Category Archives: Treatment

Farewell, Boob. Hello, Sarah Jessica Parker!

Farewell, Boob. Hello, Sarah Jessica Parker!

The boob countdown begins; in eight days, the Boob and her partner, the Other Boob, will say goodbye to me and say hello to Dr. Brew and life after a mastectomy.  I’m sure they’re off to a lovely place where post-mastectomy boobs are free to roam lush fuzzy-bunny-inhabited, wild-flower-speckled valleys with clear trickling streams and rainbows.

And, I will be on my way to a fabulous pair of these

42_SarahJessicaParker

 

Shoot, maybe I’ll even treat myself to the dress.

For more information on what a bilateral mastectomy entails, here are some useful links:

BreastCancer.org – Mastectomy

John Hopkins Medicine – Mastectomy defined and an animation of the procedure (yeah, I haven’t watched this yet, as I’m thinking it may freak me out. . .)

Dr. Brew will start with the preventative mastectomy by removing the Other Boob, and then she’ll move on to the Boob.  At that point, Dr. Mouchantat – I met with three plastic surgeons, and he was the only to entertain my Sarah Jessica Parker fantasy and also present a new “Gummy Bear” implant design option, so he’s my boob architect – will start reconstructing my new boobs by placing tissue expanders between my peck muscles and ribs where my implants will eventually reside.

Here’s what an expander looks like.  The round dark part is a port where Dr. Mouchantat’s team will inject saline every couple of weeks until my new boobs are Sarah Jessica Parker perfect.  The port will be under by skin, so the lovely, not-at-all-scary needle will go through my breast and into the port.  Yay.

expander 2

 

After expansion, I will have another surgery to place my permanent implants.  I have the option of new form-stable “Gummy Bear” implants or traditional round silicone implants.

breast-implant-shape

 

I am going to have to do some more research, as the Gummy Bear implants are very new, and there are mixed reviews:

FDA Approves New Breast Implants

FDA Approves New “Gummy Bear Implants”. . .Surgeon Urges Caution

ABC News:  ‘Gummy Bear’ Breast Implants: The Furture of Breast Augmentation Surgery?

CBS News: FDA Approves New “Gummy Bear” Silicone Breast Implant

What do you think?  Cast your implant vote as a comment today!  (So fun!)

This may all change if I have to have radiation.  Dr. Brew is going to biopsy my left sentinel axillary node to determine whether or not cancer is threatening my lymphatic system.  If it is, then I may have to have radiation, which may change my reconstruction process.  But, let’s not focus on the “may” right now, as radiation sounds horrible, and I really, really, really hope I don’t have to do it.

Here’s more information about the lymphatic system and axillary node:

Susan G. Komen: Facts for Life Axillary Lymph Nodes

September 23, 2013:  Farewell, Boob.  Hello, Sarah Jessica Parker!

 

Take THAT Tumor B$&#%!

Take THAT Tumor B$&#%!

After a second MRI a few weeks ago, I am happy to report that my tumor shrunk a little over a centimeter on each side, and there isn’t any new growth.  My lymph nodes also still look pretty good.

Hell YES, Halaven! 

I’m enjoying a nice break between the Halaven and A/C.  I start A/C this coming Tuesday.  During my break, I was able to travel, thanks to Rayan and his very generous family.  I was also able to take some time to learn how to sport the headscarf, and I enjoyed being in international cities where I was often not alone as a woman with no visible hair and fabric on her head.  At home, I tend to get a but more attention, but it’s all very nice.  I’ve received a few hugs from strangers, blessings, prayers, and even a couple of knitted hats. One woman actually carries them in her bag for when she sees someone who might need one.

Here’s my favorite headscarf travel picture:

OLYMPUS DIGITAL CAMERA

The bicycle scarf also looks quite nice on my head:

OLYMPUS DIGITAL CAMERA

 

 

Hello, Halaven!

Hello, Halaven!

After many hours of research and several second and third and forth opinions, I decided to enroll in Dr. Kantor’s Halaven (eribulin) clinical trial.  (CLICK HERE if you missed it.)

Yesterday, I found out that I am in the experimental arm, and I will have my first hit of Halaven tomorrow afternoon.  Each cycle is two injections, one a week for two weeks, with one week off.  I will do this for twelve weeks (eight injections for four cycles total).

After that, I will have four cycles of AC, which will be one injection every three weeks for twelve weeks.

Halaven is a synthetic version of a cancer-fighting compound a couple of Japanese scientists found in a sea sponge in the mid-1980s.

Here’s a lovely photo of Halichondria okadai, the magical sponge:

sponge

 

Unfortunately, one ton of Halichondria okadai and his friends could only produce 300mg of the super fantastic cancer-fighting compound, so studies were halted.

Years later, Harvard scientists picked the study back up in hopes of creating a synthetic version of the compound, and they were successful.

CLICK HERE for more about eribulin, my new magical mystery cancer drug.

The hope for the study is that Halaven will attack the cancer cells in a way that will make them less likely to come back.  The side-effects of Halaven are believed to be less severe than those of the standard drug, Taxol.  I am hopeful that this is the case.  Another bonus of Halaven is its five-minute injection time, which completely trumps Taxol’s one-hour injection time.  As long as I am feeling up to it, I do not need to miss work for treatments.  Happy day.  And, happy Halaven!

MUGA: Hide Your Children (Again)

MUGA: Hide Your Children (Again)

Today I had my first MUGA, or multigated acquisition, scan.  This is also know has a nuclear heart scan.  Yes, that’s right, nuclear.

I do believe this one took the cake.  The nuclear cake, that is.  Not only did the nuclear medical technologist draw my blood and mix it with a radioactive tracer, she then pushed my hot blood back into my body.  I positioned myself under something that looked liked an inside-out Tie Fighter; this was apparently a gamma -ray-shooting camera.   The gamma rays picked up the radioactive tracers as they rocketed through my body.  This all somehow let the radiologist know that my heart can handle chemo.

I am now supposed to drink a lot of water and urinate frequently to rid myself of any remaining radionuclides. As with the PET scan, holding babies is out of the question.  Again, hide your children.

(Do you think Professor X would go for the mutant name “MUGA”?)

CLICK HERE for more information on MUGA sans.

 

 

 

More Clinical Trail Information

More Clinical Trail Information

CLICK HERE if you missed the first post on the clinical trial Dr. Kantor is suggesting.

More information about clinical trials in general:

Most Commonly Asked Questions About Clinical Trials from Women’s Cancer Network

Clinical Trials:  What You Need to Know  from the American Cancer Society

More information about eribulin (trial drug):

Study that got eribulin FDA approved for pretreated cancers that have not responded to at least two other types of chemotherapy

Eribulin Improves Survival of Women with Metastic Breast Cancer from National Cancer Institute

Eribulin Equal to Older Drug in Advanced Breast Cancer from Medscape News

And, to make things even more confusing, here’s a study Dr. Borges is suggesting:

(Yeah, she emailed me twice this weekend after I asked her about her thoughts on Dr. Kantor’s trial!)

CLICK HERE to see the trial Dr. Borges suggests.

Her’s is much more specialized to the type of cancer that I have, but I’d have to see her in Aurora because Dr. Kantor is not involved in this study.  I was not going to consider it, but she jumped back into the picture after she responded to my email in less than 6 hours on a Saturday.  I wasn’t expecting a response really at all, let alone on a weekend.

I’m still fairly set on Dr. Kantor, but I also don’t want to miss out on anything if Dr. Borges is truly the way to go.  And, yes, even as Dr. Borges suggested in her last email, I should follow my gut, but my gut really isn’t giving me much right now other than knots and butterflies and whatever else guts do when they have no idea what to do!

Any thoughts?  Psychic powers? Genies in bottles?  Jokes that will make me forget about all of this for a moment?

 

 

 

Calling All Scouts: Eribulin Trial or Standard Paclitaxel Treatment?

Calling All Scouts: Eribulin Trial or Standard Paclitaxel Treatment?

Dr. Kantor called tonight to let me know that I’m good to start treatment later next week.   I need to decide if I want to go with the standard treatment or the clinical trial.  CLICK HERE to see my treatment options.

Sticking with the battle metaphor, I need some help scouting out the clinical trial.    I’m going to meet with the research coordinator to find out more, but I know that she will want to sell me on it, so I’d like to develop meaningful questions.  I also want to decide if it’s even worth looking into.

Any help or opinions would be great.

HERE’S another link to the trial info.

Below are some other links about eribulin (generic for Halaven), which is the drug the trial is testing.

Halaven’s official site 

Eribulin description from the American Cancer Society

Paclitaxel (taxol) description from the American Caner Society   (This is the control drug in the trial and the drug I’d receive if I go with the standard treatment.)

Eribulin may be useful in earlier breast cancer from OncologyNurseAdvisor.com

Press release from the San Antonio Breast Cancer Symposium on a trial using eribulin on metastatic (spreading) breast cancer

Find any other useful links?

I’d like to let Dr. Kantor know whether or not I’m interested in the trial by the end of the day Monday.

The Power Port: Almost as Cool as the Power Rangers. Almost.

The Power Port: Almost as Cool as the Power Rangers. Almost.

After looking into my catheter options, I decided to go with the under-the-skin Power Port.  This titanium device is now under my skin just below my right collarbone . Yes, that’s right, I said titanium.

There were advantages and disadvantages to each type of catheter, and  I am grateful for my aunt and uncle’s insight because it encouraged me to ask a lot of questions.  For me, the Power Port seems like the best option.  It requires the least amount of maintenance and cleaning, which is a concern if I am going to work; high schools are dirty, germ-infested places!

Because the port is under my skin, I do not need to worry about covering it up in the shower or cleaning it.  I also like this one because it has three bumps on it to ensure that it hasn’t gone too deep and to help the nurses  find it.

It’s also purple and is sort of shaped like an adorable little heart:

PowerPortOh, and the Power Port motto:

YOU HAVE THE POWER!!

There wasn’t a purple Power Ranger, so here’s an excellent collage of Kimberly, the original pink Power Ranger:

Pink Ranger

CLICK HERE for more information on my new Power Port.

 

Treatment Options: Chemo Combo and Clinical Trial

Treatment Options: Chemo Combo and Clinical Trial

Both Dr. Borges and Dr. Kantor suggested what seems like a fairly standard treatment plan:

  1. Cytoxan (cyclophosphamide) and Adriamycin (doxorubicin) every 2 weeks for 8 weeks (4 cycles total).  In the cancer world, this combo is called “AC”.
  2. Taxol (paclitaxel) for either 12 weeks or 8 weeks – still figuring this out.

(Click on the drug names if you’d like to see why they’re used and all of the fun things they can do to my body!)

Dr. Kantor may switch the order of these because apparently spreading Taxol over 12 weeks might be easier for me to tolerate while trying to work.   I’d then do the AC combo in the summer when I can be home.

Does anyone know anything about these drugs or this treatment plan?  Any information would be great.  I haven’t had much time to look into it, but I plan to be a chemo drug expert before I actually get started with anything.

Dr. Kantor also offered a clinical trial:

NSABP FB-9:  http://clinicaltrials.gov/show/NCT01705691

From my understanding, this study is to test eribulin, which is a drug that is already FDA approved for stage 4 cancers that have spread beyond the breast. This study if to see if eribulin is more efficient than Taxol on smaller cancers that have not spread.  If I am in the control arm, I would get the same treatment plan mentioned above, but I’d for sure do Taxol first and then AC.  If I am in the experimental arm, I’d take eribulin instead of Taxol for the first treatment, and then I’d do the AC.

CLICK HERE for info on eribulin.

I have a lot of reading to do to decide if I’d like to participate in the trial.   Any opinions?

What I Got: Triple Negative Breast Cancer

What I Got: Triple Negative Breast Cancer

My prognostic panel that analyzes the cancer’s responsiveness to specific hormones came back “triple negative”.  I need to look into this more, so please comment or post information if you know or find anything about this.

From what I understand so far, there are three hormones to which the cancer might respond.  If it is responsive to one or more of these hormones, there might be treatment options other than chemotherapy.  If a prognostic marker report comes back  “triple negative”, then chemo is the only way to treat it.  Although, researchers are looking into other ways to treat this type of cancer, so please post anything that you find, particularly treatment options and studies.

Only about 10% of women with breast cancer have this type.  Unfortunately, it’s more aggressive and more likely to spread; however, it’s more likely to respond to chemo than some of the other forms.  I think. . .???

Below’s what I’ve found so far:

BreastCancer.org on Triple Negative Breast Cancer

National Breast Cancer Foundation on Triple Negative Breast Cancer

John Hopkins Medical Center Info