Being told the cancer had metastasized to my liver was indeed a big shock.

You don’t need to be a cancer expert to know that cancer spreading is not what anyone wants to hear or be diagnosed with. Finding out the cancer has spread confirms your worst fears, the cancer is aggressive. In the space of two weeks, I went from knowing I have breast cancer to having cancer in my liver, a vital organ.

The initial diagnoses of stage 2 (II) triple negative breast cancer assumed the cancer was isolated. The treatment was not going to be easy as it was going to require chemotherapy, surgery, radiation etc. With how treatment of breast cancer has progressed the success factors are very high. The diagnosis was scary, and I knew it would not be an easy fight, but I felt confident it was a fight we could win, a temporary obstacle. However, cancer in the liver means the fight just got much bigger and harder.

The weekend after finding out the cancer is in my liver we met up with some family and friends for lunch. My cousin asked me what the Dr said the prognosis was, e.g., is it curable, how long will I live etc. It is a normal question for people to ask, but I didn’t know, I hadn’t asked the oncologist. From the day I found out I have cancer I took dying off the table, I truly believe 80% of this battle is attitude and mindset. I was not going to ask the oncologist as I did not want someone putting a timeline or death outcome in my head.

The truth is the oncologist most probably wouldn’t tell me anyway because he wouldn’t really know. If I decline treatment, then yes, they can possibly give me an indication, but if we are going to treat there is no way of knowing how the drugs and my body will react so a prognosis would be a guess.

It is funny though because once someone has asked, my brain couldn’t ignore it. I needed to know and understand more about what I really was facing. So, after some careful, conscious, research from Dr recommended reputable sites I now know the following:

Cancer Stage

Cancer is classified in 4 stages, whilst my breast cancer is classified as stage 2(II) because the cancer has metastasized to my liver it is now classified as stage 4(IV).

The stages of cancer are simply defined as follows:

Stage 1 (I) usually means that a cancer is small and contained within the organ it started in.

Stage 2 (II) usually means that the tumour is larger than in stage 1, but the cancer hasn’t started to spread into the surrounding tissues. Sometimes stage 2 means that cancer cells have spread into lymph nodes close to the tumour.

Stage 3 (II) usually means the cancer is larger. It may have started to spread into surrounding tissues and there are cancer cells in the lymph nodes nearby.

Stage 4 (IV) means the cancer has spread from where it started to another body organ. For example, to the liver or lung. This is also called secondary or metastatic cancer.

For more info on cancer stages see: https://www.macmillan.org.uk/cancer-information-and-support/breast-cancer/staging-and-grading-of-breast-cancer

Secondary Liver Cancer

Treatment for secondary cancer in the liver usually aims to control the cancer for as long as possible and reduce any symptoms. Life expectancy and prognosis for people with liver metastases can be typically poor, as the cancer tends not to be curable.

Treatment

The day after finding out the cancer is in my liver, we were back at the oncologist to discuss joining a trial treatment.  Treatment options for cancer vary, when it was isolated and in the breast, we were going to treat it with TAC chemotherapy also known as “Red Devil” because it is red in colour. The oncology team had already order it and were ready to start but with the cancer having spread Red Devil was not the right chemotherapy approach. The reality is from a treatment choice suddenly the options were limited in fact we only had one choice, a trial treatment.

A cancer clinical trial treatment generally means a trial drug is used along with a standard treatment of care. A clinical trial is a research study to find out if a new treatment provides better outcomes than the existing standard of care — the best available known treatment.

Turns out I have 3 options, I can do nothing (not an option for me personally), I can just have a standard treatment of care which would be a type of chemotherapy and hope for the best, or I could do a trial which would entail an approved, specific chemotherapy (standard treatment of care) with the trial drug added into the treatment.

Regardless of the option I must have chemotherapy, the trial just means I’m adding a drug as well which has the potential to help destroy the cancer.

A trial is a daunting option, for two reasons:

• A trial drug is experimental, there are no guarantees it will work, and the potential side effects are unknown.
• You could get the placebo drug. Every drug trial requires some candidates to get a placebo drug, and some will get the actual drug. This allows the trial company to then compare results of candidates and ascertain if the drug has an impact. 

Participating in a trial however does have some benefits:

• I may be getting a drug that could cure the cancer and help me win this fight
• By participating in this trial, I am being part of a solution, and contributing to the progress in finding future cancer treatments
• The trial sponsors will cover the cost of my treatment, the drugs, the oncologist, blood tests and all scans required during treatment. This allows me to save my medical aid funds for the other treatments I am going to need later.

2^nd opinion

In everything you read and learn about cancer there is always encouragement to get a 2^nd opinion. This is also something a lot of people ask me about. You see there are so many different cancers and, in some cases, different approaches that there surely should be many alternatives or options.

I did reach out to another very reputable South African oncologist, that was referred by a friend, who specialises in Immunotherapy treatments for cancer. After reviewing my scans, diagnosis, and suggested trial treatment they advised the approach of my oncologist is the best and that I’m in the right hands.

Outcome

At the end of the day, we have signed up for the trial treatment and will begin chemotherapy and the trial drug on the 6^th of December 2021.

More than ever I now want the cancer gone, because I can’t help but wonder where it will spread too next. I feel like I have a bug inside of me and it can multiply, move, and spread and I can’t stop it, but hopefully the drugs can.