Scans #3 on Enhertu

As most of you are aware, the treatment for Stage IV Metastatic Breast Cancer (MBC) doesn’t end while we are still alive (with a few notable exceptions that we hope will become the rule). To determine whether treatment is working, those of us living with MBC undergo scans in various intervals (usually 3, 6, or 12 months) and if we are able to ignore or look away from cancer on a daily basis, it pulls us right back when we prep for and undergo scans. I started my current line, either number 7 or 9 depending on how lines are calculated, in March of 2024 and November 8th was the third set of scans.

I’ve settled into a routine for the quarterly scans that includes bloodwork specifically for the Signatera testing, a PET/CT, and a brain MRI. This time, the brain MRI came back within about a hour but we had to wait until Sunday for the results of the PET/CT. Based on the reports, it appears that Enhertu is still doing it’s job, that Covid has left me with lung scarring that may be ongoing, and it is possible that my port will need at least some TLC and at worst, to be replaced. Just to show you how MBC changes our reactions, my first thought was not about how I might need yet another surgery, but that I may be able to get a power port, having limped along with a non-power port since 2017.

This is third PET in a row since starting Enhertu and they’ve all been good. They’ve all demonstrated that the cancer in my body is responding correctly to this 7th (or 9th) line of treatment. All of the other tests, tumor markers and signatera, etc., agree, the amount of cancer in my body is nearly undetectable to all the testing. For the third time in 7 years, I am approaching No Evidence of Active Disease (NEAD).

And I should be elated. Ecstatic. Over the moon.

The happy, thankful, elated feelings are there. It’s just that there are so many other complicated feelings just alongside the good ones. Because even though my news is good, there are so many others who aren’t getting the same news. Even some on the same medication as I am. And I’m also feeling some intense feelings since the election, not just about our present but also about what we may be facing in the future.

This ambivalence, the contradictory feelings alongside each other, is not a brand new experience; at the same time, it feels more extreme the longer I live with MBC. Some of the lows are more intense and there are more instances where the stakes feel like life or death. Coping mechanisms and therapy and medication and all the things help; at the same time, no amount of self care can take away that I live with a terminal diagnosis and experience the decline and death of so many dear friends.

So that’s where I’m at today, and so many days, thankful for medication that is working, doctors who care about my well being (even if the system does not) and my dear family and friends, and also still aware of what is and what may be coming. It can be exhausting and it can be overwhelming and we’re still living our best life in the midst of suffering and terror. It’s not easy but always worth the effort.