It’s been awhile since my last blog post, I have been concentrating on getting my bearings back after the past few days. On Friday I went into Boston to get my normal chemo yet my liver function tests came back 6 times higher than their normal. I had also been complaining about indigestion, abdominal cramping, and extreme acid reflux. Given my symptoms my doctor thought it would be best if I got a CT right away to rule out gallstones. Granted this made me nervous, for my labs have always come back within normal range throughout most of my chemo’s, and given the enflamed lymph nodes that showed up in my chest and abdomen on my last CT scan I knew something was going on.
I went down to the CT, drank the drink, and waited in the waiting room for my scan. As anyone who has metastatic cancer you know all the crazy thoughts that go through your mind while you wait in a waiting room. I held it together pretty well, it wasn’t till after my scan when I was in the waiting room waiting to get the results from my doctor that I really had to concentrate on choking back the tears. I am not sure why I was crying, as a metastatic breast cancer survivor I knew that the cancer would return in a matter of time, and that each therapy eventually stops working. I think it was the liver function tests that scared me. I have had friends that have dies from metastatic breast cancer that had spread to the liver causing liver failure and I was scared that my time was coming on a lot faster that I would like.
Once I got in to speak with my oncologist he then let me know that there was a new growth somewhere near the pancreas, gallbladder, and liver possibly blocking one of my bile ducts. Granted he still needed to talk with the radiologist, liver doctors, and GI doctors to see what our options were, but it was clear that the current chemotherapy was no longer working and that I was going to have to change my treatment plan. There was a new clinical trial that he really wanted to get me in on that was combining three drugs Eribulin, Pertuzimab, and Herceptin, yet with my liver enzymes elevated I would not be able to get into this clinical trial. He said he was going to talk with the liver doctors and see if putting a stent in my bile duct might help lower my liver enzymes enough to get me into the trial. He let me go home at that point, since I was an emotional mess and there were too many factors that still needed to be figured out before we could make a better decision on my next treatment plan.
I spent my weekend in fear; mostly fear of the unknown. I was unsure of my next plan of attack, I knew that my cancer was growing fast and I was not ready for all these changes. The clinical trial would require me to get weekly injections, when I have grown quite fond of only having to go into Boston once every three weeks. I was also unsure if this therapy was going to involve pre-meds that would render me unable to drive myself. My other option was to try oral chemotherapy for the first time. The drug is called Xeloda and is a capsule that you take several in the morning and them more in the evening for two weeks with one week off. The most common side effects from Xeloda were diarrhea, rash, nausea, and hand and foot syndrome. Hand and foot syndrome is basically when the palms of your hands and feet get red swollen and sore, and a times peel and blister. However the clinical trials side effects were not much better I would have to loose my hair again, deal with nausea, vomiting, and the therapy would be more taxing on my liver.
Thankfully my parents surprised me with a visit on Saturday, which helped get me out of my own head and stop the tears. It was nice to get the chance to hang out with them and to not think about my problems. We watched The Wolf of Wall Street and had some good food. It was a nice visit. I had been freaking out all weekend on how I was going to tell my son the new news while at the same time holding back my emotions to keep from scaring him, at least till I know all the facts.
I got a call on Tuesday to go in to discuss my options and possibly start a new treatment on Wednesday. When I got there my doctor told me that he and a group of other doctors had the time to go over my CT results more thoroughly and that there did not seem to be anything blocking my bile duct, but instead it appeared to be enflamed for some reason. The new growth actually showed to be in my pancreas. I cannot lie that when he said those words I felt I was a goner, seeing as pancreatic cancer is one of the deadliest of cancers. Yet he assured me that having breast cancer in the pancreas is a lot different then having pancreatic cancer, and that pancreatic cancer is the deadliest cancer because of the type of cancer and not because of its placement. My options from here were to re-take my liver function test and then choose an alternative treatment based on the results.
My liver enzymes were still elevated, so we decided to give the combination of IV Herceptin every 3 weeks along with the oral chemo Xeloda, which are 7 pills taken daily for two weeks and then one week off. Three pills in the morning and four pills after dinner. I guess the way this chemo works compared to traditional IV chemo’s is that the oral pills give you a smaller dose of chemo over a longer period of time instead of having a massive IV does to last you a full week. The oral chemo’s got a bad wrap there for awhile, mostly because a lot of the health insurance companies did not want to cover them like a traditional chemo and people were forced to pay extremely high co-pays every three weeks to get their pills. It seems as though my insurance is going to cover the pills so I should be ok.
My next scan will be in about eight weeks to see if the new treatment is working, and my new pills should arrive in the mail tomorrow so that I can start them on Sunday. This will give me time to stock up on Imodium, cotton gloves and socks to wear to bed with lotions, and anti-nausea meds. The good thing about starting a new treatment is that it usually takes a while to build up in your system before the side effects get more and more unmanageable. I do have the option to lower the dosage of the pills if the side effects are out of control.
So that’s the new deal with me. My crazy past few days as a metastatic breast cancer warrior. A glimpse into how surviving is not always about strength and courage, and sometimes it’s just pure fear and desperation. I have no doubt that I will learn to adjust my life to this new chemo cocktail, and that this will become my new normal until it stops working and I have to move on to the next best thing. It is frustrating to be fighting a beast that I know I cannot win, yet all I can do right now is just hope for more time.