We've Got a Plan

It always feels better to be in action than to be sitting around waiting for test results.

After a couple of consultations with oncologists, I've got a chemotherapy game plan to start with this Thursday. The fact is that there are many options to choose from, and it's kind of "dealer's choice" on what to pick first.

The plan we've chosen to start with requires an infusion at the medical center every 3 weeks. After two cycles, we'll check the tumor markers (that's a blood test) and see if there's a change. After three cycles we'll do another CT scan. If it appears to be working, we'll continue with it. If it isn't, we'll move onto the next chemo plan.

This chemo regimen does not cause hair loss. Yay for me. There are other side effects of course, and we won't know just how this regimen will affect me until I'm on it. It can cause platelet problems, bleeding problems, liver damage (not really what I need), nausea (not as severe as the drugs I had last year apparently), and of course, fatigue (all of them cause fatigue).

But my oncologist says it's "generally well tolerated" so we'll go with that.

So far my liver function is very good and it isn't inflamed. How that's possible with five nasties in it is a mystery to me. Again, yay.

Technical Details

Some people reading this blog have some experience with breast cancer, so I thought I'd include the details of this regimen. You can gloss over this section if you want!

The cancer is still strongly ER/PR/Her2neu positive, which is good news. As I understand it, it means that a variety of drugs, including herceptin and its herceptin-like pals and anti-hormone treatments may be effective against it. Although the cancer returned while I was on tamoxifen (an oral estrogen suppressor for pre-menopausal women), so I'm off of that medication now.

The chemo regimen I'm starting with Thursday is TDMI (brand name of Kadcyla) (which sounds a lot like Godzilla). It's herceptin with a chemo agent "welded" to it. It was just approved by the FDA this year. In a study it looks a little better than another option, capecitabine with lapatinib, so that's why we're going with it as a first choice. We may move on to capecitabine later (or something else) if need be.

Chest Port

Tomorrow I go in to have a chest port placed to make all of this easier (the veins in my arm therefore get to relax). I had one placed in May last year and it was removed this June after I completed a year of herceptin. But back in it goes.

I'll be at the med center for about 6 hours tomorrow, counting all the waiting you do beforehand and the observation time afterwards. I'll have IV sedation during the procedure, so whatever.

How My Family's Doing

Everyone's hanging in there. B. is always amazing and supportive and can be counted on for anything, no matter what. That's really incredible. But he's also tired and stressed, so he's looking for times he can relax. He's going to a baseball game with his brother tonight, which is a good start. Hikes, photography, driving his 1950's car, reading, and going out for a beer with a friend are all things he wants to be sure to keep doing.

The girls are sometimes worried, but most of the time are just moving forward in their lives. They're both having good starts to the school year and are busy with extra-curricular stuff and friends too.

Thank You

I've received a lot of really wonderful messages and hugs lately. Thank you! I appreciate them all. I will let you know what kinds of practical help we might need as we figure that out.

This may turn into a bit of a marathon, so I'm hoping people don't "burn out" in the next few weeks helping us. Save something for months from now!

Please keep thinking positive and hopeful thoughts about me - that makes me feel really good.