The cancer stuff

Here’s the clinical stuff (I was seventeen when all this started – I’m 56 now):

1980-81: Hodgkins Lymphoma Stage IIAE nodular schlerosing.

Tumours in neck and chest area. Treated with MVPP (mustine, vinblastine, prednisolone, procarbazine) therapy, 6 course regimen over 8 months. Followed up with staging laparotomy, appendectomy/splenectomy and lymphangiogram. Then upper mantle Radiotherapy to probably 40 or 44gy 5x weekly for 4 weeks (completed Jan 1981). Suffered radiation pneumonitis following last doses and treated with high dose steroids.

1985 and 1992: Pneumonia

1993: Pericarditus Treated with IV antibiotics and followed up with Pneumovax II vaccination (repeated 2012).

March 1999: Left breast IDC (radiation-related) Grade III stage T2 (14mm) N1 (2/17 lymph nodes positive) M0. ER/PR negative but C-erb status unknown

Left segmental resection + axillary clearance, followed by adjuvant FEC (fluorouracil, epirubicin, cyclophosphamide) 6 courses, plus low dose local RT followed by Tamoxifen 2 years. Early menopause.

2000: Secondary lymphoedema Left arm, managed with compression and exercise, plus MLD in the first year.

2001: ITP (idiopathic thrombocytopaenic purpura) Treated with Prednisolone

Nov 2011: Left breast recurrent IDC Grade 3 ER/PR/HER2 Neg, Staging pTN1c (T1 15mm).

Treated in December with bilateral simple mastectomy (prophylactically to the right, clinically to the left). Discussed adjuvant therapy with docetaxel and cyclophosphamide but decided against because of increase risk of myelodysplasia, effects on bone marrow, and risk reduction (of recurrence) only 3-4%. Consultants very sure that recurrence risk is 15-20% under normal conditions.

Aug 2012: Left chest wall recurrent IDC Grade 3 (T3 P3 M3, staging rpT1c).

Surgical excision in Sept of 11mm adenocarcinoma in lower flap of left mastectomy. Tumour extends into dermis but not epidermis, no vascular invasion seen. Followed up with 6 cycles of docetaxel/carboplatin November 2012 – February 2013

Late effects Recurrent upper and lower respiratory tract infections throughout lifetime. Hypercholesterolemia and osteopenia (schlerotic lesions, in the T4 vertebral body, left humerus, left ilium (top of pelvic bone). High risk cardio (detectable heart murmer) and respiratory issues. Multi-nodular goitre in thyroid area. Residual baldness from RT

2015: AV Node Disease (heart block): First blackout Jan 2015, three further March 31-17 April. Pacemaker fitted 24th April 2015.

2018: Heart Failure: A routine stress test in November establsihed my heart no longer expands and contracts as it should do. It’s assumed late effects from chemo are the root cause, but a CT coronary angiogram is in the pipeline to have a closer look.

Genetics Tested negative for BRCA1 and BRCA2

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