So, the blog's been very quiet lately. Basically, things have been going pretty well. Marye's been feeling good, although she is still very tired all the time. But she got her CT scan on Friday and we were anxiously awaiting the results to see if the tumor in her liver was responding to the chemo. Remember, that her last tumor marker numbers were still very high, but were moving in the right direction.
Anyway, today was her chemotherapy, since Thursday is a holiday. So, Dr. Riley came in with the CT scan report, and it's mixed. The main tumor has indeed responded well to the chemo. The last CT scan showed the tumor to be 6.7cm x 6.2 cm- about the size of a plum. The report we got today shows the tumor decreased in size to 5.6cm x 5 cm. That's good. But there was more. Previous scans showed at least two small lesions that were too small to biopsy, but they were measurable: 6mm and 9.5mm. The bad news is that these lesions have increased to 14mm and 15mm, respectively.
What does this mean? Well, we need to see the tumor marker numbers that were taken today. If they stabilize or even increase, then the doctor will want to see another CT scan or MRI in a month to keep an eye on these lesions. She will also probably look at changing the chemo to another drug. If the markers continue going down, then she'll probably wait two months for a scan and keep on the same chemo drug. It's possible that the two small lesions are not cancer, but cysts or any number of irregularities in the liver. But, given Marye's history, the report says they're consistent with metastatic breast cancer.
I asked a bunch of questions about if it could be a different type of cancer, and Dr. Riley says it's very unlikely. It's also possible for two separate tumors of the same type of cancer to react differently to chemo. Remember, cancer is cancer because of an irregularity in the genome that doesn't let the cells stop reproducing. So, the bottom line is, it's unpredictable. If the tumor markers go up and/or the two lesions keep growing, then it's only a matter of time before the large tumor stops responding to the chemo, so it's time to change it. To keep it in perspective, the doctor stressed that these are very small-- perhaps a hundred times smaller than the main tumor-- and as long as the big tumor keeps shrinking, Marye will not have the bad side-effects that she's experienced in her biliary tract. But it's a sobering reminder that Marye still has cancer, and might never be cancer free, even if we keep attacking it and shrinking it. Again, the goal is to let her feel better and have a long and fruitful life.
So, that's it. When we get the tumor marker numbers, I'll post again. Some other good news is that her blood work continues to look good. Her white blood cells are good, her bilirubin is down (so the stent is still working), and her liver functions are good. In the meantime, she got her chemo today and is feeling ok. She's not nauseas, and I'll wait until Thursday to giver her the Neulasta shot, so she can enjoy Thanksgiving. Also, she's going to see Dr. Vitale on Monday to get the stent removed/replaced. Marye's hoping that she won't need a stent anymore, so she can drive again and maybe even get some exercise.
I hope you all have a nice Thanksgiving and you can expect to hear from us again next week.
-Chris
