Thursday, April 28, 2016

Getting Back to "Normal"

This week was the first week since the beginning of January that I did not have to go in for any kind of chemotherapy infusions.  I went to work every day. I didn't have any needles jabbed into me.  I didn't have to pack a bag full of snacks and reading material to while away the hours in the infusion chair.  I just had my usual routines.  It was refreshingly normal.  

My new version of normal includes a new treatment plan that should be a lot easier.  I will now only have to go in for infusions once every three weeks, and I will only get Herceptin and Perjeta each time. These drugs are much less hard on the body in almost every way. I should start to see my hair coming back and, hopefully, an end to the sensitive fingers and toes.  I can already tell a difference in my energy levels now that I'm no longer getting Taxol.

I will still get an Xgeva shot for the cancer in my bones as well, but I will only get that on every other visit.  I am also on a new hormone therapy pill called letrazole since my cancer is fueled by estrogen. Letrazole is known as an aromatase inhibitor and it works by reducing the amount of estrogen the body produces.  So far, I haven't had any side effects from the pills after taking them for a week, and I'm hoping it stays that way.

How long will I continue on this treatment plan?  Well, that's anybody's guess. We'll keep at it for as long as it seems to be keeping the cancer at bay and as long as my heart stays strong. At this point, things are looking good. My CA27.29 tumor markers are now down to 68 (from a high of 850, with normal being 0 to 37), and my CEA tumor markers are down to 3.5 (from a high of 48 with normal being 0-2.5).  Maybe next time those numbers will be even closer to normal range.

And there's that word "normal" popping up yet again. Normal is a bit of a loaded word, isn't it?  What, exactly, does normal mean?  We like normal because it is familiar. We like normal because it feels safe. It's a day where everything sort of turns out the way you expect it will. It's a day with no real surprises. But it's all relative, isn't it.  Our expectations for what is normal are going to vary from person to person and from day to day. To quote Morticia Adams, "Normal is an illusion. What is normal for the spider is chaos for the fly."

Of course, it's also normal for the fly to get caught in the web. That's what life is. Spiders eat flies. The fly just didn't expect it to happen to him. Maybe there's a lesson there for us all. We are all going to hit that spider web, but the more we struggle against it, the faster we get entangled, and the more stuck we feel.  Maybe if we are a little more calm and peaceful, the spider won't notice we are there.


Friday, April 15, 2016

Turning the Page

Today marked a major change in my treatment plan. My oncologist confirmed that I can now quit the beastly Taxol chemotherapy. Although I've tolerated the drug really well, the last few rounds have made me really feel the cumulative effects of all these weeks of treatment. It's harder to bounce back from the fatigue, some of my toes are now completely numb, and my fingernails are so sensitive that I have trouble opening a food container. I know lots of people have much worse scenarios with chemotherapy, so I feel pretty lucky all things considered. I can still work. I can still do push-ups (only three in a row, but hey, it's a push-up and they are hard), and I can still live a pretty normal life. I know it takes a big chemo beast to tackle the toughest monsters, but I wasn't relishing the idea of allowing the beast to continue it's weekly rampage of indiscriminate destruction.

I didn't get a chance to meet with my Dr myself, but my husband ran into her in the hallway and chatted for a few minutes. She told him she was very pleased with my scan results and said that, at this point, the last three Taxols, including the one today, probably had a very exponential effect, and if I were to get a scan today, I would see an even greater difference. I will continue to receive Herceptin and Perjeta once every three weeks for the foreseeable future, but maybe even someday I can stop that for awhile too. Although these drugs are a lot easier than Taxol, they are not totally without side effects, so this was also very encouraging to hear. She said that Perjeta, the newest drug, is really doing some amazing things for her patients, and she thinks it will do some amazing things for me too.

This was all wonderful news to hear, and it really feels today like I have now turned a page and have finished one chapter and am starting on a new one.  The whole previous chapter started out kind of scary, and I was feeling a little stuck there once in awhile. You see, metastatic breast cancer isn't known for happy endings. In fact, when I scanned the other books on the breast cancer shelf for clues as to what my story might turn out like, I wasn't too thrilled with what I was finding. So many plot changes, ups and downs, false starts and so much potential drama and horror. I don't really like drama. I could barely even stand to watch the Lucille Ball show when I was younger. Even though it was a comedy, I just knew she was going to make some terrible mistake and get into all kinds of trouble, and I couldn't take the tension! I don't like horror stories either. I still get shudders over movies like Silence of the Lambs. In fact I got chills just typing the name of the film.

But I now realize that every story is different, and here is the best part. I am in charge of writing my story, and I can make it be anything I want it to be. Isn't that fantastic? We get to make it up as we go along. Since I don't like scary stories or super dramatic stories,  I don't want to write one like that.  Of course I know that sometimes you can't control every aspect of the story, and a little drama is going to sneak in even if we don't want it too. But that's the way that stories go. I guess every story needs a little bit of drama to keep the story interesting. Sunshine and daisies are great, but the daisies can't come up without a bit of rain and those spring thunderstorms beforehand.

Still, I think a little drama goes a long way, so I'm going to try to keep writing a story that makes me happy. I'm going to try to keep writing stories and songs that make others happy too.  I'm excited to turn the pages to see what the next chapter brings.  

Tuesday, April 5, 2016

Suck Up and Take Your Medicine


My long-awaited scan results came back last Friday.  I tried not to be too attached to any outcomes.  I, of course, wanted the scans to be crystal clear, but based on the tumor markers from a few weeks ago, I knew it was highly unlikely. My husband and I waited for the nurse practitioner to join us in the exam room to give us the news, but neither one of us was quite certain what we were going to hear. I was pretty confident that everything had shrunk a lot, I just didn't know how much.

My nurse clearly has done this a lot because she didn't keep us guessing. She came in right away saying "I have really good news to share with you!"  My echocardiogram, as expected, came back totally normal, which is great. That means I can keep getting the Herceptin and Perjeta drugs without worrying about my heart function.  Although they can cause some cardiac toxicity, these are the key drugs for keeping the kind of cancer I have at bay, and it would have been a serious blow if I were not able to continue with them.

The real question, however, was what the PET scan showed. The PET scans show how much of the radioactive glucose (FDG) was absorbed by the tumors. They call this FDG Avidity and they measure it by a scale called Standard Uptake Value (SUV).  You didn't know you would get a PET scan lesson today, did you? Basically, the larger and more active the tumor is, the brighter it glows.

The scans no longer show uptake in the lymph node by my thyroid. They show that the lesions on the bones are almost gone. They show the liver lesions are almost gone, with only one liver lesion that is still somewhat active with an SUV of 10.6, but it was previously 16 and the lesion is half the size it was before. They show the lung tumors are almost gone, with only one that had any real FDG Avidity, but again, it is half the size it was and has reduced in activity by about 75% from an SUV of 15.4 down to 2.7.

This is all really good.  Really, really good.  The nurse called it a "wonderful" report. She thought I might even be able to quit the Taxol going forward. The nurse gave me a big hug and told me I was doing a great job. It was a very good day, and a very good weekend.  

I learned yesterday morning, as I was driving to work, that I don't get to quit the Taxol just yet. My doctor wants me to do at least two more infusions. I wasn't thrilled about that. This news happened to coincide with my low point post treatment and I was extremely tired, my fingers and toes were numb, and I was feeling pretty down. And then I heard the song in the video above.  I have a big playlist of songs on my phone that inspire me, that make me happy, or that just make me want to sing.  I hook it up to my car stereo and let it play at random. Just at that moment when I was starting to feel sorry for myself, Take Your Medicine began to play.    

You can take it in stride, or you can take it right between the eyes.
Suck up, suck up and take your medicine.
It's a good day, it's a good day to face the hard things.

Pulled my fist from my mouth.
I beat myself for a quarter century.
Remind, remind that it's bigger than me.
Dissolve, dissolve into evergreens.

It was just what I needed to hear at that moment. It's easy to be positive when I feel great. It's not as easy when I've been hit by the Taxol truck. It's awfully tempting to fall prey to the siren song of self-pity, but I know it doesn't do anybody any good, least of all me.  The song reminded me that it's all temporary. Everything dissolves away eventually, even the hard things. The Taxol truck may have hit me hard, but it is also making it possible for me to travel farther down the road to remission.  I just need to suck it up for just a little bit longer. Nobody likes the hard things. But I think the hard things make us stronger in the long run.