I just finished my third round of treatment  (3 weeks on, one week off) and it's going well.   I'm a little more tired, I have a mild headache after treatment and I give myself two shots every week to increase my white blood cell count, but overall the CMF (cytoxan-methotrexate-fluorouracil 5) is manageable.  The schedule has been inconvenient, especially over the summer, but that's better than feeling awful AND not liking the schedule!

I had a scan on August 14th, which was "stable".  I was hoping for "shrink" (there are several liver tumors that haven't budged), but "nothing new" and "no growth' is a good thing.   I asked Dr. Kaplan about it and was reminded that because I initially had trouble keeping my white blood cells stable, I've only been on a full dose of chemo for 5 weeks.   Dr. Kaplan and I are both hopeful that after being on the full dose for the next 3 months, the next scan will show more improvement.  

I haven't talked about the emotions surrounding cancer in a while, but no matter how good things are, there's always a sense that life is forever different and will contain some level of fear.  For example, I've had a dry cough for a while and was worried that it was caused by cancer in my lungs.  It didn't cause me great anxiety, but it was in the back of my mind until I received the scan results.

And the other night Daniel said, "Mom, I"m going to keep loving you, even when I'm a grown-up.   And even when you're a grandma" (we had just returned from a visit with James' parents).  As sweet as that was, the first thing that went through my mind was, 'It's unlikely that I'll see you graduate from high school or be a grandparent".  Tough stuff and not a topic I bring up very often (or ever say out loud), but as I said, it's always there.

For now, I"m back to my mantra,  "Today, I am good".   Which is true.

The biggest thing I'm struggling with is adjusting to being thrown in to menopause after my surgery in May.   I can't take any hormone replacements because my tumors love estrogen and progesterone, so I need to learn to deal with and/or accept those symptoms .  The hot flashes are annoying, but it's harder to deal with sleeping problems, a non-existent metabolism and mood swings.  Really big mood swings.  I have an appointment to talk to a doctor about what options I might have.

I can't believe school is just around the corner and soccer practice has already started. I found out who Daniel and Olivia's teachers will be this year and I got a big hint about who Ryan's will be.   I think they'll have a good year, and hopefully I will, too.

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An update:  

The surgery went well (although it started 4 hours late -- ridiculous!).   The tumor was metastasized breast cancer and not ovarian cancer, so I "only" had my ovaries and fallopian tubes removed.

I'm recovering well.  I still get tired easily, but I feel more discomfort/achiness than pain and I'm not taking any medication.    More than one medical professional told me it can take 4-6 weeks to recover from the anesthesia alone, and I think a lot of what I'm feeling is related to that.  My mind is 'fuzzy', I'm having word finding problems and my blood pressure and energy level are still low (although I'm walking regularly).  

When I talked to Dr. Kaplan at the hospital, he said that breast cancer was the better diagnosis.  And if he thinks it's "better", than so do I.  It is concerning that I developed a new tumor while I was on a chemo that was working well on my other tumors, but there are a lot of treatment options for where I am now.  

I'm going to continue on oral cytoxan because my cancer markers have continued to drop, which means it's working on the stubborn tumors I've had in my liver for almost a year.  But I'm going to add an I.V. chemo to kill the "cancer progression cells" that are likely in my bloodstream.  This treatment won't be as strong as the drug I was on in 2010, but it has plenty of side effects like mouth sores, fatigue, hair thinning, etc.   I'm hoping the worst part is that I'm going to be "3 weeks on, 1 week off", which can be terribly inconvenient!  Especially with the kids home over the summer.  

We've already had wonderful support, childcare and meals provided and I'm sure there will be more in the months ahead to help us get through what we need to do.  We are thankful for it all.

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Unfortunately, my ovarian "cyst" turned out to be a malignant tumor.    At this point, we don't know if its breast cancer that has spread to my ovary or ovarian cancer.   Neither are great options.   I don't want 2 types of cancer, but my type of breast cancer rarely goes to the ovaries,  so if that's the case it might be a more aggressive/tricky form than we originally thought.    That doesn't sound good, either. 

I'm having at least my ovaries and fallopian tubes removed on Monday, April 28th (if its breast cancer) and possibly a hysterectomy (if its ovarian cancer).    This will be done abdominally vs. laproscopically, because that's a "cleaner" surgery when you're dealing with cancer. 

I'll be in the hospital 2-3 nights and I'm not sure how long my recovery will take, but I'm sure it will be a while before I'm back to "normal".

I won't know the treatment plan until after the surgery and I haven't asked too many questions because there's enough to worry about!    

I asked the surgeon if it was more likely to be a new cancer, because my breast cancer markers are continuing to go down (as recently as last week).  He said that's possible, but my ovarian tumor is pretty small and may not be noticeable on the blood test.

I also asked if it was more likely to be ovarian cancer because I'm on chemo for breast cancer (which is working).  That answer was also "no", because the ovaries have a layer that protects them from most chemo (which is also why the brain doesn't usually respond well to chemo). So, we really won't know what's going on until the tumor is biopsied during surgery.

If it is ovarian cancer, I likely have the BRCA gene, which I'll get tested for either way. And so will Olivia at some point.     

I had some very bad moments over the weekend, but now I'm focused on getting myself and my family through the surgery.    I'll try to update soon.   

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A step in the right direction ---

My last scan was "stable", and although Dr. Kaplan told me with a smile on his face, my first question was, "Is that good enough?".    The answer was "yes" and after thinking about it (and asking a few questions),  I understood why.

Two of the four tumors I've had since May have been slowly shrinking, while the other two have continued to grow.  This is the first time the stubborn tumors have been affected by any treatment, which is a good sign.   And because my white blood cells are stable (which has been a problem), I increased the dose of Cytoxan, which will hopefully move things from "stable" to "shrink".  

And more good news:  My cancer markers have decreased from 230 to 130, which is a significant jump. The other good news is Cytoxan continues to be a manageable drug and I'm hopeful I can continue taking it for a while. 

The scan did show that I likely have a "hemorrhagic"  cyst on my ovary, which is exactly what it sounds like -- some blood has leaked in to a cyst.  Unfortunately, its also possible that its a tumor with a blood supply that makes it look like a hemorrhagic cyst.  My follow up ultra sound is in 4 weeks and I'm going to try not to worry about it too much until then (but I'll worry a little). 

I'm still dealing with dental problems from one of the original treatments I was on.  It's frustrating because I use prescription fluoride and the dentist says my oral hygiene is "impeccable", but its hard to overcome permanent damage to your jaw.  I saw an oral surgeon and I'm going to lose another tooth next week.  This one is in the back and I don't think I'll replace it, but I'd still rather keep it!

I also have what is likely a torn tendon in my foot, or possibly several small tears. Its a slow healing process but I like the doctor I'm seeing and it is getting better. 

To add insult to injury, Daniel came home with lice the same week James' car needed a new fuel pump.    I think I was too tired to cry as I picked nits out of Daniel's hair, did a ton of laundry and figured out how to manage with one car during a busy week. 

I saw this quote in a magazine recently.   Its something I think about often, and although I'm not perfect at it, it has helped me get through some difficult weeks: 

"Every day and every breath is a gift.  If we can only see it for what it is."

I am thankful for each gift.  Well, maybe not lice. 

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NEXT!

My November scan showed that my tumors had again responded unevenly to chemo.   I'm disappointed for several reasons, including that the drug I was on, Navelbine, was a manageable one.   I felt "off" 2-3 days a week and got tired more easily, but nothing like my first experience with chemo.  I was giving myself Neupogen shots to increase my white blood cell count, but I've been doing that long enough that it didn't bother me.

I'm now on my 4th "new" treatment since May.   To review:  Arimidex (oral hormone treatment), Xeloda (oral chemo), Navelbine (I.V. chemo) and now Cytoxan.   Cytoxan is another oral chemo, which makes things a little easier.  It's processed through the bladder,  so I'm supposed to drink 10-12 cups of water every day (to avoid irritation....).  I haven't hit that goal very often, but I'm close enough that the side effects don't bother me very much.   I'm more tired (of course) and my white cell count has dropped, but so far I don't need Neupogen shots.   My hair has started to thin, but its not too noticeable (except to me!).  I'm hoping that my hair "only" thins, but its possible I'll lose enough to buy a wig.   Time will tell. 

For some reason, this "failure" hit me pretty hard.  First of all, I wanted the Navelbine to work so I would finally be on my way to finishing treatment.  I've been on some form of treatment since May, and every 3 months I "start over" with a new drug, so I feel like I haven't made any progress (although hopefully the drugs that didn't work on the stubborn tumors are helping to keep the others at bay longer).   It's also in the back of my mind that each time a treatment doesn't work,  I'm one step closer to the tumors not being so small, or worse, more tumors joining them.  I trust Dr. Kaplan, who said this isn't a "medical emergency", but he strongly hinted that if my current treatment doesn't work, he might not give me a choice next time, which means I'll have to go back to Abraxane (yuck).

My next scan will be in mid-February.  Until then, I'm drinking lots of water and hoping for the best.  I'm thankful that I was able to get through the holidays and the boys' birthday with a relatively easy treatment.  Let's see what the rest of the year brings!

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