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Stage three thyroid cancer

My thyroid cancer was found quite by accident. I was having lung symptoms so my rheumatologist thought that I might be having problems with the methotrexate. She ordered a chest CT scan. It turned out that I wasn’t having lung problems I was having a different problem.  I had a mass growing on my thyroid.

This was my first cancer and I was in total denial that I might possibly have cancer. My patient doctor explained that the next step was a biopsy. I put the procedure off as long as I could. I was a working woman and I needed to work. Finally, the day arrived. In the x-ray department I was given a local anesthetic. Guided by ultrasound and a long needle, my doctor captured a number of samples from my thyroid. When the results came back, it was definitely cancer. It turned out to be stage three papillary carcinoma. It is not an overly aggressive cancer and it  is slow growing. Lucky me.

My thyroid labs had always been normal. There was no large mass to demand attention. The cancer had been growing slowly over a long period of time. The cancer  was also in my lymph glands. I would need surgery and then I would need radiation which is a story unto itself.

My endocrinologist said I would need an excellent surgeon. The surgery is delicate in two ways. The four parathyroid glands are in close proximity behind the thyroid gland. The surgeon must be careful not to remove or damage these glands when performing thyroid surgery. The parathyroid glands control the vital process of calcium metabolism. I was kept overnight to be sure there had been no damage to the parathyroids.

Also, the recurrent laryngeal nerves can be damaged during the surgery. The result of damage causes difficulty speaking. Yes, a skilled surgeon is a must for thyroid surgery. Fortunately, I had one.

I survived. My scar is barely noticeable. I will need to take a thyroid pill for the rest of my life as my body can no long make its own.

A week after the surgery I had a repeat follow up chest scan. Two things happened. First, the technician used an iodine dye as a contrast medium. It was contraindicated in a post op thyroidectomy patient. It was missed. Bottom line was my radiation treatment was postponed for six months.

The second thing that happed was bad news. This scan found another cancer. This time it was breast cancer.

Breast cancer complications

I have survived three cancers, rheumatoid arthritis and a hip replacement.  I expected that I would eventually have another cancer. The disease seemed to be written in my stars. However, I wasn’t expecting another complication from my breast cancer treatment.

My first complication was a rare uterine cancer called uterine papillary serous cancer. It is a side effect of being on tamoxifen.  This cancer is aggressive and behaves similarly to ovarian cancer in that it is aggressive and can be deadly. It is never caught early. I was fortunate because it was picked up by my rheumatologist on a lower back MRI. So, I spent the entire 2018 with a biopsy, then major robotic surgery, followed by a summer of chemo, finished off with vaginal radiation for the holidays.

My complication was a breast abscess formed in necrotic fat tissue as a result of radiation for breast cancer.

Any surgery or radiation will cause scarring in the healthy tissue. I had a hard lump in my breast after surgery and radiation. I understood it to be scar tissue and I learned to live with it.

The softness of our breasts comes from fat tissue. It is this tissue that formed the scarring from radiation. Cancer doesn’t like radiation but neither does healthy breast tissue.  It was this scarred tissue that became necrotic or dead. Fat necrosis is a  long term complication from breast cancer radiation treatment. The necrotic tissue in my breast became abscessed. Breast abscess due to fat necrosis due to breast cancer radiation. Sounds awful.

My breast cancer surgeon recognized it instantly for what it was. I was sent to a wound care clinic. The nurses were also familiar with the condition. They said my breast looked more like a bad leg wound. It was a half inch lesion. They poked around inside (didn’t hurt). Much of the tissue was necrotic and also calcified.

I was given a prescription for Santyl which is an ointment that debrides the dead tissue. It dissolves the dead tissue to clean it out. It cost me $95. The going price is $250. The alternative is another surgery much like a mastectomy. I hope this works.

Mary Mann Cancer Journal

Fireplace, quail block and cancer

November 8, 2019

Cancer Journal

A grey fog has settled over the city. I can’t see the mountains. I can only see the neighborhood. The temperature is supposed to hit the sixties here in Albuquerque, but I doubt it. We need the sun to warm us up. Winter seems to have hit us suddenly. We turned from green to dull winter brown almost overnight. The quail block outside my bedroom window has been very busy. Lots of birds. Fat quail families making their regular visits. The squirrels have left the old tomato plant and are happily munching the quail block with the birds. I haven’t seen the chipmunks lately. Life in the backyard.

I enjoy winter here in Albuquerque. I enjoy my fireplace. Yesterday I had my afternoon coffee in a comfortable chair by the fire. I read another chapter or two from my current library book on my kindle. I am reading Ken Follett’s Pillars of the Earth. It is a seven hundred page book. The story draws you in and you feel the need to know what happens next. I keep reading. I have renewed this book once already and probably will need to do it again.

The lesion on my breast cancer scar  is stable. I have an ointment for it, and I am taking an antibiotic for the three organisms growing on it. I visit the wound clinic in a few days. It should be an easy fix.

It has taken me a long time to recover from last year’s cancer treatment. Last year at this time I was receiving another radiation treatment for another part of my body. It was a follow up to a summer of chemotherapy. Glad I have the year’s recovery under my belt.  I am stronger. I am doing a ten minute yoga routine every morning. It is good to have the energy for it and it is good to feel my muscles work.

Mary Mann Cancer Journal

Cancer Complications Never go away

Cancer Journal update

November 5, 2019

I had forsaken this website as I felt my cancer was in the past. I now understand that cancer is never really in the past. This month is the six year anniversary of my breast cancer diagnosis. It is also the one year anniversary for vaginal radiation of my uterine cancer. I spent most of last year being treated for uterine papillary serous carcinoma. It is a rare, aggressive cancer similar to ovarian cancer in behavior. It is caused by the breast cancer drug, Tamoxifen.

I have spent most of the year recovering from major robotic surgery, chemotherapy and radiation. I am stronger. My mind is back to its former self. I am so happy and relieved.

Now I have an open wound over my breast cancer scar tissue. My new breast cancer surgeon says that after being exposed to radiation, breast fat (what we feel as our breast) becomes necrotic and that damaged tissue breaks the skin looking for an out. I now have a half inch lesion. The lesion tested positive for three organisms. I have no idea where they came from. I am on an antibiotic and start the wound clinic next week.

Since cancer issues remain on my mind, I thought it would be wise to dust off and open up my cancer website. Its time to clean the site up and turn it into something useful.

Uterine papillary serous cancer 2018

I became suspicious that there was more to my D&C and biopsy than I was expecting. My GYN Doc called me in to her office a week early to discuss my biopsy results. It was also her day for surgery.  She came up from the OR suite just to talk to me. Bad signs.

I like her. She is a petite woman of Asian heritage. Friendly. Personable. Professional. She quickly arrived carrying pictures she had taken during the D&C and a copy of the pathology report. She handed it to me. I read serous cancer. Reconfirmed. No doubt about it. She said she wasn’t familiar with this type of cancer, but I suspect she was playing the discussion forward to the next doctor. I have an appointment with an experienced GYN oncology surgeon on Monday.

Uterine papillary serous cancer, UPSC for short, is also called uterine serous cancer and uterine serous adenocarcinoma. Docs and Google will understand if you just say serous cancer. It is a rare subset of endometrial cancer. It is relentlessly aggressive and accounts for a high number of endometrial cancer deaths. It is in the same class of seriousness as ovarian cancer. The treatment is brutal, and the cancer is still relentless. Scared the Dickens out of me.

Once the treatment process starts, it will change my life forever. I will lose much of the progress I have made after my hip replacement. I will be sick. I will have no energy and no hair. After a comprehensive surgery, chemotherapy is next. Radiation may be added. The cancer keeps coming back and as long as chemo can be an option, it is repeated.

The five-year survival rate is 27% when other types of endometrial cancers are eliminated from the statistics. Not good.

Serous cancer was separated out from endometrial cancer about 20 years ago. I have a GYN nurse friend who never heard of it. She stopped working about 25 years ago.

This week-end I am working in my yard, my favorite. Like many other cancer patients, I am also starting to clear the decks and to plan for treatment. My son says he will miss my cooking but will be happy to take on the duties he had when I had my hip replacement problems. He will take me to my appointment Monday.

With past cancers, I was told, “You are lucky we caught it early”. I wish that is what I heard this time. Just like everyone else, I will do what I need to do. The medical community requires that a cancer patient have a good attitude. To do otherwise is like being unpatriotic. I think that places an additional burden on a patient. I’ve seen too many incredibly optimistic cancer patients die. I sometimes think that it is a symptom of cancer mortality. I don’t want to be too optimistic. I just want to live to 95.

 

Look Good Feel Better

There is one good thing about chemotherapy. It is the Look Good Feel Better program. Fun. A time to share. Like Christmas. It is a two-hour appointment with a cosmetologist in a small group of women who have cancer.

I had participated in a program five years ago when I was in radiation treatment for breast cancer. That appointment was at MD Anderson on Indian School near Kaseman. This session was at the Rust Cancer Center and was equally as good as the one five years ago. We are each given a cosmetic bag full of cosmetics that matches our skin tones. The bags come sealed and ready for us. At our places we each have a mirror and cosmetic wipes.

Opening the bag is like Christmas. My bag had Chanel powder, lipstick and blush. Clinique foundation, Estee Lauder face cream and eye makeup, IT brow powder and a set of brushes, body lotion and sun screen. Pure joy.

Our instructor walks us through the steps of taking care of our face during cancer treatment. She used me to demonstrate for our group. I was not well. My energy level was non-existent. Yet, I looked forward to this and enjoyed every minute.

I came home with a cosmetic bag full of expensive goodies and a big smile on my face. I’m still bald. I’m still weak. But I had a good moment. A happy moment that will repeat itself every time I use any of the cosmetics in my cosmetic bag full of goodies.

The Look Good Feel Better program started 30 years ago. A doctor asked the president of the Personal Care Products Council how he would arrange to have a makeover for a cancer patient who refused to come out of her room because she felt she look horrible. Cosmetics and a cosmetologist transformed her look and her outlook.

With such profound results, the idea was presented to the Personal Care Products Council membership, the nation’s cosmetic industry leaders, who immediately offered funding and cosmetics. The American Cancer Society joined the effort as did the Professional Beauty Association. Today Look Good Feel Better is offered in every state in the union including the District of Columbia and Puerto Rico.

The program is offered once a month at the Rust Cancer Center and it is offered at most cancer centers in Albuquerque. It is well worth the time and energy to go.

 

 

I am officially Cancer Girl New Mexico

As I was recovering from my hip replacement, my RA doc thought it might be time to try the biologic Actemra. It worked for me before hip issue. It was time to do it again. But, she said, first we needed to check out the change in my uterus that was noted on my hip MRI.

She ordered an ultrasound of my uterus that included a vaginal probe (didn’t know they could do it.) Actually, she handed me the probe and told me to put it in. I did it.

Results showed a thickened uterus consistent with tamoxifen use. It also showed a mass.

Next stop was the GYN doc who thought it was a polyp not cancer since there was no bleeding.

Next stop was outpatient surgery of a D&C and biopsy. She was optimistic.

The results weren’t good. It is sometimes called Uterine Serous carcinoma, or uterine papillary serous carcinoma (UPSC), or serous adenocarcinoma. It is easily googled just writing serous cancer.My doc said she didn’t know much about this cancer. She referred me to a GYN oncology surgeon who I saw in three days. In the meantime, I googled it. And it scared me,

Serous cancer is a rare, subset of endometrial cancer that is aggressive and carries a poor prognosis. It is erratic in its behavior similar to that of ovarian cancer.

I am in the lose hair stage of carboplatin/taxol first infusion. Not as bad as I thought it would be,

So here I am, back in the world of cancer. I was expecting it, but not expecting it. Hope I can be of some use to my fellow cancer travelers.