Where to begin? Trigger warning: I'm depressed and jaded

Can you contact an NCI cancer center near you? I called their intake line, they gave me directions to send over all my test results, and then they called me to schedule me with the oncologist they thought was appropriate. For me it was starting with surgical oncologist, but with triple positive they may want you to start with medical oncologist.

It sounds like you've been through a LOT and seen too much. It can be hard to shift focus to yourself after so many years of caregiving.

I think everyone handles things differently. Your friend that was in denial - that was her way of handling it. It's painful for us to watch, but by definition it was the best choice for her. You're going to handle it your own way. I will say that I think it's worth listening to input from doctors, including second opinions if you you don't 'gel' with the first provider. The power always remains with you and you can step off the treatment train whenever you want.

Another advantage of an NCI center is that they may have a psychiatrist on staff too. I also have treated depression and it's been super helpful to me to have the care from someone with deep knowledge and experience of cancer and its impact on both pharmacology and mental state.

I'm so sorry you are going through this, especially at such a young age. The beginning is the absolute worst part of this journey. I think most would agree. My best advice is to get treated at a major university teaching hospital. IMO is that a MRI would be the next step so you know exactly what you are dealing with. I also agree that being triple positive gives you more treatment options. Remember to address your history of depression in your treatment plan. Try to find others that have been in your situation like Newfromny. They can relate specifically to your diagnosis. Best of luck to you. Please keep us posted.

You can do this. You'll find strength you didn't realize you have. Also, YOU control which treatments you agree to. This is a great place to get educated so you can make informed choices.

The MRI was the next logical step for me after the mammo, ultrasound, and biopsy. So that's okay. It's smart to do it to ensure that there is nothing else going on, and then plan your treatment accordingly. For what it's worth, I'd never been sick or had surgery, or spent any time in a hospital (other than 36 hours to give birth). So this terrified me because everything is new and scary. It's okay. If I did it, you can. The breast MRI was terrifying to me because I'm claustrophobic. But you know what? It actually wasn't so bad. You're on your stomach, which helps tremendously. It'll be okay.

I'm sorry you're here, I'm sorry I'm here, I'm sorry we all have to be here. But we're here for you.

Hi HeartShapedBox,

I was diagnosed at 41 with a 6cm tumor by ultrasound, which on MRI turned out to be a 3.3cm tumor, but was multifocal (I had three or four satelite tumors and a "area of non-mass enhancement") and surrounded by "fibrotic tissue", which I guess threw the radiologist off. I was also triple positive (eventually, it's a long story) and had spread to multiple lymph nodes, and you will want to see a medical oncologist first to get chemo before surgery. If you have a good response to chemo, they may be able to do a lumpectomy instead of a mastectomy and/or a sentinel lymph node biopsy instead of a full axillary node dissection. Unfortunately in my case the chemo didn't downgrade my surgery at all, but what cancer was left was small, much less dense, and low grade cancer cells.

I will say that the treatment wasn't NEARLY as difficult as I thought it would be, physically anyway. Mentally it was a long, hard road. I'm not a very emotional or dramatic person, but I was basically a zombie at work the whole way through chemo - just mentally not there - even though I did manage to get my work done. Like you, I'm a very independent person and not used to people taking care of me. But no worries there because my husband just played video games through the whole thing, lol. I was still able to do things for myself through all the treatments and worked through a lot of it. I probably could have worked through more of it but I had leave available so I took it. I think for most of us, depression isn't a huge issue during treatment because you're in fight or flight mode and trying to get through, not to mention you get tons of drugs, lol. After treatment or between treatments is when people seem to get really down.

You should join us on the triple positive thread. Those women have been really good support for me through all of this.

Oh, and I concur that you should go to an NCI cancer center, and if that's not possible, go to a university teaching hospital. It makes things much less stressful to have all your providers under one umbrella and able to easily communicate with one another.

I'm so sorry you are going through this! Chemo is a really important tool in the cancer fighting toolbox for a lot of us. I was terrified of it, but I did it, and though it was only a year ago, it feels like it was in the distant past. A lot of things that feel impossible at the beginning of the cancer road turn out to be very possible. Good luck getting news and making decisions. It's hard stuff!

HSB: I had six rounds of chemo + herceptin and perjeta before surgery (referred to as "TCHP") and eleven more rounds of just herceptin after surgery. That is all standard of care for triple positive. Because I was young, had so much cancer at dx, and still had three positive nodes, I was recommended for comprehensive radiation (breast, chest wall, lymph nodes). After radiation, I started on hormone therapy, which is also standard of care for triple positive. Today, I started Nerlynx, which is sometimes recommended to women with residual cancer after TCHP. Nerlynx is pills.

It is my personal opinion that fear of chemo is totally overblown. I know there are people who have bad reactions to chemo, but they are rare. For me, and for most women on my chemo thread, it was not like you see in the movies where folks are shuffling around on the verge of death the whole time. I would say that I felt mildly crappy for the first week after my infusions, not quite right for the second week, and fine the third week. I was functional almost the whole time. I started getting tired and easily winded toward the end, but worked and worked out throughout. I was given ativan up front for anxiety and persistent nausea but only took it once because it totally knocked me out. Other people have a better reaction to the ativan. Hiking and trail running were my drugs of choice for the anxiety. The six weeks after BMX where I couldn't work out were really tough on me. I think doing well on chemo is really dependent on getting exercise and maintaining good nutrition, and both of those are going to be dependent on managing any nausea, vomiting, diarrhea, or constipation that comes along. You will get a feel for how the infusions affect you after your first infusion. Take note of when/if you get any of these issues and how you resolve them. Then for the rest of your infusions, be proactive about managing the side effects; take the anti-emetics before you feel nauseous, take the immodium before you get diarrhea, etc. Also, join the monthly thread for people starting chemo. The women on this board, in the Triple Positive thread and in my monthly chemo thread, were more helpful than the oncology nurses for managing my side effects. They also made me feel better whenever I got rare side effects; the chemo nurses may have never heard of such a thing, but someone here has experienced it, which will make you feel a lot better. I was always worried that every side effect, especially the ones that I wasn't told about, were a sign of imminent death. But knowing other people had them and didn't die from it made me a lot more relaxed, lol!

Also, I will give you this last bit of advice: if you're feeling overwhelmed by the idea of going to six rounds of chemo, just make a deal with yourself to go to the first round. If it's horrible, you can just not go back. I told myself before every round that I just had to go to this one round, and if after that I thought I couldn't take any more, I could just not go back. I made it through all my rounds, with no delays or decrease in dosages. Just put one foot in front of the other until you get through this mess.

hello sweetie let me share my story I was 42yrs old when found lump we were planning our 2nd marriages at the time my true Love in my life and now this. I don't want to die is what I told him and family at this happy time in my life. Was this really happening? Well it was I had my cry and then determined to fight the good fight for my life. Was referred by American cancer society for oncologist and rads oncologist. Had 3 no chemo before and after Lmast(cytoxin adriamycin 5fu) surgery Lmast with reconstruction had one filling in implant it hardened was rush to E R by fiancee. High fever 104. It was removed body rejected it. Wear prothesis in bra no problem well sweetie I am this yr 25yr Survivor Praise God. This is why I'm still here to give Inspiration to others like you. It is doable. Hang in there I kept Positive thoughts lots Hope. msphil idc stage2 0/3nodes Lmast 6mo chemo then got married😁 then 7wks rads and 5yrs on Tamoxifen. Pray this helps you and others.🙏

You are a strong, brave woman HeartShaped. Well done. The only way out is through with this cancer crap. I'm thinking of you and wishing the best.