Here we go again....

I had a PET/CT on May 1st, which showed 4 small active spots on my liver. Dr. Kaplan described them as the size of "salt and pepper". The good news is they're small, and the bad news is the hormone treatment I was on didn't work, so I'm back to chemo.

Even though I wasn't surprised (because my cancer marker numbers have been going up), I had a small tantrum in Dr. Kaplan's office. I told him I didn't want to go back to chemo, but if I had to, I'd like to wait until the kids go back to school in the fall (I knew I was being silly, but Dr. Kaplan didn't think it was funny).

He gave me 3 options. The first was to go back to abraxane because I did so well on it the first time. I stopped receiving it because I didn't need it anymore, not because it wasn't working, so it will likely work again. I understand that, but I didn't like that option because I'd need a new port-a-cath, plus I'm well aware of the side effects and I'm not ready to go back to them. And I kind of like my hair.

The second option was also an I.V. chemo that has fewer side effects, but being "down" a couple days a week and losing my hair are on the list.   Next, please......

I decided to start with Xeloda, which is an oral chemo I take twice a day at home. Its an interesting drug. It doesn't become active until its gone through the blood stream and "finds" the cancer cells.  Once inside the cells, it converts to 5 FU (no kidding - it stands for Flourouracil) and attacks the cancer cell's production of DNA and RNA, thus (hopefully) killing the cell. It does affect other cells, but the effects aren't as widespread as with I.V. chemo.

As expected, the main side effect of Xeloda is fatigue, which will get worse with each cycle. Another common side effect is "hand/foot syndrome" which causes burning, redness and peeling. I'm taking megadoses of vitamin B6 and have lotions which are supposed to help, but unfortunately I did get painful blisters on my feet at the end of the first cycle. As a result, I'm already on an extended break from chemo (an extra week) while my feet heal. When I start taking it again, I'll be on a lower dose. I'm hoping that allows me to continue on this track.

Because I take it every day for 2 weeks and then have one week off, the effects will increase over those two weeks and my week off will be a true recovery week. One "good" thing about abraxane was that I felt pretty good at the beginning of my week off, because it had already been 7 days since my last treatment. On the other hand, if the side effects aren't as bad with Xeloda, I won't need as much recovery. Time will tell.

My next scan will be in August, but I'm not sure what will happen if my cancer marker number continues to go up. Dr. Kaplan did say we have time to figure it out because the tumors are so small. If the Xeloda does its job, I'll probably take it for at least 3-6 months after the scan. If it's not working or I don't tolerate the new dose well, I'll switch to "Plan B", whatever that is.

To be honest, I'm not happy. I'm not happy that it's only been 2 years (a little less) since I stopped chemo and the first remission is usually the longest. I'm not happy that the side effects may impact our summer. I'm not happy that I have to tell people the cancer is back. Even though this is a "lighter" version than the first time, it's not news that anyone wants to hear and I don't like putting people in the position of figuring out how to react.

I've been struggling with these emotions and trying to figure out the best way to handle them (and the recurrence in general).  Dr. Kaplan asked me how I was doing and I said, "Better, but I'm still questioning my treatment decision and wondering if I should be complaining about blisters as long as Xeloda does its job."   He told me I'm doing everything right and he knows that I'm a Warrior who pushes through as much as I can. I'm not sure I believe that, but it was just what I needed to hear.

I did cross Occupational Therapy off my list last week. I still have some things to work on, but I can finish the final steps at home. I saw the orthopedist last week and he said, "It's hard work to get over a broken wrist, isn't it? But you did it and there are worse things." Yeah, I know.

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