A new phase, indeed

We saw the oncologist on Thursday, and everything I said in the last post was accurate.  There are actually TWO sites of metastasis in Marye's spine, and approximately 15 new lesions in her liver, with the largest of those measuring about 2cm.  The original tumor now measures 6.2cm across.  It's definitely progressing.  The new drugs Marye has is Xeloda for the cancer and Xgeva to strengthen her bones and prevent any "skeletal events".  Basically, it's an osteoporosis drug.

The Xgeva is given by injection every month, so that's not really a big deal.  Also, I did find out that metastasis to the spine is not really that big a deal, since it's not life-threatening.  It can be very painful, but they found this early and Marye hasn't had any pain from it yet.  By treating the tumor and giving her the Xgeva, she shouldn't have too many problems in that area.

It's really the Xeloda that is tricky.  It's a prodrug, meaning it's given in an inactive form, then activates through regular metabolism.  With this drug, it's the enzymes produced by the liver and the tumor, itself, that activate it.  There are no more infusions; Marye takes two pills in the morning and two at night for 14 days, then she gets a 7 day break.  Today was her first dose.  Since the liver enzymes are really necessary for this drug to work, they have to take blood every week for a few weeks to make sure that her liver is functioning properly.  Once they're confident that she has good liver function, she won't have go down to the hospital except for the monthly Xgeva shot.

As for side-effects, the Xeloda is supposed to be fairly mild.  Since the drug attacks fast-growing cells, similar to other cytotoxic drugs, she probably won't grow her hair back, but she may.  Already, from her first dose this morning, she's complaining of feeling "weird", with a hint of a metallic taste in her mouth.  I don't know if that will subside or just get stronger.  She's taking it twice a day for two weeks, so I'm not confident that that will go away.  In any event, she isn't nauseous, but she is really fatigued, so she's just sleeping away.

  As for efficacy, there have been pretty good results, but there's no way of telling for how long.  Again, the cancer will eventually mutate and adapt to this drug the same way it did to the Taxol.  Then we'll be talking about another drug.  Hopefully, that will be later rather than sooner.  Over the next few days, I'll post updates on how she's doing.  As long as her liver is functioning (it was this week), the drug should activate and hopefully work on the cancer.  The next CT scan is after 3 cycles (9 weeks), so we just have to wait until then to see how it's working.

-Chris

It was a good run

It's been five months since Marye started her current run on chemotherapy.  I posted a few months ago that with cancer, no news is generally good news.  Well, today I have some news.  Recently, we've seen the tumor stop shrinking from the chemo.  Dr. Riley tried to reassure us that it's not necessarily a bad thing; it could be just a plateau period for the tumor.  I wasn't so confident.  This week, we got the results of the CT and bone scans.

The main lesion went from 4.6 cm to 6.2 cm, and there are about 15 new lesions in the liver, measuring as much as 2 cm across.  Also, the bone scan showed some evidence of metastasis in her spine.  So, that's pretty disheartening, although I'm not sure what it all means, yet.  We're meeting with Dr. Riley on Thursday to find out what the next step is.  She already told us that she's stopping the Taxol (since it's obviously no longer effective), and will be giving her a different chemo drug that comes in a pill form.  She also mentioned a shot (not an infusion) for the bone issues.  I'm thinking she's going with Fosamax, but again, I won't know until Thursday.  Dr. Riley did say that the pill she's going with has shown to be pretty effective.  I'm hoping that the side-effects are mild.  Maybe Marye will actually grow her hair back.

In the meantime, we are both still processing this, and there are a lot of unanswered questions.  But to me, it feels like we've entered a new phase in this adventure.  I'll post again on Thursday or Friday after we see the oncologist.  Expect to see some more frequent updates posted here in the coming weeks/months.