Tuesday, August 26, 2014

The Latest from the Cancer Front

My long-awaited appointment with Dr. M to discuss getting on a clinical trial finally happened a couple of weeks ago!  After a VERY long wait to see the doctor, what she presented was not what we expected.  She said that currently there were no clinical trials available for me.  :(

However, she did offer me a couple of options.  The first option is another shot at hormone therapy -- a combination of three drugs.  (1) Aromasin - I've taken it in the past and it didn't work.
(2) Afinitor - I have not taken this before.  It's supposed to work in concert with Aromasin, somehow addressing cancer's resistance to hormone therapy.
(3) Zolodex - I took it for 4 years in conjunction with other hormone therapies.  It's a monthly injection that works to shut down the ovaries' estrogen production.  The thought is that even though I've not menstruated in several years (as a result of various breast cancer treatments,) my body may, in fact, actually be producing estrogen.  If that is the case, then my cancer is having lots to "feed" on, hence its recent significant growth.

The second option is a chemo drug called Doxil.   This is a potent chemotherapy drug closely related to Adriamycin which I received 14 years ago as part of my initial breast cancer treatment.  Doxil is supposedly less cardiotoxic than Adriamycin, although the literature is very scary regarding its potential cardiac effects!  It also has many other nasty side effects ... soooo, I decided to try the hormone therapy route again (as explained above.)

I was able to start Zolodex and Aromasin right away, but  it took over two weeks to get my insurance to approve Afinitor, the most important part of the drug trio!  So frustrating!  I am finally taking all 3.  Yay!

In the interim, I was stressing out because for over 6 weeks, I was on NO cancer treatment.  This was a result of my week-long vacation, having to stop previous chemo because of severe neuropathy, and multiple brief waits for doctor appointments that just added up.

Additionally, for a few weeks I was running a low-grade fever of mostly 99's, 100's and the occasional 101.  Often I would feel a little chilly, and that's when I would check my temperature and discover the fever.  I had a nagging dry cough that was getting worse.  I'm pretty sure the coughing was just as aggravating to my family as it was to me!  I reported this to Dr. P and she ordered a chest x-ray and prescribed Cipro.  She said that I may need to consider thoracentesis if the coughing didn't improve.  I am not too keen on this!!  It's an invasive procedure that involves placing a needle or tube into the pleural space of the lung and removing fluid.  Yuck, yuckity, yuck yuck.  And, what I've learned from my reading is that the drainage ALWAYS needs to be repeated in the cases of pleural effusion caused by malignancy.  I don't want to start that!

The chest x-ray showed a large pleural effusion, which we already knew was there.  BUT, the radiologist reported that an underlying infection could not be ruled out.  A few days into the 7 days of Cipro, my fever shot up to the 102's and stayed there for a whole weekend.  The coughing was so severe that I was actually considering having the effusion drained.

And then, the fever subsided!  I guess the Cipro did its job and handled whatever infection I had.  Dr. Kim thinks she had pneumonia!  Since then, the coughing also has almost completely subsided.  Go me!

I was beginning to feel pretty good, better than I had in a while.  My foot is healing, although still a little sore when putting weight on it.  The coughing, as I said, is much improved.  My hair is growing back, which has perked my psyche up a bit.   Unfortunately I recently began having severe indigestion which has decreased my appetite and prevented me from eating much.  Guzzling the Mylanta, because I have a lot of gurgling in the throat/upper chest area.  I've lost some weight, but not really in a good way.  I'm beginning to look like an emaciated cancer patient!  Also having periodic diarrhea, which can't be good.  I'm a mess!  At my nurse's recommendation, I spoke with a nutritionist who recommended small, frequent meals/snacks, and possibly adding a supplement such as Boost.  I tried to increase my intake after that conversation, and I think it was starting to go well.

But then, about a week after starting Afinitor, I developed a mouth sore.  Most of you know how painful that can be.  For me, they usually just have to run their course before dissipating.  But this time, the "course" seems never ending, and right now I am up to 6!  Tongue, lip, under the tongue, both cheeks, and throat!  Now I really really can't eat.   I am rinsing with what the doctor recommended, but nothing seems to help.  Well, actually, chocolate snowballs feel really good and don't burn at all!   Chocolate malt from Sonic, not as good.  But woman can't live on chocolate snowballs alone.  It's getting to be a problem.

Wait ... didn't I just say that I was feeling better than I had in a while?  In some ways that is true, and for that I am very thankful.  I still have numbness in my hands and feet, but what has improved is the weakness and balance issues in my legs.  I no longer require pushing the shopping cart to feel steady on my feet.  I can walk from the car to the store without feeling like I'm simply not going to make it.  I can go up steps and get into/out of cars without assistance.  I was in a bad, bad place with severe neuropathy symptoms!  If those areas have improved, I am hopeful that I will improve in other areas as well, such as being able to type, open things, and clip my own nails!

Sunday at church, parts of the sermon really spoke to me.  It was on contentment.  I know I have contentment issues.  In Philippians 4, Paul speaks of being content regardless of your circumstances.  Even though my circumstances seem rather grim at times, I still have a lot to be thankful for, so I must dwell on that!

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