2008-07-27 (Carla Paras-Sison)
The Full Story

As many of you may know, in May 2002, Dayday Joseph-David was diagnosed with stage 1B breast cancer. She has thrived through remission until she was again diagnosed with recurrent metastatic breast cancer just last April (2008).

The First Round

Dayday found out about her first breast cancer by chance, in her first mammogram ever. She had no symptoms but simply elected to have the mammogram as part of the first ever office annual physical exam that she availed of. Things moved fast following a confirmatory ultrasound as a biopsy was recommended as a next step. She and Choloy consulted several doctors to decide on the biopsy. They chose Dr. John Pastores of Makati Medical Center to do the biopsy as he was also the one who did the mastectomy of Dayday’s mother many years back. After a week of waiting, Dayday, Choloy and Dayday’s mother, Grace P. Joseph, went to see Dr. Pastores. Results revealed that Dayday had early stage invasive ductal carcinoma in the left breast. Despite the bad news, Dr. Pastores’ reassurance that it was early stage, with high chances for a cure, encouraged them to seek further information and take immediate action.

The couple now had to look for the right oncologist and they consulted six doctors to get the best opinion. Meanwhile, the modified radical mastectomy was already being scheduled with Dr. Pastores, being that he already had Dayday’s confidence and he struck her as “the one with the healing hands".  The couple chose Dr. Conrado "Gary" Lorenzo M.D., as her oncologist, for his great bedside manner and expertise.

Dayday had her mastectomy in May 2002 and started chemotherapy in June 2002; this was complimented by alternative medicine (nutrition, supplementation and detoxification) and Qi Gong (moving meditation).

Dayday had six cycles of chemotherapy which was administered every 21 days.  The last chemo ended late September 2002 and the couple celebrated with a  vacation abroad a month later.

After two years of recovery and flushing out the chemo drugs in her body, and two years to the day of her last chemo treatment, Dayday found out she was pregnant. She considered this practically a miracle, since one of the oncologists they consulted prior to choosing Dr. Lorenzo, told her that she may never pregnant as a possible side effect of chemotherapy. She gave birth to Matteo Andres in July 2005. Dayday and Choloy believe that Matteo (whose name means "gift of God") was a wonderful gift from the Lord. He is a bright and confident kid, and he brings them much joy every day. And then, surprise of all surprises, Dayday got pregnant again after 17 months and gave birth to Pio Antonio. Choloy and Dayday chose the name Pio in honor of St. Padre Pio of Pietrelcina, who they had prayed to and whose intercession they believe led to Dayday’s healing in 2002. Pio is a carefree, sweet baby who brings out the best in the family.

Again surprisingly, Dayday was able to breastfeed both Matteo and Pio for 11 months despite the breast surgery she had had. Choloy and Dayday agreed that this would be the path to take, believing it would be best for the children. They decided on this well aware that it entailed the risk of not being able to have regular (i.e., once every six months) monitoring tests that were radioactive (e.g., mammograms, bone scans) done. Blood tests such as CA153 and SPEC 23 were done over the three year pregnancy and breastfeeding span, however, all showing good results. No one was worried.

The Second Round – Fight On!

Dayday found out about her recurrence through a routine checkup. Since she was done breast feeding Pio last November 2007, she resumed monitoring her health and started a round of regular check-ups — baseline tests were a mammogram, a chest x-ray and the SPEC 23 blood test.

Having been advised to wait till about four months after stopping breastfeeding to get more accurate results in the mammogram, which she personally considered the most important test, she had all tests done at the same time in early March. The SPEC 23 proved normal, the chest x-ray was routine, but the mammogram had her worried. She had been called in and out of the mammogram room three times for testing and retesting, close ups and various views, something that was new, from the last time she had a mammogram.

While waiting for the results, Dayday already phoned her husband, brother and mom. Her brother then "sounded the alarm" to her cousins, who immediately held a family mass for the health of everyone in the family, particularly Dayday, her mom, Grace (who has end-stage chronic obstructive pulmonary disease), and her Aunty Chiqui (who had gone through a gruelling round of hospitalizations and had just had a pacemaker installed).

Lo and behold, her mammogram came out the cleanest it has ever been since her treatment in 2002. But this time, surprise of all surprises, it was the chest x-ray results that came out with a negative finding in her left lung. Primary suspicion was pneumonia, but even as early as that, the ominous "not ruling out neoplasm" was already written in the report. Neoplasm is another word for lung cancer. After consulting with Dr. Lorenzo, who calmly advised her not to panic, she was given antibiotics in order to rule out pneumonia and was ordered to have another x-ray three weeks later, after Holy Week (of 2008). With great hope andprayers, the second x-ray was done and the results showed the same mass (which meant that it was not pneumonia, as the antibiotics had had no effect on it) and this time, a chest CT scan was recommended.

At this point, Dr. Lorenzo ordered a bigger battery of tests — a computerized tomography (CT) scan of the chest and abdomen. On top of this, the CA153 blood test and a bone scan were ordered, to find out if there were suspicious masses elsewhere in her body. The chest CT scan confirmed the presence of a cancerous-looking mass in the mid left lung, estimated at roughly 2.1cmx2.3cmx1.7cm. There were three other sub-centimeter nodules — two more on the left, and one more on the right. Things weren’t looking good. At this point, Dr. Lorenzo emphasized the dictum — "tissue is the issue", "no meat, no treat". With that in mind, the next step that Dayday took was to undergo a CT-guided biopsy, done by Dr. Ramon Santos-Ocampo, an interventional radiologist.

Results were received in early April 2008. The results showed that her cancer was indeed back. The diagnosis: recurrent, metastatic breast cancer. Her original breast cancer had metastasized to the lungs. The good news is, based on the other tests, it is not anywhere else in her body – not in the bones, not anywhere in the abdominal area. Also, as Dr. Lorenzo puts it, "her tumor burden is small". In Dayday’s mind, this translates to a good prognosis.

Dayday is undergoing a new treatment protocol for this, advised by Dr. Lorenzo, and in concurrence with other doctors. The protocol calls for six cycles of Taxol (a strong chemotherapy agent), plus Avastin (a targeted drug which aims at anti-angiogenesis, i.e., it is designed to stop the formation of new blood cells that may feed the tumors). Like in 2002, Dayday has also decided that her treatment will involve a holistic approach combining conventional and alternative medicine, which at this time largely involves changes in nutrition.

One cycle of Taxol and Avastin is composed of three weekly infusions, then a one week break for recovery. She is now starting her third cycle.