I Never Trained for a Marathon!

As we begin phase 2 of my treatment, I have to admit that I am suffering from a case of doctor visit fatigue.  I spent three and a half hours at the medical oncologists’ office on Tuesday, and another two at the radiation oncologist’s on Thursday.  I liked both doctors very much, and each was excellent at explaining my options, answering my long lists of questions, and making me feel as though they had all the time in the world to spend with me.  They were both delightful and had good senses of humor – something I always find helpful!  But after a bit my head was swimming with all the information and I was too tired after Thursday’s visit to write about it, although what I heard that day was not that complicated – at least compared to Tuesday’s round of information.  Instead I took it easy, and yesterday afternoon and evening I even indulged in stretching out on the couch and watching a couple of movies.  (My Life as a Dog and The Big Lebowski – an odd mix, I know, but both good in their own ways.)

Here’s the summary of the plan for phases 2, 3 and beyond:

Next Wednesday I go in for tests and lab work – blood work, an EKG and something called a MUGA scan.  Both the EKG and the MUGA scan look at the heart.  The EKG measures the electrical activity of the heart – or its rhythm.  The MUGA scan uses a radioactive substance injected into the bloodstream to take images of the heart in action.  It allows the doctors to evaluate the state of the heart’s ventricles.  Herceptin, which I will take because my cancer cells were HER2 positive, has a rare potential to cause heart damage. Fortunately this damage is reversible. The baseline MUGA scan of my heart function will allow them to keep an eye on my heart health throughout the yearlong treatment with herceptin.  I will have the scan again several times during the year.

 

I start chemotherapy on November 8th.  That morning they will insert a port under my skin so they don’t have to constantly stick needles into my veins.  This is a good thing, since I’m not always an easy “stick”.  I gave up donating blood years ago because it would take 45 minutes for them to get from me what others gave in 15!  After the port is in I will start the first of six treatments.  I will receive chemo once every three weeks, and, if all goes according to plan, I will receive my last treatment on February 21st.

Phase 3, radiation therapy, starts about 3 weeks after I’m done with chemo.  I will undergo six weeks of radiation and will receive it five days each week, Monday through Friday.  More on that when we get closer.

After that, I will continue on with Herceptin infusions into November, and will take the aromatase inhibitors to block estrogen and progesterone for five years.

Tiring just to read about it, isn’t it?  I started out with what I thought, based upon my early results, might be a short jog.  But now it has turned into something more like a marathon!    

Better Living Through Chemicals (aka the results from my visit with the medical oncologist)

Considering that I have cancer, the news since diagnosis has been relatively good: stage 1, no spread to the lymph nodes and the cancer cells were estrogen and progesterone receptor positive. (That may not sound good to you, but it is in a targeted treatment sort of way). The standard course of treatment for all of that would be radiation and hormone therapy for five years. Not too bad. 

The only wrench in my diagnosis was that I was three for three on the receptor front.  I also tested positive for another receptor called HER2 – the human epidermal growth factor receptor 2.  When HER2 is overproduced it promotes the growth of cancer cells.  It does not respond to the hormone therapy -- or radiation, for that matter.  HER2 positive cancer requires a more aggressive treatment.  So, despite much wishful thinking, I will be joining the ranks of those bound for chemotherapy.  The downsides are fatigue and hair loss.  The upsides, besides helping to keep further cancer at bay, are that they have much better drugs to combat nausea than they used to and I will save money for at least four months, probably more, since I will not need to pay for haircuts.  There is almost always some silver lining, if you look hard enough! 

I’m off to the radiation oncologist tomorrow, and will report on that visit, although radiation therapy won’t happen until the standard course of chemo is completed.