Tuesday, January 24, 2012

Chemo Countdown

Today was not a good day. I feel like I take two steps forward and three steps back. I guess that is just the reality of my situation. There will be good days and bad days and I have to fight to stay positive mentally and focus on the end goal. I have to stay alive. I will beat this thing.

I had a meeting with my oncologist, Dr. David M. Heyer MD at Medical Oncology and Hematology in his Fairfax office. He is a very nice man, but did not sugar coat what the next year of my life will be. It was hard to hear, but I appreciated him being straight with me. Kwiatek tried to warn me that he wouldn’t make me promises or give me false hope -- he will just be aggressive and fight like hell to save my life. Lord, hear my prayers.

By the time Kwiatek and I left, half of what Dr. Heyer had told me, I had already forgotten or missed completely. I am relying on her notes in order to remind myself what happened since I am having trouble retaining what I am being told.

Here are Kwiatek’s notes:

  • They will draw blood in Dr. Heyer's office on Monday morning to do the genetic testing. 

  • From the information we have right now, it appears the cancer is Stage IIIC
  • The cancer isn't hormone receptive 
  • When you have surgery, they will send the tissue to pathology again and they will test for hormone receptors -- if you happen to have any traces of positive receptors, he might put you on Tamoxifen 
  • You are HER2 receptor negative, so you will not receive Herceptin 


Full Body Scan:
  • You need a PETscan to make sure this cancer didn't spread anywhere else. This is JUST a precaution to ensure the cancer is isolated and can be treated with his recommended cocktail of chemotherapy 
  • If for any reason the PET is inconclusive, he can order a bone or CTscan 
  • Dr. Heyer is "not suspicious," but he wants to cover all his bases to treat you effectively and efficiently -- this is his standard M.O., to exhaust all possible options to have a clear picture of what he’s working with 

Heart Scan:
  • Assessment of your heart prior to chemo -- either a MUGA or eco-cardiogram 
  • 1 in 500 people on this chemotherapy cocktail -- the heart pumping is effected due to the drugs 

  • You might want to think about harvesting fertilized eggs to increase your chances of having another child post-cancer 
  • Pretty good odds (80%) that you won't go into menopause from chemotherapy 
  • Absolutely chemo first prior to surgery 
  • You will need to attend a chemo teaching session with Jessica on Monday at 9:00am 
  • It will be easy to tell if the chemo is working because the lump is so prominent and it will start going down and shrinking 
  • Having NO active cancer cells post-surgery is 20-30%, so you will absolutely need radiation to kill any remaining cells left over 
  • You will lose your hair within three weeks 
  • This type of cancer is very responsive and sensitive to chemotherapy, so Dr. Heyer is optimistic that this course will be effective 
  • Typically side effects from chemotherapy happen days 1-4 post-treatment (chemo day counts as day #1): 
    • nausea 
    • heartburn 
    • vomiting 
    • insomnia 
    • fatigue 

Chemo Cocktail: Option 1 (preferred): 
AC/ Taxol
AC = Adriamycin and Cytoxan -- together every 2 weeks for 4 weeks (After the first two treatments, Dr. Heyer will do imaging to ensure the cocktail is shrinking the cancer cells and will make a decision on whether Taxol will be every 2 weeks or weekly for 4 weeks).
Taxol every 2 weeks, or weekly for 4 weeks

Chemo Cocktail: Option 2: 
TAC = Taxotere, Adriamycin and Cytoxan
Every 3 weeks for 6 weeks

  • Thursday: MUGA Heart Scan (Jessica will call you to give you the time and location) 
  • Friday: PETscan (Jessica will call you to give you the time and location) 
  • Monday: Chemo teaching with Jessica at 9:00am, Mediport surgery arrival at noon, surgery at 1:30pm 
  • Wednesday: First chemo treatment 
Is your head spinning? Because mine sure is. I could really use a break from this whirlwind. All I can do is hope and pray that the cancer is contained, my body is strong enough to go through treatment and that the cancer will respond to the chemotherapy drugs Dr. Heyer has suggested. Please continue to pray and send your love and light. I need it now more than ever.

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