I always knew this day would come, the day when I am running out of treatment options, but somehow it crept up on me.
For those of you who don't know my cancer history, I was diagnosed with breast cancer almost 11 years ago. I had a local recurrence just a few months after finishing my first round of chemo, then about one year in clinical remission, and then the cancer came roaring back, this time in multiple sites in my bones.
My right arm was broken by a tumor. It wasn't pretty.
Since then, I've been in pretty much continuous treatment. I've had radiation therapy five times, and more chemo drugs in more combinations than I care to remember.
Recently, we found my first tumor in the soft tissues since my metastasis: a little tumor in my right lung.
My cancer is hormone-positive and HER2neu positive, and that has determined the drugs I've been treated with. One reason I am still alive is that I've been treated with Herceptin, Avastin, and Tykerb, again at various times and in various combinations, and these drugs have less toxicity than the conventional chemo drugs like adriamycin and Taxol, both of which I have also had.
Since the lung met, however, my doctors have wanted to put me on combinations of drugs that included a light dose of one conventional chemo drug--first it was oral cytoxan, then it was gemcitabine, by IV.
But I haven't been able to tolerate these drugs.
The parts of my body that have been harmed by chemo: GI tract, kidneys (just borderline functioning now), lungs, and possibly heart--we're still sorting that one out. Then there's the chemo brain--I can't multitask anymore, and I can't remember numbers.
"Chemo toxicity" is the term for it. And 10-plus years of chemo is a LOT of chemo.
So a few weeks ago I asked Dr. Lee if we could try a combination of Avastin, Herceptin, and Tykerb, with no conventional chemo drug. First he said yes, then he changed his mind.
Avastin has a couple of potentially serious side effects: One is that if you get in an accident while on the drug, or need major surgery, you are pretty much toast, because you will bleed to death. No dental work either, while on this one. Avastin also causes high blood pressure, although when I was on it before we controlled this easily enough with yet another drug.
For right now, the plan for the summer, which I am calling "Chemo Light," is for me to get just Herceptin (by IV every three weeks), zometa (by IV every six weeks), and Tykerb (oral, taken every day). But we know that this won't hold my cancer in check, so we are starting to look for another drug that I can tolerate.
I may end up in a clinical trial, although I don't much feel like experimenting with my life right now. I kinda feel like I've paid my dues in the cancer world, and I've taken part in clinical trials in the past.
The amazing thing about my situation is how calm I feel about it. I'm enjoying life right now, and feeling good physically. I just started a new exercise regimen, and the things that bring me joy are: my sons, my dog, my garden, my friends, and my blogging and jewelry-making. That's a pretty full life.
I'm not stressed. I'm not depressed. And not even close to a meltdown.
I can't really explain this, except to say that I've been in medical crises so many times now that I don't seem to be able to react to yet another one. Kind of a same-old, same-old feeling, although I'm the first to admit that it's a bit weird.
Burned out on crises, maybe?
As always, I am not seeking advice or suggestions. Please do not e-mail me to suggest a treatment regimen or drug. E-mails of solidarity and support are welcome. Thanks.
@ Jeanne Sather 2009.