It’s been a crazy week. Last Wednesday we meet with my oncologist to go over my blood work and scans. My scans didn’t show any major progression, but my tumor markers were almost as high as they’ve ever been. There are many different kinds of breast cancer. I have lobular breast cancer and one of the characteristics of lobular breast cancer is that it tends to grow in a more diffuse pattern and it can be much harder to detect its spread in ct/bone scans. Tumor markers don’t tell the whole story either. For some people they are totally unreliable. However, in my case we have 9 years of data on my markers and know that they are a pretty good indicator of what’s happening in my body. I’ve also been having some more pain in my back and other areas. All of this information put together lead my oncologist to determine that the current drug I’m on is not working. I agree. Problem is, the next course of action is IV chemo. There is one new drug that was just approved this month called Ibrance or pablociclib, but the chances of it being available and approved by insurance were very, very slim. So, I was scheduled to have a port placed in my chest this morning and to begin my first round of Abraxane. I’d receive an infusion once a week for 3 weeks and then have one week off. This would continue indefinitely. One of the major side effects of Abraxane is hair loss. Darn! I was ready for moving to IV chemo, I knew that was the next line of treatment, but I hadn’t quite prepared myself for being bald again. I didn’t wear a wig last time, but this time I went to the wig store on Saturday and was fitted for a wig, then I called my hair stylist and scheduled an appointment for this Friday to have my hair cut short. You usually lose your hair within 3 weeks or so on Abraxane and having it cut short now would make it easier for me when it started to fall out. On Monday my doctor called me back. He had been talking about my case with other doctors in the oncology clinic and one of them had just been able to obtain Ibrance for a patient in the clinic. Hold everything! So, we decided to cancel the surgery for this morning and see if we could obtain the drug. Ibrance is a new oral drug that works differently from other aromatase inhibitors I’ve been taking. Most drugs currently available for er/pr+, Her2- breast cancer target the hormone receptor pathways and try to disrupt those pathways. Ibrance takes a different approach and targets a family of cell proteins (CDK4/6) that are responsible for cell growth and stops those cells from dividing. Well, I just received the call today that insurance has approved my trying this drug. Whew!!! Talk about in the nick of time! Need I say more about the importance of additional research for metastatic breast cancer and treatments? It’s unlikely that when this drug stops working there will be another newly approved drug to take its place and I will have to start IV chemo. But for now I’ve been given a period of grace. There will still be side effects and I’m hoping I handle them well. I’m heading to Europe in April and for me this is all about quality of life and being able to have a great trip with my friends and my son. We’ve talked about this trip for years. We had always said that when he was accepted into med school we’d go to Europe together. It was making me pretty sad to think that the pictures he would have for memories would be ones of me in a hat or scarf and looking like a cancer patient. I’m pretty happy with flying under the radar sometimes. It’s funny how having your hair allows you to look normal and healthy even though you are far from it. So today I was grateful that I was at the club exercising instead of waking up in the recovery room and then heading over to oncology for my first infusion!
It’s scan day. A day most everyone with cancer dreads. We even have our own word for it “scanxiety”. Normally I sail through these days. But today feels different. I think it’s because the last few scans have been pretty darn good, very little progression shown in terms of cancer growth, we’ve been holding things at bay. But, I’ve had issues with my drugs lately, and even with the last one we’ve had to reduce the dosage because of side effects I’ve been having. So I wonder “has it been enough?’ Each time I get in one of those tubes I think about where those cancer cells may be hiding. I talk to my body and tell it to spill all. No hiding those buggers anywhere. I think about my immune cells and what they’ve been doing to help me. I think about how well the rest of my body has been dealing with the rogue faction and say a little “thank you.” I also experience a wave or two of pure fear and worry. It’s not a unique perspective, but I feel like I’m playing Russian Roulette. Each time I have a clean scan I know the odds are higher that the next one won’t be that way. There’s no place like the inside of a huge metal tube to have a little anxiety attack. That’s when I probably have the best little talks with myself. “Remember to breathe” I say. “Remember to think of things to be grateful for” I quietly sigh. And that’s when I bring you all into the tube with me. I think about the many little things you’ve done to support me and my family and the kind words and cards. It’s another reason I’ve been so grateful to have this time to travel with Steve. I have a few of my favorite views in my head. I’ll see something beautiful and think, “Now that’s a good one to remember during a scan.” So wish me luck today. I’ll be thinking of all of you!