From
the moment that Belinda Phillips felt a tiny lump in her breast three months
ago, she has been through two diagnostic mammograms, one ultrasound-guided
biopsy, two MRIs, one MRI-guided biopsy, two surgeries, three hurricanes,
numerous office visits with six physicians and is now beginning a cycle of
chemotherapy.On Aug. 20, Dr. Michael Fabian performed a lumpectomy -- which removes a small amount of breast tissue -- and sentinel node biopsy.
The plan was to follow surgery with five to seven weeks of radiation therapy. But, that plan had to change. Lab work determined that cancer had spread to Phillips' sentinel node. This means another surgery, followed by chemotherapy and then radiation therapy, in addition to hormonal therapy.
"I think that was the point at which I felt the saddest," Phillips says. "Because I thought that I didn't have disease in my lymph nodes. I had to get a grip on that."
On Sept. 8, Fabian surgically removed more of the cancer and more lymph nodes for evaluation. Later results showed the cancer had not spread to additional nodes.
Fabian also inserted a port into Phillips' chest wall. The port allows her to receive intravenous chemotherapy drugs more easily and safely. While Phillips is anxious about the future, she is relieved that the surgeries did not result in removal of her breast.
"The cosmetic effect is still good. It still matches my other breast," Phillips says, adding that she is pleased to avoid reconstructive surgery.
At the beginning of October, Phillips was nervous about beginning chemotherapy, but entirely satisfied she was receiving the best treatment possible.
She consulted with Dr. Richard Weiss, who placed her on a four-dose cycle of Adriamycin and Cytoxan, drugs that she will take once every three weeks.
"The goal is to get through those in good health," Phillips says.
Weiss explains that there are several types of chemotherapy drugs available for breast cancer patients, and that each has a different toxicity -- the more toxic a drug, the more disruptive it is to the body, but its strength also kills more cancer cells.
"Stronger chemo regimens have better results, but with greater toxicity. Therefore, you have to find a regimen right for each patient," Weiss says.
Chemo drugs work by killing cancer cells that are dividing rapidly, but also kill healthy cells, which causes the frustrating side effects of treatment.
Adriamycin can cause nausea, hair loss, susceptibility to infection, mouth sores and taste change, along with a general feeling of tiredness and fatigue. Weiss says that Phillips' treatment is not an easy one. While chemotherapy may save Phillips' life, getting through it takes fortitude.
"It's profoundly disruptive," Weiss says.
Chemotherapy is a frightening prospect for new cancer patients. Female breast cancer patients face the daunting possibility of losing their breast and their hair -- two parts of the body that we often identify with femininity.
Weiss says that while chemotherapy is difficult and distressing, about 99 percent of his patients complete it.
"There are two great fears," Weiss says. "The greatest fear is that the cancer will come back and they'll die of the disease. The other fear is being fatigued, overwhelmed, hairless and unable to cope."
Phillips interjects that nausea and vomiting are her greatest immediate concerns, but that she will vigilantly stick to her treatment plan.
"I want to do what I can to stay alive as long as I can," Phillips says.
Weiss has prescribed several drugs to combat Phillips' possible side effects and allow her to continue working as education coordinator of Radiologic Technology Education at Halifax Medical Center.
Her work has remained important to her throughout her diagnosis and treatment. She teaches students in the field of oncology.
"I always thought I had an idea of what patients went through, but it's not even close to what I thought," Phillips says.
Phillips believes that work gives her something to focus on, besides her condition. She knows that working during treatment may be challenging.
Weiss says some patients have few effects from the drugs and others suffer more, but he stresses there are ways that he can help patients deal with their symptoms.
"Belinda wants to work, so she gets Neulasta to cause her to make white blood cells and keep her immune system up," Weiss says.
Neulasta helps the body fight infection. It costs about $2,500 per dose. Phillips will likely receive four doses of the drug -- one for each chemotherapy cycle. Health insurance will cover much of her drug treatments.
In addition, Phillips will take Kytril, Decadron and Compazine to combat nausea. Prior to her first chemo treatment, she received Ativan to reduce anxiety. To deal with hair loss, Phillips has selected five wigs in various shades and styles.
It's Oct. 7 -- 85 days after Phillips found a lump -- Dianne Gamble, registered nurse, talks with her while they sit in a moderately secluded corner of the oncology center.
Gamble advises Phillips to take her temperature twice a day, and contact the oncology center immediately if it rises above 100.5 degrees. She also encourages Phillips to add protein to her diet. Beside the women, a syringe of vibrant red liquid rests on a tray. Gamble says Adriamycin is also known as "the red devil."
Phillips remains calm as Gamble inserts the syringe into a catheter that allows the drug to enter her body through her chest port. The procedure takes about 10 minutes, and Gamble chats with her patient while the drug begins its trip through Phillips' body.
Another patient snores from behind a curtain. Midway through, Phillips' eyes look slightly glassy and she says that her head feels funny, but she is not uncomfortable.
Gamble finishes and then advises Phillips and her husband, Denny, who has been there all along, that the Cytoxan would take about two hours to drip into Phillips' system intravenously. After Gamble leaves, Denny pulls his wife's chair from the wall so she can recline and relax. He remarks that his wife always looks good, even when undergoing cancer treatment.
Throughout her diagnosis and now her treatment, Phillips has been grateful for her husband, Denny, and what she considers "superlative medical resources" in Volusia County.
"I want to make sure that people who are afraid know that there are so many resources," Phillips says. "I've tried to utilize those resources."
Several days later, Phillips says she did not fare too badly in the days after her first treatment.
She had experienced some bone and joint pain, as expected. She is having trouble eating, but takes solace in pop-sicles and Italian ice. She is, of course, back at work.
Phillips accepts her cancer and its tedious treatment as an opportunity to teach others about the disease, and focuses on getting herself well.
"I was so concerned with being sicker than a dog, that I let that make me crazy," Phillips says. "In the end, they do so many things to keep you from being sick. It's just my learning what I need to do for me, to make my symptoms better. I am really thankful."
Look for future updates on Belinda's progress as she moves through various treatment regimens in her battle against breast cancer.