Dawn wanted to be close to family and decided to move back to Seattle after her doctor in California recommended she seek treatment at Seattle Cancer Care Alliance. Her employer in San Diego approved the move and arranged for her to start telecommuting.

Having her parents for support as she went through chemotherapy was wonderful for Dawn. Her mother accompanied her to every single appointment and took notes for her.

She finally finished her treatment in April 2006, which included chemotherapy before and after surgery followed by radiation therapy and a year taking Herceptin.
 

Treating Recurrence

In August 2006, Dawn went in to see her oncologist for a referral for a general practitioner to treat her for headaches she’d been having. “My doctor's (Robert Livingston, MD) nurse told me they could do an MRI at SCCA just to be safe,” Dawn recalls. A two-centimeter tumor was found in her brain.

“So, a week later I had a right parietal lobe craniotomy (surgery to remove the tumor) and Gamma Knife treatment. It all went very well,” she says. “Three weeks later I was able to walk the Susan G. Komen Breast Cancer 3-Day with my sisters and mom, as we had been planning for months before the brain tumor was discovered.”

The right parietal lobe controls motor and sensory function. A few moths after her Gamma Knife treatment, Dawn began to experience seizures. “I had a grand mal seizure that came out of the blue,” she says, recalling that she remembers an aura (a period of confusion). “I pulled over and wandered away from my car actually, and then I woke up in the Emergency Room.”

Her seizures are controlled with medication for the most part, though she had five major ones in the last year. “Instead of a multi-hour ordeal,” Dawn says, “about every day or every other day I feel one [seizure] coming on and I sit down, get a little headache that I don’t take anything for, and that’s it.”

During her breast cancer treatment, exercise really helped Dawn manage her side effects – and her dog Scallywag liked it, too. Her routine was to walk Greenlake every other day. But now that she no longer drives, Greenlake is a bit much on the bus from her West Seattle home. “I’ve got some energy back now, but the medications I was taking were making me so tired,” she says. “I just haven’t gotten back to it, yet.”

Dawn had a second craniotomy in December 2007 to remove a second tumor. At a “weird crux,” she says, now she’s trying to decide on the next step: whole brain radiation, a new chemotherapy, or perhaps waiting until the cancer regrows again before doing another Gamma Knife treatment. “The good news is that I’ve had a total of two brain tumors and no other metastases. I’m hoping it’ll stay that way.”

Update

February 2009, Dawn had her third craniotomy, performed by Dr. Dan Silbergeld. During the surgery, Dr. Silbergeld also inserted Gliadel wafers, a dime-sized chemotherapy wafer that was placed into the cavity in her brain where the tumor was removed to slowly release cancer-fighting medication to the site. "No blood-brain barrier issues with this," Dawn says. 

"Dawn has a rather unique breast cancer in that the only evidence of disease is in brain," says Dr. Marc Chamberlain, SCCA medical oncologist. "She has had multiple disease recurrences in her brain which we treated with surgery and gamma knife stereotactic radiotherapy. Most recently, with a recurrence in the right temporal lobe following gamma knife radiotherapy, surgery was performed in conjunction with Gliadel implantation to provide both the benefit of image-verified complete resection (i.e. macroscopic tumor removal) and slow-release carmustine (the Gliadel implants) to treat the brain surrounding the surgical cavity of small-volume microscopic disease."

The Food & Drug Administration approved this drug in 2003 for gliomas, but not for metastatic breast cancer as yet. Dawn is happy to try anything to keep her cancer in check. Dr. Chamberlain has used this treatment for this disease in the past, with good results.

"I'm feeling pretty good and have hair now, too," Dawn says.