I have had 2 weeks of wheels spinning in my mind. I am not 100% sure why scans haven’t been on the books, but we have been scan happy, and maybe it is scan break time. My last PET-CT was just a month and a half ago.
Yesterday I went in and had my blood drawn so we would have my tumor markers for today’s appointment.
My oncologist is just so darn cute. I just have to say that.
We started off the appointment doing the pain chat and moved on to looking at my PET-CT rechecking my side for anything old that would indicate the cause of the pain for the last 3 weeks. My right side is a disaster, and that is the side I sleep on. Right side is where I got the ONJ – which has been feeling great, infection is behaving at the moment, pain is good, just a little hole right now. Now rib… something something something? I mentioned to my oncologist I think it is my ribs. I hope it is my ribs. I don’t know the difference between ribs and liver pain but I think she poked at my liver and came to her own conclusions (whatever they may be).
My tumor markers went from 113 (they were 113, not 112) to 123 in 2 weeks. Another 10 points. They were excited about a .2 drop, so I am assuming a 10 point increase over 2 weeks is no bueno (plus we did a 30 increase between December and January).
With new pain, we knew there was a new tumor in my spine and my tumor markers are being wacky my oncologist said it was time to change the game plan. They were going to possibly do Everolimus (Afinitor) and exemestane (Aromasin). I kind of squinted my eyes in the Mandi squinty kind of squinty way and say “weren’t we going to add a HER2 med into the mix if I had progression?” It seems really odd to find out I have HER2/nue positive breast cancer that makes new tumors within a couple of months and not hit it with a hormone blocker and HER2/nue treatment. That was the plan in December.
My oncologist smiled and said YES! Let’s do that, but are you ready to start chemo? She pondered Lapatnib (an oral HER2 med) for a moment, but if I started there, with the current requirements – I wouldn’t get access to Perjeta – which has been shown to be a very effective first line treatment on HER2/nue metastatic breast cancer cells. Plus we are all tired of kind of watching my cancer spread what feels like quite a bit in the last 6 months (I just had some lung nodules and what we thought was a LOT of time). I expected more out of removing my ovaries. I really thought that would be my golden ticket. Not so golden. Bad ticket. Bad ovaries.
We discussed my appointment at MD Anderson in 2 weeks. She was happy about the additional input from the doctors down there and asked if I wanted to wait until after my appointment to make a decision. I told her right now I am kind of tired of waiting (I know this isn’t a sprint, but I feel like I have been sliding downhill fast). If we find a trial or something we want to do we can change course if we need to based on what they say. Most of the immunology trials I have seen that look interesting will allow me to have been on the chemos I am doing (and will actually let me be on an antihormonal and an anti-HER2 treatment), I just can’t be on antibiotics. We are still looking at me being on antibiotics for several months, so I just can’t explore that yet and would rather get the HER2 regimen under my belt for now (oh man I DO hope this works). I will start to get back into looking into those trials once we figure out my jaw and we have HER2/nue as an option in my regimen.
This trip to Houston will also help create a consult for when we are stuck on a decision.
I had a chair reserved for Zometa today (the scheduler just automatically scheduled it), my oncologist told her before she saw me that I wouldn’t need it. When we talked about starting chemo I told her Fridays are a better day for me, and she went out trying to figure out when I would start and came back in dancing telling me that she did get me in today (told you she is adorbs).
We had discussed doing weekly Taxol originally, but she opted for Taxotere now instead, because I had Taxol with my first treatment – my cancer survived it, and Taxotere may work better (every 3 weeks is easier for my brain to wrap around right now too).
I started singing songs to the nurses as they brought me meds (ok. I only made one up about steroids, but now I have to come up with some more…). That was a long day. I got harassed about my lack of a port (I am waiting for information and date on when we are getting that in in the next 2 weeks). I am having a heart scan before my next infusion so we keep an eye on what Herceptin does to my heart.
We will also do another PET-CT soon.
So. BOOM. Taxotere, Perjeta, Herceptin.