When we discovered that the cancer in my body had spread to my liver back in January of this year, we had to make a lot of decisions rather quickly, which always seems to be the case in this experience with Stage IV Metastatic Breast Cancer (MBC). No matter how much we prepare or research or discuss, we’re almost always in a situation where decisions have to be made quickly and there is a crisis of some kind. In this situation, the crisis was the discovery that the cancer had outwitted the last two treatments I’d had and was rapidly getting out of control (or at least this is how I interpret the spread to an organ for the first time in 5 years).
And so we decided to go with a combination of Taxotere (IV chemotherapy) and Xeloda (oral chemotherapy). I signed a consent to do six (6) infusions of Taxotere every three weeks with the option to add a few more, if necessary, in February. This combination allows my medical team to add or subtract Taxotere while I continue to take Xeloda, for as long as it works. Additionally, the combination of these medications intensify the affect of each (also intensifies all of the side effects of each).
Let me just say that I know that IV chemotherapy is often something that is daunting to many. For those of us who are hormone positive and can often stay on oral therapy for years and years, chemotherapy can feel like failure and like the beginning of the end. While intellectually I knew and know that including IV chemo isn’t a failure or the beginning of the end, it certainly has marked a period of experiencing MBC differently.
I’ve had years of stability, of nearly feeling “normal,” of having energy, and definitely not looking sick. Sometimes these years of not feeling so much like a cancer patient can lull us/me into a false sense of what MBC is like. While I always knew the other shoe would drop at some point, that I would be on IV chemo again at some point, the experience of it has been very different from the initial IV chemo experience. When we found out that the cancer had invaded an organ, I knew in those same bones that are still cancery, that we needed to bring out the “big guns,” meaning more than just targeted therapy, to get the cancer back under control and it felt like we didn’t have any time to waste.
So, I started the IV and oral regimen in February, which are administered in three week cycles with the IV chemo at the end of an off week from the oral meds. After the first three cycles, we did a PET/CT in April, which demonstrated that the regimen was working as it should, that the liver lesions were/are all dead, and the bone lesions following. My tumor markers, which have been a good leading indicator for good and ill, have pretty much followed a good downward trajectory after increasing to the highest they’ve ever been since diagnosis in 2017. All good signs.
The only fly in the ointment, outside of pesky side effucks that have been a lot to manage, is the ongoing tachycardia. My heart rate has been consistently in the 130s and a visit to a cardiologist with the all the tests hasn’t revealed a specific cause. Well, we suspect the cause is the strain on my body from chemo, the ongoing edema and enforced lack of activity because of extreme fatigue. Hoping to see that heart rate go back to my normal in the weeks and months ahead and definitely watching out for the rare cardiac side effect of Xeloda.
In light of our move from Miami to Orlando coming up next weekend and the adjustments to the new medical team, both local in Orlando and at Mayo, my next PET/CT won’t be until mid-July. I’m hopeful that the side effects of Xeloda will calm down a little now that Taxotere isn’t intensifying the affects of the medication and that the PET will show that the oral meds are doing their job for now. I’ve a second opinion at Memorial Sloan Kettering planned for the summer to review all of the new options available to me now that the cancer had mutated substantially.
And so we return to taking things one day, one minute, one second, at a time and hoping like hell that the medication is doing its job. I’ve a little bit of hair growth coming back on my head, which my boys think is hilarious and we had a lot of fun with the henna crown and our photo shoot for Mother’s Day. The boys are getting older and asking more questions and having more opinions; at the same time, I’m thankful that they roll with all of the changes probably better than Elliot and I do. The last five (5) years has been an education for us all and I suspect they will never remember me before MBC.