Tuesday, September 25, 2012

This is getting real.

After our first visit to the Oncologist on Friday, the cancer diagnosis became very real.  We really connected with the oncologist here and her office happens to be just a couple of minutes from our house.  We knew we were going to like her when she asked us if we were familiar with the "Lord of the Rings" trilogy and then proceeded to describe cancer and my cancer treatment using the movie as an analogy.  She said, imagine the cancer cell as "orks."  There are a lot of them and they continue to multiply.  To kill them, you not only need to stab them in the heart, but also need to cut off their head (sorry if that is a bit gruesome). Now, it does no good if you continue to kill them but don't do anything about the fact that they are multiplying.  You don't gain any ground.  So, what we do with the cancer is we attack it with two separate chemotherapy treatments.  If the first doesn't kill the cells, we hope the second round will.  At the same time, we have to prevent new cancer cells from growing.  Since my cancer is estrogen receptor (and progesterone receptor) positive, the cancer cells thrive on those hormones and needs estrogen in order to grow.  So, we fake them out with a drug called "tamoxifen" which binds to those cells but does not activate them.  Thus, breast cancer growth is hopefully blocked.   So, here is her recommended treatment regimen:

  • 9/26/12:  (yes, that is tomorrow) 11am:  Port (or portacath) placement via sedated surgery   3pm (echocardiogram of my heart to use as a baseline)
  • 9/27/12:  First Chemotherapy treatment.  I will do one dose of AC (Adriamycin and Cytoxan) every 3 weeks (takes 4 hours) x 4 doses.  So, I will have 12 weeks or three months of this chemotherapy.  Apparently, I will feel like I have the flu, with a lot of fatique, with this treatment.  I will most likely feel my worst around day 7 after treatment, with the day or so leading up to and following the treatment being pretty tough as well.  The doctor said she can give me plenty of meds to help with nausea, but she cannot give me anything to help with the fatigue.   During days 8-14 following the chemo treatment my immunity will be at its lowest.  We are going to need to implement some really good routines at our house to prevent illness.  This means that Luke will need to be doused in Purell every Tuesday and Thursday when he is picked up from school.  We will also have to be careful about having people over.  The doctor jokingly said, "I am going to help you beat this cancer, but I don't want you dying on me with a silly cold!"   The doc also mentioned that I WILL lose my hair.  It starts falling out around two weeks into the treatment.  
  • 9/28/12: Injection of Neulasta (prescription medicine used to reduce the risk of infection due to the strong chemotherapy I will be receiving, which lowers the number of infection-fighting white blood cells)
  • Following the first three months of this strong chemotherapy, I will go through three months of chemo treatment using the drug, Taxol.  I will have an injection weekly for 12 weeks (approximately one hour).  Apparently, this treatment is not as hard on the body as the first treatment (AC).
  • Then, I will have surgery, then radiation, and then "BAM" the cancer is gone.  This is what we are praying and is actually how the doctor described the process.  I said, "OK, let's do it!"   We told her we had an appointment at MD Anderson on Monday.  She told us they would recommend pretty much the same treatment, only in reversal.  She said she was fine with that, but recommended the reversed way because she likes her patients to have the less harsh on the body treatment right before surgery.  I will also be taking tamoxifen for 5 plus years daily.  

Before we left, I had 5 vials of blood drawn and I was scheduled for an MRI Brain, MRI lumbar and echocardiogram.  Is there a test or imaging study that I have not had in the past week?   Going to all of these doctor's appointments has been like a full time job for the past week and a half.  But, I am so thankful I have been able to be scheduled for all of these exams so swiftly. The oncologist said that I need to start chemotherapy as soon as possible due to the aggressive nature of my cancer and my age.  We were so thankful to have the appointment with MD Anderson on Monday as a second opinion so that we could begin treatment as soon as possible.  Stay tuned for another blog post about our MD Anderson appointment.  

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