Everything just changed

In mid-December, Anne-Marie went in for her quarterly scans. This included the typical bone scan and CT scan. On the following Friday, we were back at Compass for the every-three-weeks hormonal therapy treatment. The scan results were back and we anticipated reviewing the results with Dr. Smith during the pre-treatment consult.

Dr. Smith told us that Anne-Marie's treatment plan was canceled starting immediately. The scans showed that lymph nodes to the right of Anne-Marie's sternum had become enlarged.  This was concerning enough to the doctor that he not only decided to schedule a biopsy but also decided that the current Herceptin treatment was ineffective.

Matters became even more complicated when Anne-Marie mentioned that she noticed a bump near her collarbone.  Plans switched immediately from a lung biopsy to a biopsy of the bump.  So they scheduled us between holidays for a consult/biopsy/both/neither at Compass Oncology's Vancouver office.

We went to see Dr. Storm in Vancouver on Wednesday (12/28/16) and talked it over for an hour.  What we came up with was that the biopsy was impossible to do in the office.  Dr. Storm preferred to do the procedure in the hospital ASAP, but we couldn't get the schedule to work for next week.

So it's Tuesday, January 10.  We know nothing and won't until at least a few days after the biopsy.  All we know is people are concerned.  Including us.

However, we may just go ahead and enjoy the arrival of 2017.  Since there's nothing to do right now we'll make it a small deal until it needs to become a big deal.

Heart Issues (or, what we didn't tell you in the spring)

Back in March, Anne-Marie was just wrapping up her radiation treatments. The doctors wanted her to start up Herceptin treatments again (I've already explained Herceptin a bunch of times here; it's chemo for all who don't need the subtle details of why it's not.)

After about two months of Herceptin treatments, Anne-Marie was scheduled for a MUGA scan, which is a really thorough ultrasound of the heart tissue. It's standard procedure. The results were not at all what we were expecting. The Herceptin treatments had caused congestion in her heart to a concerning level, causing Dr. Korde to immediately order a stop to treatments.

The plan was to allow a little time to pass and allow the tissue in Anne-Marie's body to recover for a few weeks/months and then start Herceptin again. As Anne-Marie was discussing this with Dr. Korde a few weeks later in July, she mentioned to her that she was having recurring fevers. The doctor agreed that it was a concern and worth monitoring. 

If you've followed the blog you'll know that a few days later, in late July, Anne-Marie was admitted to the hospital due to the fever-causing infection. Emergency surgery followed a few days later. 

Now we're back to where we were in July. They wanted Anne-Marie to begin treatments again, so they scheduled another heart scan two weeks ago. Her heart hasn't quite recovered. There's been measurable improvement, but not enough to risk more treatments. 

We thought this was just a bump in the road and not worthy of mention. We just didn't want to worry people with a "heart problems" discussion.  After four months without resolution, it seemed right to tell the story.

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So what's next?  During all of the testing and complication, somebody caught a glimpse of some enlarged lymph nodes near the tumor site. It is believed to be the body's reaction to July's infection problem. As a precaution, Anne-Marie will go in this Friday for a more in-depth CT scan on Friday.

Kicking Tykerb to the curb

And we're done.

Our first attempt to treat Anne-Marie's cancer is done and over.  A couple of weeks ago, Tykerb (the pill-form chemo treatment) made Anne-Marie break out in a rash all over.  This was not just any rash.  It was a rash that nearly incapacitated her for ten days.

After lowering the dosage three times, we figured that balance and harmony had been acheived and we could set a schedule for next couple of months.  We got the calendar all figured out.  Anne-Marie only had to go to Seattle Cancer Care every three weeks and take three chemo pills every night.

It took three or four days to realize her body was saying, "I don't think so."  By the time Anne-Marie quit taking Tykerb, the damage was done.  She had a rash all over her body that wouldn't go away and began to lose her hair.  Even though she quit taking the pills, the rash lingered on for another week.

Let's fast-forward from three weeks ago to today.  The doctor says that--putting aside the horrible side effects--the treatment was working.  The tumor has shrunk by about 30%.

The question is whether or not it was Tykerb or Herceptin (Anne-Marie's other treatment she gets at the clinic every third week) killing the cancer.  Dr. Korde is counting on Herceptin only to eliminate the tumor prior to surgery.  Because of this, the doctor is recommending doing Herceptin weekly (starting 9/6) instead of every three weeks.

We don't know how to work this out with our schedule yet, but there's probably more good news here than bad.

Checkup and Herceptin

Today I had a checkup with Dr. Korde and my second Herceptin treatment.  Thankfully, I did not have any problems with the Herceptin this time, but I did come home and sleep for three hours!  That stuff just wears me out!  A few days ago, Dr. Korde had instructed me to stop taking the Tykerb pills once again due to troublesome side effects I was having.  It has been a difficult balancing act trying to figure out how much medication to take to lessen the side effects versus too much extra medication causing a whole different set of side effects.  Today we discussed how I could better manage the symptoms and medications.  I can't say that we have it figured out completely, but hopefully it will be better.

Dr. Korde also believes that my tumor has shrunk just from the small amount of treatment I've already had. That is really great news, especially since today was only my second Herceptin and I've stopped, then started, then stopped taking Tykerb again in that short span of time!  She says I may not need to take Tykerb after the surgery, especially considering it's effect on me, but she may want me to continue Herceptin for two years instead of just one. 
 
 I have a lot of difficult decisions to make in the coming months regarding the next phase of treatment after surgery.  I received some very tough news Friday at my consult with the plastic surgeon at University Medical Center in Seattle. What they are recommending for me to do is physically and emotionally difficult, mostly because of what I've already been through the first time around.  It's a long story and a bit personal to convey on here to everyone, but it has to do with radiation and RE-reconstructive plastic surgery.  I'm trying to figure out how I want to proceed, especially since the news was worse than I thought it was going to be.  There are pros and cons, of course.  I know what THEY want me to do, but I ultimately have to make the decision.  So puhleeeze don't start offering me opinions and advice, haha!  =)

Starting Treatment (Herceptin and Tykerb)

Update from Anne-Marie's Facebook statuses this past weekend.

Friday, July 6th:

It's warm outside, but I'm missing the electric blanket. Home and in bed with severe chills and body aches after my 1st Herceptin tx this afternoon. I looked like a mummy during the tx due to being swaddled with mounds of oven-warmed blankets. 

Saturday, July 7th:

Started my chemo pill Rx last night. I was very nervous to take it and had a few tears. Been really sick to my stomach all day long today. The dosage may need to be adjusted. Average dose is 5 huge pills at a time daily. They started me at 4 since I'm a small person. I'm thinking maybe 3 would be better?!? Need to contact my Dr tomorrow.

Certificate of Completion

From Northwest Cancer Specialists!

Herceptin 17: the end of all treatments

Friday, October 5, Anne-Marie had her last Herceptin treatment. It was almost sad to be in the treatment room for the 21st and final time. Surprisingly, it was the slowest day in the treatment room since we began there last August. Anne-Marie was with only two other patients and no more were supposed to come in for the rest of the day.

Included in those two other patients was a nice lady beside us who had taken chemo for a year only to be told a few months after finishing that the cancer had returned. I've heard so many stories like this, I've long since run out of opinions or easy answers. I just expressed my sympathy in the most real way I could.

I went downstairs and got a grilled chicken sandwich from Green's Cafe downstairs. I've tried almost everything on their menu over the last year and a half. I don't know why I finally picked the one thing that I liked the last day.

We were told by Dr. Smith that we wouldn't need to come in for three months. I remember when it used to be years between visits to the doctor, now three months feels like enough liberty to become intimidated.

We feel for those people that we left behind in the Professional Plaza Friday. We'll never look at the chronically ill the same way.

The end of Herceptin treatments

Anne-Marie goes in for her final Herceptin on Friday!

Herceptin 16

One more to go!

Herceptin 15

At last Thursday's Herceptin appointment we learned that Anne-Marie has just two more to go. She'll have her last treatment on October 5!

Herceptin 14

Herceptin 13

Anne-Marie's thirteenth Herceptin was Friday before last, two days after surgery. The clinic was so busy that she never did get a consultation with Dr. Smith. By the time Mom brought her home from the Professional Plaza, she was ready for a good rest.

Herceptin 12

Anne-Marie reached the two-thirds mark for Herceptin treatments Friday before last. Along with that, she had an echocardiogram to check for heart damage from all the various medications and treatments.

As far as we know there was no problem, but of course the technician, technically, was not supposed to tell us anything. However she did, show us the different areas of the heart and what it would look like if it were damaged. (Leading us to believe that since it didn't look as she described that we were just fine.) Unfortunately, the cardiac sonographer--that's what they call an echocardiogram technician--inadvertently found an obstruction in Anne-Marie's gall bladder. We'll probably worry about that one later.

Hereceptin 12 and echocardiogram tomorrow

Anne-Marie goes into the imaging center of Providence Portland Medical Center tomorrow morning to see if the last year's treatments have had any effect on her heart. She follows that up with a Herceptin treatment in the afternoon across the campus in the Professional Plaza.

Saturday morning we head to Salem for BQ finals.

Herceptin 11

Herceptin 11 was on Tuesday, May 29.

Mom took her to the appointment. Doctors say Anne-Marie is anemic again.

Next time, on the 22nd of June, they're going to send her in for an echocardiogram to check her heart for damage from the treatments. Standard procedure.

Herceptin 10

Herceptin 9

Mom took Anne-Marie to her ninth Herceptin treatment today. The treatment was rescheduled, due to our vacation, from last Friday to today.

To the best of my knowledge, eighteen doses are required. That means we're half done!

Herceptin 8

Herceptin 7

Hey, I forgot! Mom took Anne-Marie to her seventh Herceptin treatment last Friday. Though there's still eleven to go, we try to make a note of every milestone here.

Anne-Marie also started her Tamoxifen pills on Saturday. She will be taking one of these daily for the next five years. Only 1,821 doses to go! Maybe I should start counting those down, too...

Herceptin 6

Anne-Marie had to switch her Herceptin appointment to today in order not to clash with her recovery. Mom is going with her to the clinic.

We will spend this evening...(see next post)