Chemo Cocktail #... What # Are We On Again??

The plan today was to start a new chemo cocktail... keeping with Tykerb, Herceptin, Zometa & Femara (a combo that I've been on the last 7 months), however we've taken Navelbine out of the cocktail and replaced it with Cisplatin.  Now, I've said this a million times, I LOVE having options, but I'm not going to lie... this new chemo cocktail was not one of our top 3 options.  Do you know how frustrating that is?!  The top 3 drugs that Dr. H recommended for me were quickly taken off the table due to various reasons... an unexplained spike in my lab work disqualified me from a trial, my insurance was unable to approve a drug b/c it had not been FDA approved, etc.  So over the last week I have convinced myself that maybe this new chemo cocktail is "the one" for me.  Everyone responds and reacts differently to each drug... maybe Cisplatin is "my drug."  Regardless if it's Dr. H's first pick or last, it could be "THE drug" that kicks this cancer's ass!  On top of my "convincing" myself of this being the one, I've also been preparing for what this new drug has in store for me.  How will I deal with the side effects?  Will I finally lose my hair?  I tell ya, after this last week, I'm emotionally and mentally drained.  And after all that, I walked into the infusion room today ready to start kickin' cancer's ass with my new secret weapon... Cisplatin!

(insert record scratching)

I'm sitting in the infusion room getting my Zometa when my Nurse Prac strolls in.  Before they even brought out my "secret weapon" Cisplatin, I'm being informed that the FDA approved one of our top 3 drug options AND my insurance covers it AND that's what Dr. H is wanting me to start.  Buuuuuuuut, what about the secret weapon I've been preparing myself for?  What does this mean?  Well, surely we're not limited to just one secret weapon, right?!  Ya, I didn't think so either!  So Cisplatin is being put on the back burner for some other time and now I need to get ready for another secret weapon.  Seriously, all this convincing and preparing myself for these new drugs is exhausting!!

So my new chemo cocktail will consist of Pertuzumab, Herceptin & Taxotere (in continuation w/ my Zometa & Femara).  I received my Zometa infusion today and now I'm waiting to hear when I'll start my other infusions (we're basically waiting for the pharmacy to order and receive the new drugs).  Until then I'm sure I'll be repeating exactly the same thing I did leading up to today... convincing myself this is "my drug," "THE drug" that kicks this cancer's ass and of course preparing for what this new drug has in store for me.  Oooooh, the viscous circle that is my life!

Here's to Chemo Cocktail #... Oh hell, I've lost track!  But this one could be "the one!"

Back to the Drawing Board... Again

Ugh!  We were SO close!  The ablation didn't get everything we were hoping it would.  Which really isn't a big deal... we knew there was a big possibility that they weren't able to get everything.  It appears that they annihilated the smaller lesion... yes, meaning it's no longer there.  Woohoo!  However they were only able to get a portion of the larger lesion.  So this is where the problem is... there are a couple of new lesions.  Granted they are pretty small lesions, but the fact is, the lesions are no longer "contained" like they were.  Which of course means that my chemo cocktail must have lost it's momentum (insert Debbie Downer music).  So back to the drawing board!  

Now I've said this in the past, but what's great about my cancer and my diagnosis, is that I have lots of options!  There are some amazing new drugs out there and Dr. H has 3 in particular in mind that she'd like me to consider.  There are of course the usual hoops and hurdles we need to jump through and over... for example, one of the drugs needs a certain Drs approval for me to start taking.  The reason for this is because it's no longer in a trial phase, but it's still not FDA approved.  And then one of the drugs needs approval from my insurance company.  So basically this week Dr. H has some wheeling and dealing to do.  I'll meet with her next week to discuss what she found out and which drug will be my best option.  

I'll keep you posted when I find out what my next chemo adventure will be.  The only question I have now is... how big is this drawing board?!? 

And We Wait... In the Meantime, We're Krewesin' for a Brewsin'

I am finally feeling better after my radiofrequency ablation (rfa).  As soon as I broke free from my antibiotics and pain pills last week, I surprisingly felt like a new person!  It's amazing how difficult it was to jump back into reality... the littlest things were just exhausting.  I made myself get out of the house as much as I could without overdoing it (believe me, I've heard the lecture and now preach it) and this week I'm feeling great! 

Not only am I feeling great, but my lab work is great and my tumor marker is coming back down.  After the procedure, my lab numbers were all over the place which is typical and expected after having something like that done to your body.  But anyway, last week my tumor marker went down from 131 to 111... not quite as low as we were earlier this year, but not surprising after the procedure.  Of course don't get me started again with my love/hate relationship with this tumor marker!  At least we're heading in the right direction!  And as for my lab work, the nurse not only said all my numbers were looking good, but that my liver was happy.  And who doesn't like a happy liver?! 

So I'm continuing on with my chemo cocktail and then on Monday, July 9th, I'm scheduled to have another PET scan.  The results from this scan will help us determine what our next step is.  We could do another rfa procedure to burn off what was left behind.  We could do a chemo embolization which I had described in a previous post where they actually inject chemo into the tumor site.  OR it is possible that they got everything the first time and I won't need another procedure.  How cool would that be?!  Yep, that's what I'm rooting for!  ;)  From there we would begin to transfer into the maintenance phase.  Oooooh, that sounds good! 

So you might be asking, what does one do with a happy liver?!?  My answer... celebrate with a few good friends and libations!

Yes, I know it sounds a little crazy that I would consider having a drink after what my liver has gone through, not just with this procedure, but over this entire last year.  This is something that I've discussed with my doctor on numerous occasions and the fact is, there is nothing wrong with my liver (remember, it's happy).  It's what's on my liver that we're fighting.  So when the time comes for a celebratory drink... I'm there!

So this weekend, 12 of us participated in a pub crawl, Austin's Crawl For Cancer™!

Here's a little background info taken from their website:

Our purpose and mission: 

Crawl for Cancer is a fundraising organization driven to plan and host events that support lifesaving research and those affected by cancer while having a little fun doing it!  Though not a charity, we are a for-profit company that donates 100% of our profits to the charities we serve.

What is Crawl For Cancer? 

Crawl for Cancer is an event where hundreds of volunteers, businesses and participants come together to help raise money to fight cancer.  Participants go to 5 bars and/or restaurants in a pre-planned order to partake in social networking and ice-cold, frothy beverages.  No actual crawling is required.  :)  What is required is to have a good time, be respectful and understand that all teams are here to help raise money for a great cause.

Oddly enough, it wasn't too difficult to convince a few of my "Casey's Cancer Kickin' Krewe" members to participate in this with me.

And now, I present to you our 2012 Crawl for Cancer team... "Krewesin' for a Brewsin'"

I had a blast... and all for a good cause!  ;)

And so we have some waiting to do before the next PET scan and the results... but that's no surprise!  As frustrating as it is, I'm actually getting pretty good at it!  

The Aftermath: Die Tumor Die

I mentioned in my "Operation: Die Tumor Die" blog post that I would be in and out of the hospital the same day of the procedure (put under local anesthesia) and I would be back to my daily routine after a few days of rest.  Well, that just sounds too easy.  And we should know by now that I don't like making things easy on anyone!  


So with this radiofrequency ablation (RFA), Dr. K and his partner, Dr. Vasan, were targeting 2 lesions that remained on my liver that the chemo was unable to reach.  One of these lesions happened to be in close proximity to my small intestine and the other one up against my lung.  Because of this, they were concerned that the heat from the ablation would heat up or cause harm to the small intestine and/or lung.  My "easy peasy procedure" wasn't sounding so easy peasy after all.  So to avoid complications with any other organ in my body, they put fluid into my abdominal cavity to be able to move things around, out of harms way.  By doing this, they were able to completely burn off 1 of the lesions on my liver and about 85% of the other lesion.  After being put under general anesthesia (breathing tube and all), the procedure took about 4 hours and I was required to stay in the hospital overnight to be monitored.  Thankfully they weren't serving fava beans and chianti!

I've been resting up the last few days and I'm slowly but surely feeling better each day.  I actually tried to cut back on my pain meds yesterday, but I quickly realized that was a BIG mistake.  I need to keep reminding myself that the procedure wasn't as easy peasy as I was expecting, never mind the golf ball size burns on my liver and the jostling around of my organs.  But hey, this has added a few more freckle sized scars to my right side.  Maybe when this is all said and done I'll have a tattoo artist connect the dots and see what we come up with.

So yes, this was a successful surgery.  Dr. K and Dr. V were very pleased with the amount of the lesions they were able to burn (considering their locations and their sizes).  But where does that leave us now?!  We still have 15% of one of the lesions still remaining.  I'm meeting w/ Dr. H this week (who has been consulting w/ Dr. K & Dr. V) to discuss the next step.  Anyone heard of chemoembolization?  This is where they inject a concentrated amount of chemo directly into the tumor.  Until then, I'll continue on with the chemo cocktail I've been on (every Wednesday for 3 weeks, then off a week).

I can't say this enough, but thanks again for your prayers, thoughts and good vibes throughout all of this.  We are just SO close to where we need to be!  

I'm Baaaaaaaaaaack

Thank you for all the prayers, good thoughts and good vibes!  I was released from the hospital this afternoon and I am comfortably back at home in Austin.   The surgery went well, but the pain meds are even better!  On that note, I'll fill you in on the details later.  Talk to ya soon!

Operation: Die Tumor Die!

When the time is right, the time is right!  Whether I'm having surgery in 2 months from now or 2 days from now, right?!  Well, I hate to rush things, but it's looking like it was "meant to be..." my liver surgery is in fact in 2 days from now.  Last week after receiving Dr. H's 2 Surgical Oncologist recommendations, I began the process of setting up my consultations.  I hate to admit it, but after meeting with one of the surgeons, my mind was instantly made up.  He was the one!  Dr. Kahlenberg gets the final rose!  The hoops and hurdles I was having to go through with setting up an initial consultation with Dr. Aloia was just too much.  I know that Dr. Aloia must be an amazing surgeon if he received a seal of approval from Dr. H, but over the last year I've also learned that your experience and interaction with the Doctor's staff and office should definitely be considered in your decision process as well.  

After meeting with Dr. Kahlenberg, I was sold.  I liked his demeanor, his confidence w/out being arrogant, he was informative, he was realistic with cautious optimism and I really appreciated the personal attention.  After several phone consultations... Dr. K with Dr. H, Dr. H with me and then me with Dr. K... we were all on the same page.  Not only did Dr. K have an opening this week, but it just so happens to be my week off on chemo.  Perfect timing!  I can have the surgery this week (having a higher WBC count than normal because it is my off week), recover and then continue on with chemo next week without skipping a beat.  Perfect!

So you might be asking, "what is it exactly that Dr. K will be doing?"  Well, it's a procedure called Radiofrequency Ablation (RFA).  Under local anesthesia, RFA is performed under image guidance (x-ray, CT or ultrasound).  A needle like RFA probe will be inserted in the tumor where radiofrequency waves will increase the temperature within the tumor resulting in TUMOR DESTRUCTION!!  Muahahahahahaha!!  

The procedure is scheduled for this Wednesday down in San Antonio.  I should be in and out of the hospital that day and after a few days of rest I should be back to my daily routine.  Now that's my kind of "surgery."  Unfortunately they weren't having any 2 for 1 deals to remove my ovaries at the same time (I need to talk to Groupon about this), but no big deal.  Getting my liver under control is our main priority so we'll deal w/ the ovaries at a later time.  

The crazy thing... I woke up on Sunday with "the pain" in my right side.  Yep, the liver quiver!!  The same pain that raised the flag that I had breast cancer... and this is no Pancho's mexican buffet!  To be honest, I'm not surprised at all.  If the chemo isn't able to reach this lesion AND the PET detected more uptake/cancer activity in this area... you know it's pissed.  I'm chalking this pain up to the tumor's F-E-A-R!!  This tumor knows that it's about to get a serious ass kickin'!!!  

Que Sera Sera

After meeting with Dr H, I feel like a weight has been lifted off my shoulders. The PET results are in and even though we're still seeing 2 lesions on my liver, we have the disease under control everywhere else.  So here is the deal... We're seeing more "uptake" in the main lesion on my liver, meaning more cancer activity.  This of course isn't what we were hoping for, wanting or expecting, but there might be a reason for this.  Dr H thinks that necrosis may have destroyed blood vessels along its path of cancer cell destruction, ultimately preventing the drugs access to this specific tumor/area.  Well, if this chemo cocktail can't infiltrate that war zone, then who's to say another chemo cocktail will.  So the good news there... I'm not having to change drugs right now.  WHEW!   So where does that leave us?!?  Surgery!  This is ultimately where we were heading.  Even though the lesions didn't shrink like we were wanting them to, they're thankfully not any bigger and we still have the disease under control everywhere else.  There are 2 surgical oncologists that specialize in abdominal type surgeries that Dr H recommends. There's Dr. Aloia in Houston and Dr. Kahlenberg in San Antonio. I'm setting up a consultation with each Dr to discuss what my options are (removing the lesions, freezing the lesions, liver surgery in combo w/ removing my ovaries, etc).  So if anyone has any input on either of these 2 Drs, I'm all ears!  In the meantime, looks like I have a couple of road trips to make in my near future... Stay tuned for "the rose ceremony!"  Dr Aloia or Dr Kahlenberg... who will get the final rose?!?


Oh, and yes, I will continue on w/ the chemo cocktail that I am currently on until I have this surgery.  If anything, I may cut back on the Navelbine as the surgery gets closer (whenever that will be) because that particular drug effects my WBC count so much.  And believe me, I'll need all the WBC I can take for a quick and easy recovery!!

This has been an exhausting last couple of days... this morning I woke up w/ Doris Day's Que Sera Sera stuck in my head.  It's hard to accept that whatever will be (will be), but I think this surgery is a step in the right direction to kicking this cancer's ass!  Que Sera Sera!

P.S.  I thought it was appropriate to change up the lyrics a bit... Please sing along and enjoy!  ;)

When I was just a little girl
I asked my mother, what will I be
Will I have cancer, will I be Stage IV
Here's what she said to me.

Que Sera, Sera,
Whatever will be, will be
The future's not ours, to see
Que Sera, Sera
What will be, will be.

When I was young, I fell in love
I asked my sweetheart what lies ahead
Will we have chemo, day after day
Here's what my sweetheart said.

Que Sera, Sera,
Whatever will be, will be
The future's not ours, to see
Que Sera, Sera
What will be, will be.

Now I have nieces of my own
They ask their aunt, what will I be
Will I be pretty, will I be rich
I tell them tenderly.

Que Sera, Sera,
Whatever will be, will be
The future's not ours, to see
Que Sera, Sera
What will be, will be.