Friday, July 26, 2013

Cancer Survival Update

It feels weird to be fighting for my life, and seeing my doctor weekly, at minimum, and then all of a sudden hear my doctor say, "see you in October," at my last appointment.  My next appointment with my oncologist is in three months!  Now, I do have a PET scheduled on August 13 though.  It has been 6 months since my last one. I can't believe that much time has gone by!

I do have a new prayer request though.  One of the biggest parts of my treatment is the 10 plus years that I will be taking the hormone therapy drug, Tamoxifen.  As a reminder, my cancer was highly estrogen receptor positive.  This means that estrogen binds to the receptor sites of the cancer cells and is what makes it grow.   Tamoxifen works as an anti-estrogen--it actually binds at the cancer cell receptor sites since it looks like estrogen (but is not).  So, since those cancer cells can no longer grow, they die.  I have been told that Tamoxifen is my key for survival and to prevent recurrence of cancer.  In fact, my MD Anderson oncologist told me that this was one drug that I could not even miss one day taking--it is that important.  Well, I have been on Tamoxifen since I completed my radiation therapy in early June---and I have been having problems with it.  About a week or two after I began taking it, I broke out with hives all over.   I take my tamoxifen at night with dinner; each morning I would awake covered in hives.  The only change in my lifestyle was taking the drug, so I have assumed it was due to that.  I began taking Benadryl every night before bed, and that really helped control the hives.  Then, after about 3 week of hives, I stopped taking the Benadryl and my hives didn't return....for a couple of weeks.  Oh...and by the way...I had no idea that taking Benadryl was contraindicated with Tamoxifen.  Apparently, it can prevent it from working, and the Benadryl side effects can be increased when taken together.

Two days ago, I awoke with hives once again.  Unfortunately, they progressed as the day progressed.  Yesterday morning, I awoke with hives all over my body, literally from head to toe.  I was miserably itchy and even Benadryl didn't help control them.  When my lip began to swell, I thought I probably should notify my oncologist.   So, I did and they wanted to see me.  Apparently, when your face and lips begin to swell it can be somewhat of an emergency.  I took a prednisone (I was already loaded up with Benadryl) and headed to my appointment....with the kids.

Entertaining the kids at my doctor appointment in the exam room with their favorite things:  food for Abbey and the ipad for Luke.
Thankfully, my doctor's office is very understanding about having kids tag along with me.   Anyway, here is the new plan.  They want me to quit taking the tamoxifen for a week.  I took some more prednisone to clear up the remaining hives.  After a week without Tamoxifen, I am going to try a new generic brand of it (the original maker is no longer manufacturing it).  Drew and I read that sometimes people can be allergic to the inactive ingredients, which differ from brand to brand.  Thankfully, the only pharmacy that I am allowed to order the drug from, since it is one I am taking long term, is able to special order a different brand for me.  So, I am praying that this new brand does not cause me to break out in hives.  If it does, we are going to have to take a different route with regards to preventing cancer recurrence.  One option that my oncologist mentioned is taking a drug to shut down my ovaries, which will lower the level of estrogen that is currently circulating in my body.  I asked her if it is as effective as Tamoxifen.  She said that there are not enough studies on it yet (many studies have shown Tamoxifen's ability to decrease chance of recurrence).  But, she said she thought that it was at least as effective as Tamoxifen.  The bad thing about that is that I am so young, and it can put me at risk for things like bone density issues and heart disease (since estrogen helps prevent those things).  A lot of women my age who have hysterectomies or have their ovaries removed (due to being BRAC+), still take Tamoxifen so that they can prevent issues like osteoporosis or heart disease.  So, I guess we will have to figure this out.  I know, regardless, God has a big plan with all this.   I am just praying (and asking for your prayers also) and following along with his direction--like he has already entered the destination and route on the GPS, and I am awaiting all of the directions.  Thank you for your continued prayers for me and my family.  We really appreciate it.

Prayer requests:  
1.  Please pray that we will figure out the best solution for my body with regards to preventing cancer recurrence, and keeping it away!
2.  Please pray that my PET scan on August 13 shows NO EVIDENCE OF DISEASE (NED)!  That would be pretty exciting and it is what we are expecting!  :-)  If it does, I think we need to have a NED party!