The Next Steps

We are so deeply grateful for the outpouring of love and support that we have experienced in the past few days.  I wish I had the time and energy to respond to each one of you individually, but I hope you know that we read and appreciate every message.  I am beyond fortunate to have so many wonderful souls in my life.  Thank you.

I forget that most people have never been in cancer treatment world, and I have been asked a lot of questions as to what this treatment might include and how in the world can I have breast cancer in my lungs? I admit it is highly ironic that I do not have any sign of cancer in my remaining left breast, but I do have breast cancer in a whole bunch of other places. Here's how it works for those of you who like details.

In my first go-round, I was Stage III because there was not evidence that it had spread beyond the lymph nodes. However, cancer cells that break off from the primary tumor may be microscopic and can travel through the lymph system of the body. For breast cancers, it is very common for them to move (metastasize) to the lungs, liver, and bones.  Any time a primary cancer has moved to a different part of the body, this is considered Stage IV cancer. It is considered incurable, but that doesn't mean it is not possible to go into remission and achieve NED status (No Evidence of Disease).  This is the goal, and we have a new drug weapon now that we did not have the last time I went through treatment.

The arsenal of monster-fighting weapons will include the following treatment regimen.

Starting on Friday, and then moving to Thursdays, I will get 12 weekly infusions of Taxol (a chemo drug I had last time and tolerated very well). Doing it once a week means I can get a smaller dose and it's a lot easier to handle.  All the usual chemo side effects apply.  Hats and scarves will likely be in my future.

On week 1, 4, 7 and 10 I will also get two additional drugs, Herceptin and Perjeta. My cancer is HER2 positive which means that it tests positive for a protein called human epidermal growth factor receptor 2. HER2 promotes the growth of cancer cells and about 20% of breast cancers have this gene mutation that makes an excess of the HER2 protein.  While having lots of these HER2 proteins means cancer spreads fast, it also creates an Achilles heel that Herceptin and Perjeta can target.  These two drugs are monoclonal antibodies that target that specific protein and block its growth.  I had Herceptin last time and now we have this new drug called Perjeta to add in to the mix.  I wish I could share with you just how confident my doctors are about this treatment. I've talked to a lot of cancer doctors in my life, and I've certainly never heard them be so excited about something.

Once those first 12 weeks are up, I will continue to get the Herceptin and Perjeta every three weeks for another three months.  The side effects from these two drugs are much less than from the Taxol, and I had no issues when I was on Herceptin last time. I will also be getting a once a month injection of a drug called Xgiva which will help my bones to stay strong and will deal with the cancer in the bones more effectively.

Once those three months are done, we will assess the results through more scans with the goal being NED! Hopefully, I will be able to just go on a hormone therapy at that point and take a pill every day to keep it in check. I may never fully be rid of my monster, but we can turn it into a little tiny mouse that I just have to get after once in awhile.