Living fully, even with treatment in the background

The Fade-Out

When I was first diagnosed in January, the world rushed in.
Messages, meals, flowers, check-ins.
People I hadn’t heard from in years showed up like it was a homecoming.
And in a way, it was—just not the kind I ever wanted.

There was urgency in the air.
An unspoken pressure to “do something,”
To make a casserole, send a card, show love quickly—publicly—before the moment passed.

And then the moment passed.
And I am still here.

Chemo and Surgery came and went. The scans, the waiting, the pathology calls.
Recovery moved in quietly, settling into the corners of my days.
And I went quiet too.

I haven’t written in weeks—not because I didn’t want to, but because the story I thought I was telling took a turn I didn’t expect. The shock of diagnosis, the rush of plans, the endless appointments and changes in my body—those were loud, almost easy to share, wrapped in sarcasm, with your tears and laughter alongside mine.

This part is quieter, and it’s harder to find the words.

The days are longer now, and so is the silence.

And I’ve come to understand something:
For many, the need to show up was tied to the beginning—
The moment it was fresh, dramatic, marked by action.
They did what they could, then quietly returned to their lives.

But there are others.
The ones who are still here.
The ones who don’t need updates or milestones to care.
They know the hardest parts often come long after the diagnosis,
In the quiet, in the waiting, in the slow work of getting through.

And so I’m learning to hold space for both:
Gratitude for those who came,
Grace for those who left,
And deep love for those who stayed.

This is the part no one talks about.
But I will.
Because the quiet deserves words too.

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Where I Am Now

I’ve officially moved my care to MGH, and over the past few weeks, I’ve had appointments to finalize my radiation plan and map out what the next round of chemo will look like.

After surgery, the pathology report confirmed the breast itself was clear—cancer-free. Yay for small wins, right? But let’s be real: that was one battle, and I’m here to win the whole war.

Meanwhile, the lymph node was busy being that problem child. Not only was a tumor still growing in there, but it busted out of the node like it was late for Pilates, changing its biology along the way. Because of course—cancer will do everything possible to survive, shifting its gears, dropping receptors, and rewriting its own playbook just to keep going.

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From Triple Positive to Tricky

I was originally “triple positive,” meaning the cancer was positive for estrogen (ER), progesterone (PR), and HER2. But the lymph node tumor decided to rewrite the script mid-story. Now it’s HER2 positive and ER positive, but PR negative—which means it still responds to estrogen and HER2 signals but dropped the progesterone receptor, making treatment more complicated.

Right now, there’s no blood test or scan that can spot HER2+ cells—though here’s hoping they figure that out sooner rather than later. There is a blood test for ER-positive cells, but it’s far from perfect. And in this world, HER2+ gets top priority because these cells are the faster troublemakers—more likely to spread quickly if left unchecked—while ER+ cells tend to be the slow lurkers we can manage long-term.

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HER2 Explained: The Dandelion Analogy

At my appointment, Dr. Jurik—aka My Forever Cancer QB (because he insists he’s my “quarterback of care” and, apparently, will be calling the plays for the rest of my life)—explained HER2 in a way that finally clicked:

Imagine a HER2-positive malignant cell like a dandelion. When you blow on it, all those tiny dandelion seeds scatter everywhere, and there’s no way to catch them all. That’s what HER2-positive cancer is like—even if you remove what you can see, you can’t guarantee you’ve caught every seed. Treatment doesn’t end when scans are clear; it’s about managing those seeds so they don’t take root somewhere else.

And where do those seeds love to land if they’re going to misbehave? The brain, bones, liver, and lungs. Those are the four places My Forever Cancer QB will be watching carefully—looking for any changes in how I’m feeling, new symptoms, or signs a dandelion seed has decided to sprout where it shouldn’t.

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The Role of TCHP Chemo (and Why It Didn’t Get Everything)

Earlier, I had TCHP chemo before surgery—a heavy-hitting combo designed to shrink tumors and clear HER2+ cells systemically.

The goal? Hit HER2+ cells hard and fast, shrink the tumor, and ideally leave no active cancer cells behind.

While TCHP did its job in the breast, the lymph node tumor changed its biology during treatment, dropping PR while staying HER2+ and ER+. This genetic shift likely made the cancer less responsive to TCHP, which is why a tumor was still growing in the node post-chemo.

In short: TCHP was the best first-line option, but cancer, being cancer, adapted to survive.

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HER2 Treatment Plan and Chemo: What’s Next

Because HER2+ cells are the fast misbehavers, they remain the priority. Now we move to Kadcyla (T-DM1), a “smart bomb” chemo that combines Herceptin with targeted chemo inside HER2+ cells, aiming to finish what TCHP started while sparing the rest of me as much as possible.

This will be every three weeks for 14 cycles at MGH Boston with My Forever Cancer QB running the show.

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Why Radiation—and Why Now?

If the breast is clear, why radiation? Because radiation is like vacuuming the neighborhood after a rowdy party—it helps clear out any microscopic cells lingering around the chest wall and lymph nodes, even if they don’t show up on scans.

Radiation will run concurrently with Kadcyla, which is both safe and effective:

• Radiation: cleans up the local area.
• Kadcyla: mops up HER2+ cells systemically.

Radiation starts July 10 at MGH North (Danvers), five days a week for six weeks. Not exactly the summer I planned, but if it keeps those dandelion seeds from setting up shop, I’m in.

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The Next Year

Here’s what the next 12 months look like:
✅ Radiation: July 10 start, 5 days/week for 6 weeks in Danvers.
✅ Kadcyla (T-DM1): Every 3 weeks for 14 cycles at MGH Boston.
✅ Scans, labs, check-ins: Watching for signs of dandelion seeds in the brain, bones, liver, or lungs.
✅ Reconstruction surgery: Delayed at least 6 months after radiation.
✅ Aromatase inhibitor therapy: Starts after chemo and radiation to block estrogen.

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And Forever: The ER-Positive Plan

Since I no longer have ovaries (but my body still finds ways to make small amounts of estrogen—because, of course it does), Tamoxifen isn’t used. Instead, I’ll be on an aromatase inhibitor, which blocks estrogen production throughout the body, cutting off the fuel supply to any slow-burning ER-positive cells that might still be around.

Because ER-positive cells are the quiet lurkers, long-term hormone therapy keeps them asleep, ideally forever.

Ongoing forever:
• Regular monitoring for life.
• Hormone-blocking therapy for 5-10+ years.
• Scans and labs to catch anything early.
• Living my life with My Forever Cancer QB watching the field so I can focus on actually living.

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I Will Never Ring the Bell

Unlike many, I will never get to ring the “cancer-free” bell at the end of treatment. HER2-positive breast cancer with residual disease means it becomes a chronic condition to manage rather than a chapter that closes neatly. My goal is to keep the dandelion seeds asleep and out of trouble for as long as possible while living fully, even with this reality in the background.

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A Final Note

This isn’t the story I wanted, but it’s the one I’ve got. And I’m still here, living in the quiet, managing the seeds, and protecting the life I love, even on the days I’d rather not.

And if you’ve been wondering how to show up, or if you’ve been holding back because you don’t know what to say, just know:

I’m only a text away.

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Tidbit

If you’ve made it this far, you’re officially in the “Inner Circle of People Who Now Know the Dandelion Story.” You’re my people, and I’m grateful you’re still here—even in the quiet.

Quick Note:

After I posted, a few of you reached out, and I realized I may have made it sound like you all disappeared when I went quiet. The truth is, there hasn’t been anything to read for the past four weeks because I hadn’t written. But you were still there—holding space, checking in, caring quietly even without new words to meet you. I’ve felt that. It means more than you know, and I’m so grateful for it. I just wanted you to know that.

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