posted by Amy on Apr 8

I have metastatic breast cancer. When I was first diagnosed in 2011 I had metastases in my liver, and possibly in my lungs. The liver mets were confirmed first. My first course of treatment “resolved” them, and they have stayed gone. (Knock on wood.)

Not long after that, I developed one bone met–in one vertebra in my lower back. I’ve had it for five years. Bone mets can cause a great deal of pain and disability (though not, so far, in my case) but they don’t kill.

For me the big issue is my lungs. A biopsy four years ago confirmed that I have lung mets. One lesion in my right lung was causing recurrent pneumonia in 2016. My medical oncologist referred me to radiation oncology. I got radiation treatment to that lesion, which appears to have been successful in the sense of resolving that structural problem. I haven’t gotten pneumonia again. But I got radiation pneumonitis, a common side effect of radiation treatment to the lung. I had to take steroids for that, and I was having trouble breathing with the slightest bit of exertion. Little by little that has gotten better, and now, over six months after my last radiation treatment, I’m off steroids and slowly regaining aerobic capacity.

But I want to talk about coughing. In the last year and a half I’ve been coughing a great deal, but I’ve had different kinds of coughs. There have been times there was more than one kind of cough going on at the same time. Cancer in your lungs can cause coughing. Apparently, lung impairment can cause acid reflux somehow, and that can include a dry cough. Then there’s coughing that can be caused by pneumonia (check), sinus infection (check), bronchitis (check), radiation pneumonitis (check), and postnasal drip from allergies or viral infections (check). This evening I was coughing a lot. Then I took an antihistamine and a proton pump inhibitor (for acid reflux) and I stopped coughing.

In today’s highly-specialized health care environment, it ends up being the patient’s job to sort out what’s going on. Last fall at every cancer treatment visit when asked if I had any pain I would say my face hurt. I had wandering pains all over the right side of my face (jaw, teeth, ear, etc.) My oncologist said she didn’t think that was cancer and said to go to the dentist, who didn’t find any dental problem that could be causing the pain. Months later, it occurred to me to go to my primary care provider, who diagnosed it as a sinus infection and gave me two DIY things to do, plus an antibiotic prescription. One result of that, besides fixing the pain in my face, was to reduce the amount I was coughing.

On my last PET/CT scan the report said my right mandible (lower jaw) was lighting up, and flagged that as cancer progression even though they didn’t see a lesion. One molar had been hurting, and I knew it had a hole in it. So I went to the dentist and found out the tooth had broken in half and was infected. My dentist pulled the bum tooth and put me on an antibiotic, and now the pain and inflammation are gone. Too bad I lost a tooth, but that beats cancer progression any day.

And so it goes. Yes, I know I have cancer in my lungs. I accept that reality. But you can have more than one thing wrong with you at a time, and sometimes the symptoms overlap. I realize I have a deadly illness that will most likely be the death of me eventually. But it would be a damn shame to succumb to some garden-variety bacterial infection instead.

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