Breast Cancer Treatment Journal

Background

I am a civil servant working in a health department. As the only administrative staff in my unit, I handle all the work in the secretariat (procurement, maintenance of the hall, documentation, information technology, etc.). The pace of work is fast and urgent. During the past two years of the pandemic, while many industries were in decline, health units in the public sector often had to work overtime, even on weekends. Consequently, due to the oppressive atmosphere and high stress, I frequently dined out, drank sugary drinks, and when I had a rare day off, I indulged in barbecue and fried foods. Despite this, I have always cared about my figure, maintaining a relatively light diet without a family history of diseases, breastfed my children, and kept up with a routine of jogging or yoga twice a week.

Discovery Opportunity

At the beginning of this year, I noticed a spa promotion nearby and decided to try a breast massage for the first time in my life. The masseuse felt a lump that seemed unusual and, with my permission, asked the manager to check. After her examination, the manager strongly advised me to get a mammogram. My left breast tissue has been firmer than the right since development, and in my thirties, I had it checked. The doctor told me it was normal breast tissue and not to worry, but I still kept an eye on it. When I was pregnant and breastfeeding, I noticed that several milk ducts in my left breast were particularly prone to clogging and were difficult to clear even with warm compresses and massage. Looking back, if I had paid more attention to this issue at the time and sought professional help from the spa, perhaps I wouldn't be facing breast cancer today.

Treatment Process

Initially, due to fear, I went to a hospital near my home for a mammography right after my spa day ended. Then, on the recommendation of my younger sister, who had a history of tracking breast cysts, I switched to another hospital. I had to use a queue helper service to secure an appointment with a renowned doctor there. Disappointingly, I waited from 7 a.m. to 5 p.m. to see the doctor. Multiple times we inquired about getting a breast ultrasound first, but the nurse insisted it wasn't necessary. Only when it was finally my turn did they inform me that "today's ultrasound quota is full." During the consultation, the doctor's professionalism was questioned by my sister; why didn't he have me lie down for the examination and only had me sitting? Why were his hands not sanitized? Moreover, he didn't perform the ultrasound himself; logically, there was no need for him to touch my breast so casually.

In a state of anger, my sister demanded the nurse cancel my appointment and transfer it to the doctor who had been monitoring her. So, I made another trip to the hospital. This other doctor performed the breast ultrasound personally and meticulously. He alerted me to abnormal blood flow near the tumor and recommended a biopsy, but he only performed surgeries in Hualien and asked if I would consider a referral to his colleague. Eventually, with the help of my sister's mother-in-law, I went to the Koo Foundation Sun Yat-Sen Cancer Center to see Dr. Chii-Ming Chen, by which time it was around March.

Bonding with KFSYSCC

KFSYSCC stands out from other hospitals bustling with people. When new patients arrive, volunteers lead and explain the layout of the hospital, making the whole process very smooth. The atmosphere is tranquil and peaceful, and the architectural style resembles that of a hotel, which impressed me greatly when I first stepped in! (Occupational hazard... I think about how our unit can improve and provide services in terms of procedures and equipment.)

Dr. Chii-Ming Chen is exceptional! Unlike doctors at other hospitals who might comfort me by suggesting the tumor is likely benign, Dr. Chen looked at my mammography images and directly told me, "I judge it to be multifocal carcinoma in situ; a full excision is needed, don't be afraid!" Then he quickly arranged for a biopsy (Haha, not being afraid would be a miracle... I was already scared out of my wits...)

I underwent a biopsy twice; the first time was with a fine needle, which didn't detect anything, and the second time was with a thick needle, which detected a malignant tumor. Then, in the outpatient clinic, Dr. Chen told me, "You can be admitted for surgery today and go home the day after tomorrow!" Honestly, I was still in shock from the cancer diagnosis, wallowing in self-pity, and worrying about how to complete my work. I responded, "Really? I haven't even procured the generator yet...!" At that time, I knew nothing about cancer, not realizing that early removal was best or that Dr. Chen was thinking of my well-being by arranging surgery quickly; I even superstitiously chose an auspicious day and scheduled the surgery towards the end of April.

After going home and becoming more clear-headed, as well as looking up some information, I began to silently worry about what if the cancer changed too quickly? So I went back to the clinic to ask if the surgery could be moved up. Dr. Chen smiled and said, "I'm very glad you came back to see me," and after discussing, we confirmed the surgery for mid-April.

Tumor Biopsy Results

After the surgery, the biopsy report indicated that I had stage I HER2-positive cancer that had begun to infiltrate. I, who initially thought removal was the end of it, was advised by the case management nurse to also consult an oncologist. After hearing Dr. Nai-Ming Chu's analysis, the high recurrence rate of 58% made me struggle with whether to accept chemotherapy! Later, after divining with tarot cards and hearing the advice of a classmate’s company's breast cancer support group, I decided to not only undergo chemotherapy but also target drug therapy. I took an active stance against the cancer cells, because, in the end, if a recurrence happened, I would still have to tread this path.

Chemotherapy Treatment Process

I was prescribed a regimen of Taxol and Adriamycin for six cycles, followed by 18 cycles of Herceptin; I've always had a sensitive stomach and had previously undergone treatment for Helicobacter pylori. Any bout of the common cold would leave my stomach unsettled, so I was naturally apprehensive about starting chemotherapy. Indeed, by the third cycle, my white blood cell count wasn't recovering every three weeks as expected, prompting a shift to a four-week cycle.

I vividly recall the severe stomach bloating, digestive issues, and constipation followed by diarrhea for a week after my first chemotherapy session. It felt as though every cell in my mouth and esophagus was being torn apart, accompanied by insomnia. Researching the side effects of chemotherapy online during this period was absolutely terrifying!

However, it was then that I realized the side effects of chemotherapy come on quickly, and I had to meticulously document everything for better management. I prepared a small booklet with a calendar to record daily physical changes, medication, and nutritional supplements. The blank sections at the back were filled with a gratitude list and notes on insurance claims, among other things. Once the treatment process starts, you're inundated with information and need to deal with numerous issues simultaneously. As someone who tends to worry and experience strong emotional fluctuations upon learning new information about my condition or feeling unwell, keeping a detailed record and managing everything systematically has been crucial in helping me confront everything in an organized manner.

Treatment Process Side Effects, Problems, and Strategies

• Bloating and Gastroesophageal Reflux Disease (GERD)

  (1) For a consultation at a gastroenterology clinic, bloating usually requires a 3-week medication regimen, whereas GERD is managed by taking medicine before sleep if one feels discomfort or coughs an hour and a half after dinner.

  (2) Take Wakamoto with every meal.

  (3) Probiotics: For gastrointestinal discomfort or nausea, consume the children's version (powder form) during the initial discomfort, then switch to the adult version (capsule form) during the 3rd or 4th week. I have tried multiple brands including Motre and group purchases from my company, alternating between them.

  (4) Sugar-free yogurt: In the 3rd or 4th week, consume with fruits to supplement intestinal probiotics.

  (5) Continuous exercise: During the beginning of chemotherapy, due to severe bloating, I would jog extremely slowly every day, varying from 10 to 40 minutes according to my physical condition, followed by 20 minutes of simple stretching or yoga; if I was really exhausted, I would take a walk with someone's assistance to avoid accidents due to fatigue.

• Constipation

  After completing chemotherapy, use medication prescribed by a doctor for the first three days, and then increase the intake of fruits that aid in bowel movements and digestion after meals. Consume 2-3 times a day (about 5 bites each time, half a kiwi) such as kiwi, bananas, pineapple, papaya, and dragon fruit.

• Dry Eye Syndrome

  (1) As I had laser eye surgery six months prior to the onset of breast cancer and my eyes were already prone to dryness, during severe episodes, I apply warm compresses to my eyes three times a day (it is important to use hot water for compresses as a warm eye mask is ineffective without steam!) and use over-the-counter artificial tears.

  (2) Consuming fish oil: Besides aiding in eye protection, it also helps in detoxifying the liver.

• Eczema

  (1) Use dermatologically prescribed medications.

  (2) Before applying medication, gently pat on a bit of ceramide: Ceramides, in combination with hyaluronic acid, can effectively help build a skin barrier, but since the hyaluronic acid I have is not a single-ingredient product, I only use pure ceramide to avoid further irritation.

  (3) Shift exercise time from morning to afternoon and work out at home, keeping the room temperature cool, and shower immediately after exercising.

  (4) Supplement with vitamins C, E, and zinc: Usually taken in the second week, if I want to take it in the first week, I open the capsules to avoid indigestion; their primary function is to assist in skin repair, many supplements contain vitamins C and E, you can look for a combined tablet form, otherwise, there's a lot to consume.

  (5) BHK’s Luxury Diamond Supplement: This is a nutritional supplement I already had, containing glutathione which is not only good for the skin but also helps with the second phase of liver detoxification, to be taken starting the third week when the digestive system is more robust.

• Hair Loss

  (1) After the first chemotherapy session, as I started losing hair, I cut it down to a buzz cut for easier maintenance.

  (2) Pu Xin Fang Polygonum Multiflorum Handmade Shampoo Soap: Its ingredients are simpler than those of regular shampoo, protecting the scalp; I also apply a bit to my eyebrows when shampooing.

  (3) DR.CYJ Hair Growth Serum: After the third chemotherapy session, I heard a nurse mention a patient whose sister worked in hairdressing and had taken great care of his scalp. Even though he was receiving strong treatment, he didn’t lose much hair; she just used existing hair products for exfoliation, scalp care, etc., without sticking to any particular brand. So, I started using the hair growth serum that a classmate gave me, which I initially planned to use after completing chemotherapy, applying it morning and night (also on my eyebrows), and gradually, my hair started to grow back lush like little blades of grass. Even though I still experience hair loss, it's minimal. Those concerned about their hair might want to start using it from the first chemotherapy session!

• Mucosal Laceration

  (1) Glutamine: I take Fubao Le, recommended by the unit's nursing staff, usually 10g each in the morning and evening. However, in the fourth week when my condition improves, I only take it in the morning.

  (2) The doctor prescribed an oral anti-inflammatory paste.

  (3) Biotene Mouthwash: To prevent my teeth from bacterial erosion and to avoid irritating the sore inflamed mouth, which is quite painful, a friend recommended this mouthwash. Although many mouthwashes claim to be alcohol-free, this one is truly the most gentle. It's just very sweet!

  (4) Sancto B12 Soft Capsules: To aid in cell repair and improve the condition of oral inflammation.

• Low White Blood Cell Count

  Essences of chicken and beef, high-protein (San Duo milk protein available at PXMart), later the doctor changed my regimen to an injection every four weeks, which basically solved the problem.

• Anemia

  Eat more pork liver and beef.

• Night Sweats

  Try to stay at home wearing loose clothing, and keep the indoor environment cool. The symptoms usually last for a week. If physically able, maintain exercise habits as the body feels more comfortable, and recovery from discomfort will be quicker.

• Pain after Breast Reconstruction with Tissue Expander

  (1) Rehabilitation exercises can be initiated shortly after surgery by visiting the rehabilitation department. Post-expansion discomfort may include chest tightness and shortness of breath, which require gradual adaptation. Physical exercises help with improvement and adaptation.

  (2) Applying frankincense massage oil: The affected skin is thinner, and the oil can slightly relieve the tension caused by stretching and prevent rapid expansion that might cause stretch marks. I gently apply it around the wound area in the morning and evening.

  (3) A month after the tissue expander is filled, the second stage of reconstruction surgery can be performed. During this month, I started practicing simple and slow yoga moves to stretch my body, which helps improve posture and correct arm length discrepancy.

  (4) Sports bras with the largest size and removable pads: These are ideal for dealing with the initial asymmetry post-expansion. They are convenient for post-surgical needs and check-ups, despite being hotter to wear. After about 14 days, when the wound heals, cotton bras with removable pads are a better option. They are cooler and absorb sweat. As the reconstructed side grows, the pad can be removed to continue wearing the bra. I always recommend buying the largest size, which can later be repurposed as winter thermal wear or summer sleepwear, making it a cost-effective choice.

• Fluctuating Body Temperature, Spinal Pain, Headaches

  (1) It's best to stay at home to easily layer or remove clothing. Spinal pain is usually located around the brainstem and coccyx. I use a hot compress on my neck and soak in warm water (sometimes with a herbal pack of mugwort) to alleviate the pain but avoid prolonged exposure to prevent skin issues. Usually, I drain the water after cleaning with soap, within about 10 minutes.

  (2) Using a fascia gun to massage the buttocks improves discomfort in the coccyx area.

  (3) Applying mugwort essential oil for scraping massage on the shoulders and neck, and rubbing the ears helps promote circulation and alleviate headaches.

• Nausea

  (1) Consuming more sour foods: From my fourth chemotherapy session, I began to experience nausea. The gastroenterologist said it was due to the accumulation of drug toxicity in my body. Preferring not to resolve it through unnatural means, I would eat sourer fruits or add vinegar or lemon to my food (drinking lemon water directly causes me gastroesophageal reflux).

  (2) Holding vitamin C lozenges in my mouth

• Insomnia

  (1) For the first three days, I took the sleep aid and antiemetic medication prescribed by my doctor. Usually, after three days, I feel very exhausted and weak, which leads to a lot of sleep and no issues with insomnia. About a week later, the situation usually improves and medication is taken as needed. If possible, I avoid taking medicine to reduce the burden on the liver and kidneys.

  (2) I’ve developed a bedtime ritual. I set an alarm to remind myself to brush my teeth and enter my room, where I light some essential oils. In the first week, aiming to enhance detoxification, I massage my gastrointestinal tract and perform gua sha (scraping) on my liver and gallbladder meridian lines. I take care not to scrape too hard or too often to avoid damaging the skin. Before sleeping, I avoid using electronic devices and prefer reading books instead.

• Facial Skin Allergy

  Originally, the condition of my facial skin was good and unproblematic. Then, I thought exfoliating and applying a facial mask would be beneficial. However, after doing so, my skin had a severe allergic reaction, becoming red, swollen, and painful. I had to consult a dermatologist. Following the doctor’s prescription, I incorporated ceramide essence and hyaluronic acid into my daily skincare routine before applying my usual 10% Vitamin C and retinol. I also switched my lotion from La Roche-Posay’s B5 Repair Cream to the Physiogel’s Restoring Cream recommended by my doctor, which led to improvement.

• Dry Skin

  I've always valued skin care, and normally my skin is both fair and tender. However, after chemotherapy, my skin began to become abnormally dry. My usual bath gel, coupled with my autumn and winter essential, L'Occitane's 25% Shea Butter Moisturizing Body Cream, was no longer sufficient. Fearing the excessive chemical additives in bath gels, I completely changed my bathing habits.

  (1) I avoid using hot water for showers, and unless I feel very uncomfortable, I try not to soak in baths.

  (2) Pure Heart Workshop's Grandmother's Pu'er Handmade Soap: After my cancer diagnosis, a colleague gave me a bar of this handmade soap, claiming it would leave my skin silky smooth. I was skeptical at first since I hadn't noticed much difference with other handmade soaps. But when my skin became too rough, I gave it a try and was amazed by the results! Paired with L'Occitane's moisturizing cream, my skin returned to its pre-chemotherapy suppleness. Given the soap's simple ingredients, I plan to continue using it.

  (3) Using coconut oil for makeup removal and as a body lotion substitute: A classmate of mine used coconut oil as a body lotion and felt their skin become smoother! Cancer made me more conscious of the natural and simplicity of the ingredients in the products I use. So after finishing my regular makeup remover, from around my fourth chemotherapy session, I too started using coconut oil for makeup removal. I apply it to my damp skin after showering and am really satisfied with its moisturizing effect! Plus, since coconut oil is edible, it's absolutely safe to apply to the skin! The scent of coconut usually dissipates after about 1-2 hours, and even when I feel nauseated by most smells, it doesn't bother me (probably because it's so natural). Just choose a coconut oil with more than 50% lauric acid at the store, and that's a good quality oil! For those who dislike the scent of coconut, you can opt for fractionated coconut oil, which lacks some nutrients but is more stable, transparent, and easier to preserve. Those who find coconut oil too greasy for makeup removal or worry about acne might want to consider this alternative!

• Other Health Supplements

  Supplement according to individual health condition

The above details my cancer treatment journey and methods, in the hope of helping those in need. I am deeply grateful for my family's care, and for the concern and encouragement from friends and colleagues! I also consider myself very fortunate to have discovered my condition early, allowing me access to treatment options that some fellow patients lack, with each option presenting its own challenges. And let's not even speak of those who don’t have access to targeted drugs… their situation is truly difficult!

During this time, I’ve taken the opportunity to reflect on my past attitude and approach to life, trying to identify the causes and make adjustments. For fear of overburdening my liver and kidneys with processed foods, I've become much more adept in the kitchen beyond just enjoying my mother’s cooking. I pay close attention to the ingredients in everything I buy, and I always bring my own containers for take-out meals. Choosing more natural foods and products benefits not only ourselves but also the environment. With reduced environmental pollution, we have access to cleaner food, which creates a positive cycle!

Lastly, I want to thank all the doctors, nurses, and other staff at the Heshin Hospital who have assisted me along the way. Everyone has been so professional and kind! The phlebotomists have top-notch skills — absolutely painless! It’s really different from other hospitals! Thank you all for your service, which has allowed me to heal with peace of mind. I am very grateful and wish everyone good health.

Author: KFSYSCC Patient, Yang Pianpian