the great staff in Oncology!) - we're not sure if it's doing anything, but it can't hurt to try and so far, so good!

I hope that helps someone out there - when we started this journey, our biggest fear was the unknown and now that we're getting on with it, hopefully we can be a little beacon of hope for others who might be struggling as well. We're obviously nowhere near done, and recognise the road ahead is still going to be pretty arduous, but we know now that a positive mindset, good moral support and a great medical team can definitely help carry you a long way.

Hope you all have a great week - I'll definitely be back with another update soon.

Take care ❤️

George