Well, it's been nearly a month since I last posted an update, so you might be thinking that it's been relatively quiet. That's sort of true. We've had a fair amount of activity, but, for the first time in a long while, it has been quite peaceful. When I last posted, Marye was still suffering the awful side-effects of the Gemcitabine. We were told that this is a very mild chemo and that most patients tolerate it well. Of course, Marye fell into the small percentage of people who got sick from the drug. She suffered terrible nausea with actual vomiting, and a lot of felling lousy, generally. After the New Year, we were very hesitant to continue on the same course, and Dr. Riley agreed. So, on to the next weapon in the chemo arsenal -- Navelbine. A plant alkoid, like Taxol, and others, Navelbine is also advertised as being very mild. So mild, in fact, that it is generally given weekly. This is more frequent than Marye has ever received treatment. Her previous treatments have all been bi- or tri-weekly.
She got her first dose of the Navelbine on Jan. 3rd. Interestingly, it is also a very quick infusion. The entire dose is given via gravity drip from a small bag and takes 6-15 minutes. So, although we have to go to the clinic every week, we're there for only a few hours, as opposed to all day with the Taxol and Gemcitabine. The routine is like this: she first gets her port accessed and her blood drawn for lab work. While we're waiting for the bloodwork to come back, Marye gets comfortable in the chemo lounge and starts knitting. It takes about 45 minutes to get the lab reports back and they get sent to the doctor upstairs to verify that everything is ok and she clears Marye for treatment. When that happens, they plug in the chemo bag, it drips for 6-15 minutes, and we're done. Time to de-access the port, and it's off to McCallister's Deli for a Reuben sandwich. What the onc is looking for on the the blood work is liver function, and -- especially with this drug-- blood counts. (More on this later.) Another factoid regarding the Navelbine: it's a vesicant, meaning it causes extensive tissue damage and blistering if it escapes from the vein. So they handle it very carefully. I don't know why it causes damage to tissue (skin), but not to the interior of the vein and heart. But they take it pretty seriously. Of course, the IV is engineered to eliminate the possibility of contact. They insert the infusion plug into the bag and it drips into her port.
Anyway, the great news is, the Navelbine is treating Marye very, very well. Compared to all of the other chemo drugs (with the possible exception of Taxol, which was also very tolerable), this one has very mild side effects. After three treatments, I can recognize a pattern where she may or may not have some nausea on the day of treatment, then she usually bounces back nicely through the rest of the week. She has had the occasional bad day of nausea. But it's nowhere near as frequent as she was experiencing before. It's like the heavy fog of chemo has been lifted after the last few months and her days are much better. That's the good news. And aside from the aforementioned occasional bad day, that's the second best type of news that you can hope for with Stage IV metastatic breast cancer. The only downside to this drug so far, (more on this later) is that being weekly, it is affecting her blood counts. What that means is that her white and red blood cells, hemoglobin, and platelets are dropping every week. This can affect her immune system and energy levels. So, I am extra careful about not bringing home any bugs (we both had our flu shots earlier this year), and her energy level is down. I haven't talked about this to the onc, yet, but this has happened before and there are several possible remedies, including a blood transfusion to boost her counts. She could also take a week off of treatment to give her body a chance to boost itself. This is another benefit of weekly treatments: she is in the clinic every week. If we have questions for the doctor, we're right there, and they're keeping a close eye on her condition.
Ok, that's a lot to absorb. I said I'd address a few things, but I'll save those for another day. To summarize: Marye's new chemo is treating her well. She still has the occasional bad day (1-2 per week), but overall, she's feeling much better than she has for the past few months. She is scheduled for a CT and bone scan in March, so we'll know then how effective the chemo is. Until then, I'm expecting things to stay quiet. Blissfully quiet.
-Chris
