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
