The Lusk family will be one person bigger!

Hello Family & Friends:

Sorry for not updating you sooner...we've been a bit busy around the house and have had a couple visitors! My mom came out for a couple wks to spend some time with us & help out with Maryn - what a big help she was!!! My best friend from Boise, Heather, also came to visit for a little under a wk, and we had a really nice time - got a little shopping done for the holidays (and for us!), and had a bit of mommy relaxation time up in Napa Valley as well. Jeff's parents will be also coming to stay with us as I begin my first round of chemo, and will stay for a couple wks to help out.

I have some big news to share with everyone...we have been keeping it fairly quiet until now, but I'm pregnant! The surgeon called us a couple days before the mastectomy to let me know that my blood work came back positive, and by best guess I was JUST pregnant. We were amazed, especially since we had a bit of a tough time conceiving Maryn, and weren't going to start trying again until Maryn turns 1 in January. It was a bit scary at first, but after a lot of research on our part, as well as the doctors', it appears that everything will be just fine. I will continue with my chemo treatment as planned, and the regimen my Oncologist (and the Tumor Board) have chosen is completely safe in pregnancy...the risks are pre-term labor and low birth weight. Since Maryn was only 4 lbs 5 oz when she was born (unexplained low birth weight), the Maternal Fetal Specialist (MFM) & OB will be following the growth throughout the pregnancy to ensure everything is on track with this baby. The doctors would like to see me get to as late in the term as possible, looking at 38-40 wks for delivery.

The pregnancy is the best news we've received throughout all of this. Our biggest concern upon finding out the diagnosis was whether or not I would be able to have children anymore. I was worried that I would be sterile as a result of the chemo, and was looking into possibly doing an egg retrieval and trying to freeze embryos prior to starting chemo (upwards of $12k!!). Come to find out, we didn't need to look much further! What a blessing. We found a MFM in New Jersey (Cooper Univ) who specializes in cancer patients who are pregnant and undergoing chemo, and she has joined our team of doctors...she is the #1 specialist in the US, and has been recommended by the Stanford Breast Cancer Center. She told me that being pregnant throughout my chemo may actually prevent me from becoming sterile, since my ovaries are in a "hibernation" mode throughout the pregnancy and will be much less affected by the chemo. So not only do we get to have another baby (yippee!), but this little miracle may save my ability for more children in the future if we chose to have another. I am currently 12 1/2 wks pregnant, and we had an ultrasound on Wed to look at risks for birth defects - so far, so good! The next big ultrasound is Jan 2nd, and that's when we hopefully will find out if Maryn is having a little brother or sister, who, by the way, is due on June 5th.

The other news is that the chemo start date is moved back a little over a week, so I will now be starting on Dec 6th. The dosage has changed slightly as well - I will be on a 28-day cycle for a total of 6 rounds (6 months). I will take one of the meds (Cytoxin) orally for 14 days, and will go in for IV bags of the two other drugs (Adriamyacin & 5FU) on days 1 & 8. This type of cycle should reduce the overall side effects of the chemo, although it sounds as though I will likely lose my hair within a couple wks of starting the meds. With the current chemo sked, it would bring me to 39 wks of pregnancy. From everything I've read so far, doctors don't recommend chemo administration past 35wks, so the mom has time to rebound prior to delivery. Since it's still pretty far down the road, we'll talk about that when we get closer. I should then find out if I'll do a catch-up round of the CAF regimen, whether or not I'll also need 8-12 wks of Taxol, etc.

SO, that's the news from our household. Lots going on!!! I've been pretty tired, but who knows if that's caused by the pregnancy, Maryn (who still wakes up 1 to 3 times/night...ugh!), or life itself. Maryn took her first steps (last wk) and Jeff and I are celebrating our 3rd anniversary this week.

I also wanted to thank everybody for the amazing support you've given so far. I feel so fortunate to have such amazing family and friends as I continue my journey to recovery. With all of you behind me, this isn't difficult to go through.

Happy Holidays!!!
Leanne (Jeff & Maryn)

October 24, 2006: Post-Surgical Update

Family & Friends,

I have to apologize for the late update - things have been a bit crazy in the last week around the house, and I've started going back to work on the days that I don't have doctor's appts. I have been very bad at replying to emails, so you'll have to forgive me if I haven't personally replied to you yet.

We finally got some good news from the Tumor Board last week. It looks like they are not recommending that I go in for a second surgery right now, and that the positive lymph nodes will be treated through chemo & localized radiation (of the chest & axilla).

Right now, the plan is that I will start chemo around Nov 27th and will do a regimen called CAF for 18 wks (every 3 wks x 6). Once that has has concluded (approx March), they will give me a break. There is some discussion about whether or not I will have Taxol for an additional 12 wks after the CAF, and that remains undecided at this point. Once the chemo has concluded, I will have 8 wks of daily radiation (during weekdays only), and will start another drug called Herceptin every 3 wks through my VAP (port in my chest) for another full year. Herceptin is considered the biggest break-through in cancer research and because my tumors are Her-2 positive, I can have the medication...it reduces recurrence levels by over 50%! My tumors are also Estrogen/Progesterone receptor positive, so I will likely take Tamoxifen for 5 yrs once the chemo has concluded to prevent recurrence. From what I understand so far, the Herceptin and Tamoxifen don't have the std chemo reactions, so I'll be able to go back to normal life after the chemo/radiation are over.

On a side note from the Tumor Board mtg - the Pathologist let Jeff & I go in to look at all of my slides under the microscope and spent over an hr explaining what they look for, how the cells looked different, and how they identify the different hormone & Her-2 receptors. It was fascinating!! I really feel confident about my doctors and believe that they are doing everything they possibly can to give us the best medical attn available. My Oncologist has been speaking with specialists from Stanford (she just moved out to the East Bay from the Breast Center at Stanford) as well as Cooper Univ in NJ. The Tumor Board was also a conglomerate of many Oncologists, Pathologists, Surgeons, etc who are part of the John Muir Medical Center system...having all of those heads together on my case is amazing to say the least.

Over the next 5 wks, I will be undergoing genetic counseling to find out if I carry the genes for breast/ovarian cancer (BRCA1/BRCA2)...if I do, then I will likely have a preventative left mastectomy and have my ovaries removed since there is a large correlation between genetic breast cancer & ovarian cancer, and monitoring the ovaries for cancer is not down to a science yet. The removal of the ovaries will put me into menopause (if the chemo doesn't already do it), so there will be concerns about my bone density and a much higher risk of osteoporosis in the future. I am also going in for a baseline echo-cardiogram, and will be continuing these every 3 months to ensure there aren't any dangerous changes in my heart...heart problems are one of the side effects of the meds I will have to take, so the docs will be following me closely.

I saw my surgeon yesterday, and she says the scar is healing wonderfully and that I have great mobility in my right arm (not at it's full potential, but better than her normal post-menopausal patients....I attribute that to picking up Maryn, who is almost 19 lbs now!!). I'm feeling good overall - a bit tired still, and I find that I really hit an exhaustion period in the afternoons, especially with Maryn waking 1-5x/night (lovely teething & colds in our house). My mom came in this past Sat, and has been a huge help around the house and with Maryn. Jeff seems to be doing well, and is accompanying me to all the appts to ensure we get the same info out of the discussions. He has been incredible through all of this!

Thank you so much for all of your support!!

With love,
Leanne