So, I've rewritten this update like 3 times because it's kind of boring, but somehow I feel like you'll manage to slog through it. I guess sometimes cancer is just boring.

Time for the end of cycle update. I don't have too much to say about this cycle, so maybe somehow I'll manage to refrain from turning this into a novel. But, before we get into a discussion about chemo, I have two pieces of important news.

1) Both my medical oncologist and my surgical oncologist agree that my cancer has gone down a stage. While clinical staging studies can't be completed until after my surgery, at diagnosis I was somewhere in the Stage III range (there are 3 types of stage 3, and I was either B or C). Now, both doctors think I'm Stage II. The 5 year survival rate for people with Stage IIIC breast cancer is 54%. It's 86% for people with Stage II breast cancer. So, IN YOUR FACE, DEATH!

2) I finally got a cancer puppy! Don and I have been talking about getting a second dog since we decided to move to State College, but neither of us had the time to invest in a new dog. However, since I'm spending a lot more time at home and we have 3 people on deck, we decided the time was right. Also, the cancer card may have been played. At any rate, our puppy is a black lab/golden retriever mix named Beulah, and I'm completely head over heels in love.

So, chemo news. Much like last cycle, the overt side effects, such as mouth and nose sores, have been pretty mild. I've still been having some nosebleeds, but they haven't been too bad. I did get a pretty awesome gusher in the first meeting of my Neuroscience and Memory class, but it stopped pretty quickly, leaving a giant bloodstain on my pants as the only reminder. I also got to say, "Sorry to inconvenience you by getting cancer," which brightened my day.

However, less obvious side effects, like fatigue, have been worse. At my chemo appointment, I managed to convince my oncologist to prescribe low dose ritalin, as it's been shown to help with chemo brain and fatigue in some small sample studies. (Note: I feel my doctors both love and hate having a patient that reads the scientific literature.) I figured it might help, and if it didn't I could make a quick buck selling it to undergrads (this is a joke). It's actually been fairly effective, so I won't be able to buy that timeshare in Colombia quite yet.

One of the weird things about chemo is that it kind of changes assumptions I've had about the way my body functions. This has been particularly evident with the fatigue. For example, I've always been a terrible napper. Usually, I can't fall asleep during the day, and if I do, I can only sleep for 20 minutes or so. I also am typically incapable of sleeping in, so regardless of when I go to bed, I nearly always wake up around 7:30. However, since I started chemo, I'll lie down for a nap, thinking I'll get up in half an hour, and wake up 2 to 3 hours later. Also, for the first time in my life, I've been oversleeping. This sort of thing has been happening with food as well. Chemo increases your metabolic rate, but it changes over the course of the cycle. It also changes the hunger signals. As an adult, I've pretty much always had the same "food budget" (i.e., the number of calories I can eat to maintain my weight), and now I'm never quite sure how to manage my food intake. It's an odd feeling to have all of these changes, and I feel like I need to watch some of those "My body is changing" videos from middle school health class.

Speaking of body changes, I met with the surgical oncologist, and we've decided to go with a bilateral radical mastectomy. It's going to be radical! I'll probably have surgery in late December or early January, followed by 10 more chemo cycles (I only get these b/c of the clinical trial) that will run concurrent with radiation. Then I get another reconstruction surgery (most likely) and later a revision surgery (also most likely). After that, it's 5 to 7 years of hormone therapy and then I'm done!

Okay, I'm off to the hospital for my infusion. I get different drugs this time, so it will be a new adventure. Yay!