Another Herceptin is in process (and I just want to point out that I got the window overlooking the dog park again. Someone obviously loves me. There's a beautiful chocolate lab out there chasing his ball). Anyway, I'm drinking in all of it's HER2 killing properties in hopes that over the last 5 treatments the Herceptin will take care of any possible breast cancer still floating around in my system. My last appointment is scheduled for September 22nd. Technically, after that point I'll be done with the adjuvent part of my treatment - only to be followed with my exchange surgery and hopefully the creation and tattooing of nipples (sorry if that's too much information, but its the reality of the breast cancer patient)! I've also learned that September will be the month I have my braces removed from my teeth. New teeth, new boobs, new outlook! Its going to to be a hell of an end to one of the hardest years imaginable.
I met, as usual, with Dr. Luoh this morning. He went through the usual questions and then waited patiently for my to ramble through my weekly concerns of Metastasis and my analysis of recent studies and possibilities for my treatment. He must find me the most obnoxious and insane patient ever. I discussed my recent back pain - which seems to be getting better with chiropractic treatment. He assured me that he was confident my pain was not related to the return of my cancer, and he laughed at me while moving only his lower jaw, similar to how a puppet would laugh. I've often wondered if his laugh is forced, but after watching his facial movements I'm convinced that this is, in fact, real emotion. I then brought up the possibility of adding Zometa to my treatment regimen. Studies in recent history have indicated that Zometa might protect against bone mets, but most recently additional studies were performed that indicated that breast cancer patients (especially those who are young) were not benefiting from the Zometa. You can read here for more information: http://www.medicinenet.com/script/main/art.asp?articlekey=123253
Anyway, Dr. Luoh is going to do a bone density test to ensure that everything is ok. He said that he could use Zometa preventatively if it is something that I wanted to work with, but I'm not sure that i'm interested in taking another drug that so far does not demonstrate the kind of results that I could benefit from. I believe that Tamoxifen also has some bone building properties (hence the pain in my bones and joints all the time) that may be beneficial to me.
We also discussed the ever-changing clinic trial issue. I mentioned a couple of clinic trials, one in Berkley, CA and another in Tacoma, WA that are testing HER2 vaccines. I laid out my concerns about the vaccine trials vs the Neratinib trial. In the Neratinib trial, we are aware that the agent directly kills HER2 - but there is only a 50/50 chance of receiving the drug. Dr. Luoh told me mostly what I have already heard - that so far the clinic trials for HER2 vaccines are not going well and that while this vaccine could be the "magic bullet" it was unlikely. Of course Dr. Luoh can't tell me which trial is going work, otherwise they wouldn't be trials, they would be standard of care, but our discussion has me leaning strongly toward the Neratanib. Since the Neratanib has pretty significant side effects, I should know immediately if i'm receiving the actual dose or the placebo. He said I can enter the trial as soon as i'm done with Herceptin in September. YAY!!! Even if the Neratanib only decreases my re-occurance chances 1%, to me, its better than nothing!
The last thing that we discussed is my mild lymphedema, which seems to have gotten worse over the past couple of weeks. I have slight swelling and some cording in my left arm that is uncomfortable and often painful. Luckily, the condition hasn't interferred with my ability to use my arm or my range of motion in any way. It looks like i'll be headed back to my physical therapist in Salem to work through these quirks. I'm not excited to be adding lymphedema to my list of conditions, but I suppose I'd rather be living with Lymphedema than not at all!
I'm hoping that eventually this blog will chronical things far more entertaining and fun outside of the cancer world that Shane and I have been living in since June of 2010. We look forward to the future and remain hopeful that eventually our lives will get back to normal! We are excited to finally meet and get to spend some time with our first niece Amelia Ann McDaniel (congratulations Nick and Heather!). We are also excited to celebrate Shane's graduation with his Master's of Social Work on the 11th of June. I am so proud of my amazing husband for his accomplishments. I know he is going to do amazing things in his lifetime!! There are many things to look forward to and we look forward to continuing to share our life and updates with you!