Bitch is Back!

Bitch is Back by Elton John 

This is definitely an appropriate title. My latest cancer treatment, Gemzar, quit working. I'm not sure it even started. 

If you follow the blog, you know I started getting Gemzar infusions on December 10. Luckily for me, my oncologist runs tumor marker tests at least once a month. I knew we were in trouble when the markers kept going up and not down. The February 3rd PET confirmed our suspicions. Here is a summary of the PET results:

Description/Location                                                     2/3/2021

Left submandibular                                                 12 x 8, max suv 11.4

Portacaval Lymph Node                                                 Max suv 27.7

Right subpectoral                                                         16 x 6 mm; max suv 6.5

Anterior mediastinal lymph node                                 ill defined, max suv 2.2

Aortopulmonary window lymph node                         Max suv 11.2

Left Infrahilar lymph node                                         Max suv 8.2

Right Paratraceal                                                         11 x 8, max suv 12.3

Right subraclavicular                                                 Resolved

Left jugulodigatric                                                          11 x9 mm; max suv 13.3

Lungs - left upper lobe                                                 Biapical scarring; trace pleural effusion

Liver #1 - Segment VIII                                                 Max suv 16.3

Liver #2 (lateral left hepatic lobe); Segment II         Max suv 16.8

Liver #3 Caudate lobe                                                 Max suv 16

2/3/2021 - 1. Overall findings are concerning for progression of disease, with several hepatic lesions having increased tracer avidity. 2. Mixed nodal findings are seen, with a couple newly avid nodes appreciated, others unchanged, and a few decreased or resolved. 3. New from prior are trace bilateral pleural effusions, and a small amount of free fluid in the pelvis.

Items highlighted in red indicate progression. Items in green indicate marked improvement from the December scan. Items without any highlighting are basically stable with little movement. So, not a great scan, but not completely horrible either. Frustrating is a better description. Surprised? I am surprised it wasn't worse. So I count my blessings every day.

So now what? Now we move on to Abraxane. This chemo stops cancer cells from dividing and making new cells. It is 48% effective in killing, as in wiping out, cancer cells. Let's hope my resistant sneaky suckers succumb to Abraxane's charms! This chemo is given in 3 weeks on, one week off. Sadly, I only had one treatment before the mother of all winter storms hit Texas. Texas Oncology was closed all week so my chemo AND COVID vaccine appointments were canceled. Bummer! My next scheduled chemo is Friday. I suspect we will just stick with that and schedule another round for the following week. We'll see. 

I think I am slated to see Dr. Kocs this week before chemo. If so, we have things to discuss. First, I was told that when Abraxane quits working, we go to a chemo that is given once a month. OMG! Red Devil? Not sure, but I don't think I will skate through that one without some side effects. I suspect I will definitely need the weekend to recoup. No worries. Hubby is here to help in case I struggle. Chemo queen hasn't been beaten yet .... let's keep the streak going!

I have also been doing research on chemo used to fight MBC. I want to find out from Dr. Kocs which ones are available to me. Interesting what I've found:

• 5-Fluorouracil - Inhibits DNA synthesis; slows tumor growth, possible liver damage
• Abraxane - On this one
• Carboplatin - Inhibits DNA replication, inducing cell death
• Cisplatin - Binds to N7 reactive center; can cause DNA damage in cancer cells resulting in apoptotic cell death
• Cyclophosphamide (Cytoxan) - Binds to DNA; slows or stops cell growth by inhibition of protein synthesis
• Doxobubicin (Red Devil?) - Slows or stops growth of cancer celss by blocking enzyme tope isomerase 2; used to divide and grow
• Epirubicin - Inhibits nucleic acid (DNA/RNA) and protein synthesis, which can result in mechanism to cell death
• Eribulin - This one quit working - Suppresses microtubule growth; stops cancel cells from separating into 2 new cells
• Gemzar - Did NOTHING for me - Kills cancer cells undergoing DNA synthesis by inhibiting ribonucleotide reductase enzyme
• Ixempra - Microtubule inhibitor in combinataion with capecitabine; low success rate
• Navelbine - Interferes with genes and stops the cells from reproducing themselves
• Pegylated liposomal doxorubicin - Doxorubicin encapsulated in a closed lipid sphere that work in multiple phases of the cell cycle
• Taxol - My first chemo -Kills cancer cells by inducing multipolar division; prevents cancer cells from dividing 
• Taxotere - Interferes with the cancer cells ability to divide
• Xerloda - Binds to cancer cells to inhibit formation of thymidylate triphosphate, essential for DAN synthesis

This does not include the list of 13 targeted therapies, usually in pill form. 

Anyway, this girl is still feeling fine. My liver appears to be "talking" to me more these days, but not as much since my new chemo session. Definitely something to discuss with Dr. Kocs. My blood work is okay, nothing alarming to report. 

I still have at least two more blankets to make before I can relax. I have another three that I want to make because of the color schemes; new things I want to try. Just trying to buy the right colors, while on sale, is a challenge. They put the yarn on sale .... but the colors I need are never available. I've reached out to the craft store asking how I can take advantage of the sale and get the colors I need. Their response? These has been no response. Sigh.

Anyway, wouldn't it be wonderful if my most pressing issue was yarn colors! 😄

Stay warm, my friends!