It was a busy week, relatively speaking. Last Wednesday, Marye had a CT scan at U of L to take a look at the tumor. We were expecting to see the tumor shrink, based on all of the chemotherapy she's had and because the tumor markers were down from the last blood test. The next day, she had to go to Norton for another ERCP to get the stent replaced. That went off perfectly, and the doctor put in a fancy, new, metallic stent that will last 6 months instead of the 3 months for the plastic one. It's much more expensive, but will save her having to go through the procedure so frequently, so it actually will be less expensive over time. He's been waiting to put in the metallic stent because he kept hoping that she wouldn't need it, eventually. That doesn't seem to be working out, as he said her bile duct was still pretty blocked without it. Anyway, that should hold her over until November or December. One less thing to worry about for the short-term.
During our visit to the oncologist yesterday, we got the results of the CT scan. The tumor went from 4.2 x 4.2 x 3.9 cm to 4.4 x 4.1 x 3.6 cm. While this shows very little actual shrinkage, the report noted lower central density of the tumor, indicating necrosis (it's dying). Also, the second lesion went from 2.2 cm to 0.8 cm, so that's great news. The chemo is effective. No new lesions in the liver or anywhere else and everything looks normal.
The only bad news in all of this is the debilitating fatigue that Marye suffers from. Even the steroids that accompany the chemotherapy haven't really had much effect, and she feels weak much of the time. Sometimes she changes up the pain and nausea meds and finds a little improvement in her daily fatigue levels, but it's fleeting. Overall, though, she's not nauseous or vomiting and the cancer is reacting to the therapy, so we'll just continue on this course of action for the foreseeable future.
There is nothing scheduled until her next chemo in three weeks, so if you don't hear from me, then everything's ok! Hope everyone is enjoying their summer!
-Chris
Friday, June 22, 2012
Monday, June 4, 2012
Update long in the making
It's been exactly one month, I think, since the last update. That's good, mostly, since there really has not been too much going on. With cancer, as a rule, no news is good news. There actually have been some things going on behind the scenes, but we've been pretty busy and so updating the blog moved lower down the ladder of important stuff to do. But, we just got some good news, so I'll bring everyone up to date.
The last update had Marye just getting back on chemotherapy after a two month break due to her sick gall bladder. Since then, she had another treatment, followed by a call from Dr. Riley telling us that her tumor markers were still climbing. Specifically, the CA 15-3 went from 356 to 441, and the CA 17.29 went from 330 to 390. There were several possible explanations for this: 1) the chemo hadn't had a chance to work, yet, since Marye had only one or two treatments, 2) the tumors could still be growing despite the chemotherapy, 3) nothing at all. Maybe the tumor markers were coming from something besides cancer. In any event, the plan was to wait until the May 31 treatment to check the markers again. If they continue to climb, the plan is to get a CT scan to see exactly what the tumors are doing. Since Marye has a CT scheduled for June 13, anyway, this would not have changed much.
So, we just got the results of Thursday's blood work, and the CA 15-3 was down to 341(!) and the CA 27.29 only fell to 389-- but at least it's going in the right direction. The CT scan is still scheduled for the 13th, and she is due to get the stent replaced with another ERCP on the 14th of June. My guess is that since she still has tumors floating around her liver, the Dr. Vitale will continue to keep the stent in there, even if it's not clear that she needs it.
Looking forward, if the tumors do stop responding to the Taxol that she's taking, Dr. Riley will find another chemo drug to use, then we start this whole process over again. That could happen in a month, a year, or not at all. There is just no way of knowing how long the drugs remain effective.
In the meantime, Marye is managing her nausea pretty well. She still suffers from debilitating fatigue. That's pretty much a given. So much so, that when I tell people "she's not doing too badly", I usually don't even mention that she's pretty well exhausted by 2 pm every day and needs to take a nap. My point is that even though she is not suffering from the stereotypical side-effects of chemotherapy (vomiting, constant nausea, etc.), it's still a pretty lousy way to live. "Not doing too badly" is very relative. Also, she's bald. Overall, though, she's comfortable most of the time and I'm confident that she's getting the best treatment available.
To that last point, I'm always interested in how well doctors keep up with the latest research that comes out about their specialty. I use a Google news alert set to "Breast cancer" and "Breast" to read the latest articles, myself. (That last one is rather amusing, sometimes. Not every story with the word "breast" in it is about cancer.) Anyway, I try to keep my eyes peeled for new information and often ask Dr. Riley about it when I see her. As you can imagine, there are so many different types of breast cancer, that many of the studies don't even apply to Marye's situation. But I always get encouraged that Dr. Riley not only keeps up with this news, but often travels to conferences around the country to meet with other oncologists. This week she is at the ASCO conference in Chicago, IL, getting presented with much of the same information I see in the news. She's just about as up to date on this stuff as I am, so I'm grateful. It's important that your doctors (in any specialty) stay in touch with the latest research. There are new things coming all the time.
Ok, that's it for now. Marye had chemo last Thursday and is just now starting to get over the bone pain from the Neulasta shot I gave her on Saturday. So, she should be ok until the next chemo, although very, very tired. I should post again after we get the results of the CT scan and the ERCP next week.
-Chris
The last update had Marye just getting back on chemotherapy after a two month break due to her sick gall bladder. Since then, she had another treatment, followed by a call from Dr. Riley telling us that her tumor markers were still climbing. Specifically, the CA 15-3 went from 356 to 441, and the CA 17.29 went from 330 to 390. There were several possible explanations for this: 1) the chemo hadn't had a chance to work, yet, since Marye had only one or two treatments, 2) the tumors could still be growing despite the chemotherapy, 3) nothing at all. Maybe the tumor markers were coming from something besides cancer. In any event, the plan was to wait until the May 31 treatment to check the markers again. If they continue to climb, the plan is to get a CT scan to see exactly what the tumors are doing. Since Marye has a CT scheduled for June 13, anyway, this would not have changed much.
So, we just got the results of Thursday's blood work, and the CA 15-3 was down to 341(!) and the CA 27.29 only fell to 389-- but at least it's going in the right direction. The CT scan is still scheduled for the 13th, and she is due to get the stent replaced with another ERCP on the 14th of June. My guess is that since she still has tumors floating around her liver, the Dr. Vitale will continue to keep the stent in there, even if it's not clear that she needs it.
Looking forward, if the tumors do stop responding to the Taxol that she's taking, Dr. Riley will find another chemo drug to use, then we start this whole process over again. That could happen in a month, a year, or not at all. There is just no way of knowing how long the drugs remain effective.
In the meantime, Marye is managing her nausea pretty well. She still suffers from debilitating fatigue. That's pretty much a given. So much so, that when I tell people "she's not doing too badly", I usually don't even mention that she's pretty well exhausted by 2 pm every day and needs to take a nap. My point is that even though she is not suffering from the stereotypical side-effects of chemotherapy (vomiting, constant nausea, etc.), it's still a pretty lousy way to live. "Not doing too badly" is very relative. Also, she's bald. Overall, though, she's comfortable most of the time and I'm confident that she's getting the best treatment available.
To that last point, I'm always interested in how well doctors keep up with the latest research that comes out about their specialty. I use a Google news alert set to "Breast cancer" and "Breast" to read the latest articles, myself. (That last one is rather amusing, sometimes. Not every story with the word "breast" in it is about cancer.) Anyway, I try to keep my eyes peeled for new information and often ask Dr. Riley about it when I see her. As you can imagine, there are so many different types of breast cancer, that many of the studies don't even apply to Marye's situation. But I always get encouraged that Dr. Riley not only keeps up with this news, but often travels to conferences around the country to meet with other oncologists. This week she is at the ASCO conference in Chicago, IL, getting presented with much of the same information I see in the news. She's just about as up to date on this stuff as I am, so I'm grateful. It's important that your doctors (in any specialty) stay in touch with the latest research. There are new things coming all the time.
Ok, that's it for now. Marye had chemo last Thursday and is just now starting to get over the bone pain from the Neulasta shot I gave her on Saturday. So, she should be ok until the next chemo, although very, very tired. I should post again after we get the results of the CT scan and the ERCP next week.
-Chris
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