Monday, July 23, 2018

I heard two "R" words from my Oncologist today...

PET/CT results

So yeah, last you heard, I was prepped for 50 minutes with an injection of radioactive mCi F-18 something or the other, gobbled some cappuccino flavored Barium, and then crawled into a humming tube with my eyes closed for 18 minutes while the tube took 3-D radioactive pictures of my body. Lots of pictures, it turns out. With the magic of modern medicine and availability of results I learned that each of the PET/CT combined pictures are really a composite of 150 +- individual images, or slices of my body. How cool is that?!
Here are two of my favs, not shining so bright these days and that's a good thing. By the way, I do have arms, they just don't appear in the pictures.

Even cooler than that, ALL my organs are clear ("unremarkable" in doc-talk) and everywhere else the beast is either slightly receding or stable, even after reduced dosage of poison and three weeks completely off the palbociclib, my Don Quijote, the big badass cancer-cell poison.

Even my Oncologist was optimistic

And, boy, he's a tough one to please! But he actually said two "R" words to me today. First he started talking about "partial Remission" although I'm not there yet, which is defined on WebMD:  Partial remission means the cancer is still there, but the tumor has gotten smaller. 
Wait wait, don't start dancing, I'm NOT THERE yet!
But he talked  a bit about my cancer "score" which takes into account number of cancer nodes and their size as measured by a mysterious PET-scan-scoring computer no doubt. When the score hits half the beginning score, they start talking about partial remission and possible discontinuation of medication. Making steady progress toward that goal!

Good news is my score is down from the beginning and this last PET shows everything stable, and THAT means we can discard the P-word, or progression phase. Whew! Yay! And the other "R" word he mentioned was Remarkable! He said my stable state was remarkable! Well, heck, I think so too then!

Back on the poison now

I can't hardly believe I'm saying this but I'm happy to be back on the palbociclib starting with tonight's dinner. Yummy. We talked a bit about my very tolerable side effects and long-term quality of life, which in my case are respectively, minimal and new-awesome. I liked it that he used "long-term" quality of life, as opposed to (for example) "have you filed a will yet?" Just a little cancer humor for ya.
So we proceed as before and looking forward to "stable," a very remarkable-stable BTW, and perhaps more "R" words down the line. Meanwhile, I'm going hiking...remarkably hiking...

Friday, July 13, 2018

I'm getting another PET!

Oh how I love pets...



Wait, no, not those pets, this PET!

I am scheduled for a follow up PET/CT scan on Monday, yeah, that was quick! Let me back up to events preceding. Went to see my Oncologist this week and we had a nice chat about my tumor bio-markers being a bit wacky, in his words "schizophrenic." Turns out one of them (CEA) is now "normal" and by that I mean normal for a normal person not for a cancer person and that is fantastic news. But another one (CA 27-29) is slowly rising again after being down and has really always been elevated. I dunno, I'm thinking manic-depressive more than schizophrenic, but he's the doc. 
Here is a pic (hint: green=good, red=not so):

Not normal...
Soooo...yeah, no, Oncologist is not worried, not "too" worried, could be several explanations, some cancer patients have levels in the thousands that drop mysteriously after a while, test not considered very reliable as a standalone marker, bio-markers lag behind actual cancer presence or absence...BUT JUST TO BE SURE let's do another scan.
Okay, I'm game for PET/CT scans, they tell the truth. Good or bad, the truth is the best thing.

Nervous? me? naaaah (she says while she nods head up and down). There's no hiding from the PET/CT scan, no amount of oatmeal and green smoothies between now and Monday will make that pesky monster not show up. If it has receded more since last scan, then we're in good shape to ignore the bio-marker for a while. If "it" has grown or spread...well, I'm not thinking along those lines but, you know, could happen, the bastard is sneaky that way. So yeah, I'm nervous.

Meantime, I'm off the poison chemo-pill for another week until we see what's up. I predicted that since my WBC count is still down and I had a tiny fever twice last month. Hopefully my superhuman blood-making stuffs kick into high gear and get me back up to where I can restart the regimen (Ibrance/Letrozole, or in my case Don Quijote/Sancho Panza). 

My Zen books tell me if I'm going to make up stories about the future, make up nice ones. So that's what I'm doing and looking forward to those images with my live-in "beast" looking a bit smaller and a bit more beatable on this coming scan. Hey, stay tuned, images coming next week!

Sunday, July 8, 2018

One of my docs doesn't want to see me anymore...

...and that's good news!

I had a follow up appointment with "my" breast surgeon who is very knowledgeable and pleasant. She quotes results from recent research to help me arrive at some decisions, which really help. Of course I go home and Google all of it later, but it is refreshing to have such a communicative doctor who includes her patients in the decision making process to such an extent.
Anyhow, I like research studies and enjoy the austere language in which they approach such dreadful subjects as "should we remove your breast now or not?"
In short, we are not yet considering surgery, mainly because there is a diffuse mass disappearing in my breast and the chemo-hormone-therapy is working slowly but surely.
Besides the life-long consequences of taking out the main lymph nodes are not exactly bright and sunshiny, in fact most women don't miss the breast much but the removal of lymph nodes seem to cause all kinds of problems later in life.
I'm keeping all my body parts for now and she deferred decision of surgery to my oncologist or for at least a year. A year. So many of my fellow survivors don't have a year. I may have many, how lucky am I?

Learning many new things

I also learned that some studies are showing that if we take out the origin site of the cancer, my immune system (what's left of it, more of that in a sec) won't "learn" how to combat possible occurrences of the cancer. Yeah, I'm looking forward perhaps too far to remission and recurrence, but I was born an optimist. Not there yet, I know, I was raised a realist.

And the therapy is working, I learned that slow growing cancers such as mine also recede slowly. My own must have started about one to two years back, unbelievably enough, spreading through my bones while I wasn't looking.

Trouble in WBC world

So yeah, meanwhile back in the world of immunity, my white blood cells seem to be stuck in low-key mode and aren't even responding to my week of rest. I mean really? 
I can add another "condition" to my collection: agranulocytosis secondary to cancer chemotherapy (say that 3 times fast)

I  feel fine, I did run a tiny fever this month because of an increase in the dosage of Ibrance (palbociclib) but I felt "normal", new normal, but normal. Exercised almost every day, got a new Garmin Vivofit 3 to help me stay true. Sleeping fine, eating great especially since my hubby started to lower his blood sugar, we're both human bovines right now eating carrots and greens and other marvelous things.

But back to the White blood cell puzzle, I searched and searched and couldn't find anything else I can do to bump them up aside from getting proper rest, avoiding stress, light exercise, great nutrition. So this Wednesday I defer back to my oncologist for help on that. According to the web there is little to be done except maybe discontinue the cancer meds to let my blood recover, a prospect that terrifies me. Allow the beast to grow again unfettered? Agh, hopefully it won't come to that. We got my hemoglobin up with Procrit and lots of steaks, maybe there's some magic WBC potion? I'm a bit tired of green smoothies, I confess.

Nothing to do but wait. And now you're all caught up!

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