Let The Games Begin

...and may the odds be ever in our favor

When we last left our heroine, she was pleading for the umpteenth (ok, third) round of Prayers For The Pit. Happily we can report that the lymph node biopsy came back NEGATIVE which is gloriously positive! Our intrepid protagonist thanks you all heartily for your pit prayers which were surely filled with the fragrance of Christ,¹ and now she will not only leave the armpit jokes behind but also the third-person because she is not the Queen/Consort of England and thus the pretense is obnoxious.

I have approximately 1200 updates for you, and also I’m so tired that I just woke from from a 2-hour nap and might take another, so let’s dive in!

I.² Biopsy negative.

A.³ Pit clear from cancer. HALLELUJAH!!! Never thought I’d be this excited about a stage II diagnosis; clinging to those survival stats like an Olympic medal right now.

B. You have to have a B if you have an A. So let’s just shout out again that I am 100% certain your prayers made a huge difference in this. Too many wild stories to tell right now about the Spirit at work in all this, but suffice it to say, it’s hair-raising what you all are up to. Keeping all these things and pondering them in my heart…

II. Mayo Clinic.

A. The magic kingdom. Where to begin to describe it? We stumbled upon a Rodin statue tucked in the basement. Also a hallway of four Chihuly sculptures. The whole place looks like old Hollywood money married cutting-edge technology and they had a baby in Rochester, MN. We took stupid pictures like this everywhere.

Great vibes for a day of discussing the demise of my breasts

Mayo does this cool Multi-Disciplinary Approach Whose Acronym I Forgot, but basically all the docs get together and discuss your case and then decide collectively what the treatment should be. Then you spend all day meeting with each specialist while kind nurses bring you snacks between endless appointments. You cannot remember everything so they give you 1,000 brochures and you watch 100 videos and at the end of the day you feel bewildered but somehow smarter.

The best part of Mayo was not the regal Elizabethan pose we struck every time we walked down what I dubbed the Royal Staircase (although many strangers laughed). It was that the smart docs ALL AGREED that the clinical trial I’m doing—which they also offer at Mayo—is 100% the right path. Whenever Mayo stamps 100% on anything,⁴ you praise the Lord and then donate a million bucks (I’m guessing, judging by the art?) but since I don’t have a cool mill I will simply praise the Lord. Huge relief to know we are taking the right step.

B.⁵ The Mayo Elite also offered me a seductive selection of surgical options that enticed me to consider doing my fantastically fun double mastectomy there whilst I seek the rest of my treatment elsewhere.⁶ They contacted the clinical trial big-wigs to confirm this since it’s not standard operating procedure, and the official big-wigs gave two thumbs up. This felt like very cool backroom politics.

C. Mayo also has a high-tech radiation option that I won’t even attempt to explain but it’s a proton beam vs a photon beam (or maybe the other way around). But I’m not worrying about radiation now. That crazy sunburn comes way later.

III. The Clinical Trial

A. I am firmly in the Kate Bowler camp as a lifelong member of the “don’t come at me with your toxic positivity” BUT I would like to thank the Good Lord for making me fall in love with a boy from Minnesota instead of…anyone else at Notre Dame, because look at me landing in a state with two national cancer centers and one is only 30 minutes from my door. Belated thanks to our guardian angels for shoving us toward each other That One Epic Night at the Linebacker Lounge, because here we be.

B. The clinical trial I’m doing is 15 years old and has established the current standard of care for breast cancer treatment. Which is incredibly cool. Right now it’s in its second stage, which is using targeted drugs to shrink the tumor before surgery in the hopes of avoiding or lessening chemo. What I have learned in the past month about the future of cancer treatment and immunotherapy replacing chemo and even surgery is nothing short of miraculous.⁷ So everything I learned about this trial made me confident to jump on board even before Mayo's seal of approval. For those as curious as me, it's an adaptive randomized trial which means they combined the genetic blueprint of my tumor along with the current responses of other patients to various drug combos in order to place me into a particular arm of the trial.

B. More good news! I got randomized into the drug option I really wanted, the combo that includes immunotherapy with the targeted drugs. When the research nurse called to tell me, she was elated because she just had a patient have a pathological complete response (medical talk for no more cancer) from this drug combo. I am so relieved and grateful that I get this extra boost.

C. Infusions will start tomorrow. Side effects are nasty and much the same as chemo (including lots of GI fun and hair loss, sigh) but all are short-term and reversible. I’ll get an infusion every 3 weeks for 12 weeks. They’ll do the first MRI after 3 weeks and the target is for the tumor to have shrunk by 35%. No, that’s not a typo. THIRTY-FIVE PERCENT IN THREE WEEKS is the goal. See the future of cancer treatment blowing our collective minds?! Best-case scenario, these drugs could annihilate my cancer completely before surgery. (Though I still have to have surgery.) Skipping chemo would be a huge boost for someone as *young* as me because the long-term side effects are no joke on the rest of my organs/systems.⁸

C. MORE GOOD NEWS!! Bloodwork and yet another fun ultrasound from last week showed no cancer in my ovaries. So even though they still have to get removed, they aren’t actively trying to kill me.⁹

IV. Prayer Time

A. In thanksgiving for my amazing parents who came to stay with us for 2 weeks to help with the kids while we went back and forth to Club Mayo.

B. For everyone who loves or loathes Mother’s Day, that this new week might dawn brighter and gentler.¹⁰

C. For this potent drug combo to kick the snot out of my tumor.

1. If there are any petitions left over, I’d love for not-the-worst side effects if the Divine Mercy Incarnate is into that icing on the cancer-fighting cake?¹¹

2. But mostly I'd rather pray to reach that blue-ribbon prize of 35% reduction in tumor size in 3 weeks. LET'S GO!!!

Much love,
Laura

Final fawning Mayo shoutout: any nursing station that quotes Tobias Wolff gets 10/10 stars from me. Highly recommend/would repeat.

1. Unsure if the Fragrance of Christ Ministries still exist in Flint, MI, but growing up I used to puzzle mightily over what went on inside that building. Potions? Perfumes? You do have to hand it to Paul when he attempts a good metaphor: “For we are the aroma of Christ to God among those who are being saved and among those who are perishing; to the one a fragrance from death to death, to the other a fragrance from life to life” (2 Cor 2:15-16).

2. I wanted to make this a numbered list, but I’m enjoying the ridiculousness of the footnotes and don’t want overkill. So I’m resorting to Mrs. Sharp’s Infamous Whale Notes technique learned in the 8th grade at St. Robert Bellarmine Catholic School. Guarantee a handful of you are also still excellent note-takers because of that deep dive into the ocean depths.

3. Really bugs me that I can’t indent the capital letters per Whale Note outlining protocol.

4. The other obnoxious stamp of approval Mayo gave was “Your Cancer Is Really Terrible!” judging by each doctor’s winces whenever we talked about triple negative breast cancer. One oncologist jovially declared, “You drew the worst hand!” which is dire but also made me laugh. So if this could please gently stop everyone from sending me their stories about their sainted moms and grandmas who easily beat breast cancer, it would limit the times per week I have to grit my teeth and say THANKS BUT MINE IS TRIPLE NEGATIVE which makes anyone who knows flinch. I do welcome any positive triple-negative stories though! Which sounds like an oxymoron but isn’t!

5. Did you forget we were footnoting? I bet you did.

6. Modesty forbids sharing the hilarious conversations we had with nurses and surgeons re reconstruction options, but I did tell one doc, “I don’t need to go Dolly Parton but I could definitely go back to college perkiness?” and he chortled so I think game on.

7. Gonna quote my brilliant physician college-roommate here: “The human immune system is nothing short of proof of God’s existence.”

8. Will be writing a whole newsletter someday about how delightful and ironic it is to go from “geriatric pregnancies” to “young breast cancer patient.” Can you hear my eyes rolling?

9. My bar for body parts is basement low these days.

10. Also for my kids who collectively added the trifecta of bodily fluids to my Mother’s Day at 11:00 pm last night. Weirdest part was that as I was cleaning up vomit and pulling wet pajamas off a toddler, I actually thought: Please let me stay here and do more of this. I know this is a crazy prayer, but please let me stay, even for this.

11. Having spent a conservative estimate of 30-40 months (!) of my life actively sick from hyperemesis during pregnancy, I am reaaaaaaally not looking forward to jumping back on the Zofran bandwagon. IYKYK. But given the alternative, I’ll take the side effects!