I have breast cancer. Surprise! Also, I haven’t blogged regularly in **checks notes** over six years. All it took was a good, solid tumor, but I’m back, baby!

There is so much to say about having breast cancer, and when you’re as long winded as I am but also going to near daily doctors’ appointments, there’s basically no time to say it. I hope that will change. In the interim, I would like to share some FAQs that I wrote previously for my closest friends and some family members. Because when you get diagnosed with cancer, people want to know a lot of things about it. Which is fine by me! My life is an open book with a few pages stuck together! But also, I live at the hospital now, so it’s much easier if I just answer your questions in one fell swoop.

Ed’s note: Some of these answers are slightly different from what I originally wrote either because of new information or to make them more understandable for a wider audience.

What exactly is going on?

I was recently diagnosed with triple negative breast cancer (TNBC) three days after my 38 birthday! Triple negative means the cancer is not powered by estrogen or progesterone (weirdly, that is not good news) or the HER-2 protein (that is good news). It appears to have been caught early (good news) and does not appear to have spread to my lymph nodes or beyond (good news), though it is grade 3, which means it is the most aggressive kind (not good news). The tumor is 4.3 x 3.1 x 7.8 cm, which makes it kind of a honkin’ big tumor (big news? overachiever news?).

Where are you being treated?

Since my cancer seems pretty straight-forward right now, I see no need to run off to MD Anderson in the middle of a pandemic. My very cool medical team, who we’ll dub the Boob Brigade, is located at Thompson Cancer Center at Fort Sanders in Knoxville. The Fort, as the area is known locally, is where we all partied when we were in college at UT, so my life is coming full circle.Included in the Boob Brigade is longtime friend and overall good human being Sarah, who just happens to also live next door to me. She is an oncology NP and will be involved in my chemo treatments and keeping an eye on me. If you expect to get cancer, I highly recommend making sure you are friends with an oncology professional or two first.

What’s the treatment plan?

TNBC basically has one standard treatment plan, which is to blast it with three kinds of chemo drugs to try to shrink it as much as possible and then remove what’s left through surgery, possibly following up with radiation to clean up any little bits that are left in hopes of it never returning. The first two chemo drugs come during an intense eight-week stretch that will start as quickly as we can get our ducks in a row, and then the third drug comes over the following 12 weeks, which means I’ll be chemo’ing through the end of the year and maybe into early 2021 with surgery in Jan. or Feb. if all goes as planned. There is a potential for a fourth chemo drug to be paired with the third, but no decision has been made on that yet.

Whether I have a lumpectomy or some form of a single or bilateral mastectomy will be determined after additional tests and we get a sense of how the tumor responds to the chemo. Radiation depends on a number things, including type of surgery and ongoing scan results.

Fun fact: One of the chemo drugs is nicknamed the Red Devil, which just happens to have been the mascot of my rival high school!

What’s the prognosis?

Pretty darn good. Neither an ultrasound nor an MRI found evidence that the cancer has spread beyond my boob, which is about the best news you can learn when you have cancer. We will check again with a CT scan and come surgery time to be sure.

TNBC is known to respond well to neoadjuvant chemo (ie, pre-surgery chemo), and two of my doctors have used the word “curable” in my presence. I’m not thinking much about what the prognosis is if scans turn up things we don’t already know about. You can consult Dr. Google if you really want an idea, but he’s not a member of my Boob Brigade, so I honestly don’t care what he thinks.

What about the pandemic?

Yep, it’s still going on. The upside is the pandemic has kept me from making life plans, so cancer isn’t ruining any life plans. The downside is that it would be very, very, very, very bad if I caught The Corona now. I will not be allowed to have visitors with me during chemo treatments (but I’m gaming the system by having Sarah on the inside). If my surgery were to happen today, The Modern Husband would be allowed to be there. Unfortunately, COVID cases in Knoxville are spiking, and the UT students will be returning to town in a couple weeks which does not bode well for the situation here. If things are out of control in January, there’s a chance I’d be going it alone in surgery.

I know you’re already doing these things, but WEAR YOUR MASK AND SOCIALLY DISTANCE YOURSELVES FROM OTHERS so that Robert will have to suffer through my surgery as payback for me suffering through multiple surgeries of his. (That’s a joke, I promise. But please wear a mask.)

How did you find out?

On a trail run in mid-June I felt a sharp pain in my right boob while running downhill — bad enough that I was uncomfortable even as I walked the rest of my route. You could say things kept going downhill. I felt around after I got home and noticed something that felt neither soft nor normal and called my primary care doctor a few days later. She ordered a mammogram and ultrasound, which lead to a biopsy on the day after my birthday (happy birthday to me!), and now here we are. I have been told many times that it is unusual for breast tumors to present with pain — usually pain means it’s a nonthreatening cyst — so I am extremely grateful for the pain, even though it has persisted and is DRIVING ME CRAZY. Ladies, in case you do not already hear this enough: FEEL YOUR BOOBS UP REGULARLY! You may not be as fortunate as I to have a tumor knock so loudly at your door.

How could this happen?

Friends, I think we know by now anything can happen in the Year of Our Lord, 2020. I do not have a direct family history of breast cancer. I had every cancer gene that is testable tested, and they all came back negative for mutations. I exercise regularly, believe in God and eat very little processed food, though I do regularly consume Aspartame. I blame neither God nor gluten nor my unyielding devotion to those little blue and pink packets of fake sugar for my cancer and am not entertaining any other potential explanations beyond cancer is random and 2020 is ruthless. I ask that you follow suit.

How are you doing?

Mostly OK. There were a lot of tears in the first week and more than a few out-of-body feelings after. (Do you know how a port works? It is WILD, and I do NOT recommend having a surgeon explain it to you!) I’ve gotten amazing support from my people, not the least from The Modern Husband, who, of course, has his own roller coaster of emotions to ride in this. I’ve talked extensively with several friends who sadly have walked this path already — including someone my own age who received the exact same diagnosis just seven months ago — and have a wealth of information on what to expect and how to cope with what’s to come. My manager and team at work are incredibly supportive too, so while I will work as much as possible during treatment, I have the space to step away as needed. It’s a shitty hand to be dealt overall, but I feel like I have a cheat card and few trumps to play.

How can I help?

I can obviously use your prayers if you’re into that sort of thing and your good wishes and petitions of the universe if you are not. Jokes, memes and puns are accepted. Otherwise, just please wear a mask and practice social distancing and encourage others to do the same. And check your boobs!