Stay the Course

Stay the Course by Iration  I do not own the rights to this music.

This song has a reggae vibe and definitely worth a listen. The video features a sea turtle. Who doesn't like sea turtles?  Another cool find while looking for an appropriate blog title. Check it out.

Mike and I met with Dr. Kocs today. We had a whole list of questions. But, true to form, Dr, Kocs answered most of them before we could ask. Our opening dialogue is true Bishop/Kocs banter.

Me: How do you like the new system?

Kocs: I hate it! Can't you tell? I have less hair!

Me: Well, I have you beat. I have a nice round bald spot where they radiated one of the brain mets. For the rest of it, I was shedding like crazy, so Mike buzzed it off this weekend. I now have less hair than you for a change. I am blaming it on the radiation.

Kocs: Yes, let's blame it on the radiation!

We have fun.

Anyway, as you know we have mixed results from the PET. Some tumors can take longer than others to be impacted by the chemo. Some may have mutated and are a bit more resistant. I asked if we needed to biopsy some of these resistant suckers and see if any of the cancer characteristics have changed. That may be something we consider down the road if tumor markers, liver enzymes, and other tumors seem to be getting better but some tumors continue to progress for some unknown reason. Bottom line, we won't rule it out. 

I also asked why radiologists change the descriptions of the tumors they are reporting on. One of my pet peeves when reading PET results. How can I keep an accurate spreadsheet to compare results from one PET to another if they keep changing the description? That's code for "I can't project manage this cancer with bad or incomplete data"! I think I am going to blow up a picture of the lymph system and go back to all my PETS and mark the ones mentioned in the various scans. I bet I become a lymph system expert before we are done, as far as where the various nodes are located and their scientific names. Maybe that will help me decipher the PET results.

We talked about the possible mets on the bones. He isn't convinced we have mets on the bones. Could we radiate the possible mets on the L1?  We watch to see if there really is an issue on the L1; if we see a risk of fracture, high pain, or other issues caused by the cancer on the L1, then we can radiate it. The goal is to make sure I am comfortable, pain free, and prolong my life as long as possible. Dr. Kocs reiterated we still have lots of tools in our toolbox, including Piqray.

The final question is can I travel to help Matthew drive Sadie home, then go back to help nurse him to health when he has oral surgery on 6/14. Dr. Kocs says yes I can travel since we all have our vaccines, but the traveling could wear me out (I've made the 2-days each way round trip before; rough, but doable. I'll be fine). If we need to, I can send Mike back to nurse Matthew back to health on 6/14 if my cancer is misbehaving. I hope it isn't!

So ... what's the final verdict on treatment plan? We "Stay the Course"; continue with Abraxane. Abraxane has proven to be 48% effective in killing cancer cells. We have seen evidence of that ... just not across the board yet. Hoping that, between my diet and the Abraxane, we kick some of that cancer to the curb! We will be checking tumor markets every two weeks (did I tell you they are heading down  after going up two months in a row?). Let's give Abraxane a little more time to do its magic. If we notice that tumor markers are heading up, then we move up the PET, see what's going on, and possibly move on to Plan F.

Fingers crossed Abraxane does it stuff!

Friday is chemo aka "Get Your Groove On" day for the self proclaimed dancing Chemo Queen. Now that it's warmer, I can wear my Chemo Queen t-shirt (Thank you Ms Jay!), my black leggings, and my latest dancing shoes! Are these not too cute?!!

Meanwhile, in celebration of my lifestyle change, I've decided to post a recipe of one of the dishes I really, really like at the end of each blog. That by itself should keep you coming back for more 😍

First up, my new vegetable casserole. It is really, really good!

Tomato Vegetable Casserole Recipe | Giada De Laurentiis | Food Network

 https://www.foodnetwork.com/recipes/giada-de-laurentiis/tomato-vegetable-casserole-recipe-1914994 Total: 55 min  Prep: 15 min Cook: 40 min Yield: 6 servings 

• 1 medium potato, peeled and cut into 1/2-inch pieces 
• 1 medium yam, peeled and cut into 1/2-inch pieces 
• 1 red bell pepper, seeded and cut into 1/2- inch pieces 
• 2 carrots, peeled and cut into 1/2-inch pieces 
• 5 tablespoons olive oil 
• 1 red onion, thinly sliced into rings 
• 2 small or 1 large zucchini, cut crosswise into 1/4-inch-thick pieces 
• Salt and pepper 
• 2 large ripe tomatoes, cut crosswise into 1/4- inch thick slices 
• 1/2 cup grated Parmesan 
• 2 tablespoons dried Italian-style bread crumbs 
• Fresh basil sprigs, for garnish 

Preheat the oven to 400 degrees F.

1. Toss the potato, yam, bell pepper, carrots, and 2 tablespoons of olive oil in a 13 by 9 by 2-inch baking dish to coat. Sprinkle with salt and pepper and toss until coated. Spread vegetables evenly over the bottom of the pan. 
2. Arrange the onion slices evenly over the vegetable mixture.
3. Arrange the zucchini over the onion.
4.  Drizzle with 2 tablespoons of oil
5. . Sprinkle with salt and pepper. 
6. Arrange the tomato slices over the zucchini. 
7. Stir the Parmesan and bread crumbs in a small bowl to blend. 
8. Sprinkle the Parmesan bread crumbs over the vegetables in the baking dish. 
9. Drizzle with the last tablespoon of olive oil. 
10. Bake uncovered until the vegetables are tender, and the topping is golden brown, about 40 minutes. Garnish with fresh basil sprigs, if desired. 

Soooo good!

One Day You Will

One Day You Will by Lady Antebellum - I do not own the rights to this music.

This is a song of hope. Facing dark times, knowing better days are ahead. This is what I hang on to. This is what I fight for ... better days ahead.

PET results are in. Whee! Once again, we have mixed results. It isn't good, but it isn't all bad. Here is a summary:

• Liver
• One slight progression
• One slight decrease
• One unchanged
• Lymph Nodes - there is a lot of lymph node involvement
• Nearly all cervical nodes show significant decrease
• Mixed response in the thorax nodes
• Two show progression
• Two show significant decrease
• One new active one showing uptake
• Overall progression in the abdomen 
• What? These have never shown up before or at least were not mentioned
• Left and right common iliac
• Porta hepatis increased
• Gastrohepatic decreased
• Bones
• New; this is disappointing
• Uptake in right aspect of L1 vertebral body suggesting early metastasis
• Focus of uptake in the lateral right fourth rib barely conspicuous
• Can we zap these?
• Overall
• Mixed response of FDG and lymphadenopathy
• Somewhat mixed response of hepatic metastatic disease
• Couple new FDG avid osseous metastases (bones)

So ... not great, not all bad. Am I surprised? By the new bone mets, yes. Overall results? No. I expected mixed results. Still hoping for NED (no evidence of disease) someday. Hope is a must!

Mike and I meet with Dr. Kocs on Wednesday to go over the results and next steps. I honestly can't predict what next steps will be. Stay the course or try something new? I can make an argument for both. Meanwhile, I'll keep doing what I can to keep up my stamina, my strength, and remain hopeful. Despite the results, I feel fine. If there is a silver lining it is the fact I feel good.

I went off the vegetarian band wagon during PET preparation. I made a new batch of lentil soup, thinking I could eat that before my PET. I was wrong. ARA called me before I had to start the special high protein low carb diet pre-PET and basically told me I could not eat my lentil soup. My only options, to stay vegetarian, was to eat leafy greens with oil and vinegar for dressing. Uh .... NO! So I finally broke down and bought a rotisserie chicken. That is all I ate beginning at noon on Tuesday. Nothing but water on Wednesday until after the PET. I lost two pounds.

I am now back ON the vegetarian band wagon and I look forward to trying some dishes my sister posted on Facebook. This girl will be cooking this weekend. I am also on the hunt for a good smoothie recipe book, one that explains the health benefits of each smoothie. If its just to give you a natural sugar rush, I'll pass. 

I will post again once we talk to Dr. Kocs. Meanwhile, here are some pictures of the lymph nodes in the abdomen and the 4th rib and L1:

Rise

Rise by Katie Perry  I do not own the rights to this music.

This song is perfect for where I am in my life right now. Although things are not exactly looking rosy, I am committed to take charge of my destiny and "Rise" to the occasion. Take a listen if you are so inclined.

Brief update on the cancer front. One tumor marker heading down, one heading up. I just have to shake my head  ... "Whatever"!  Liver enzymes are good, other blood work is good. This Friday is the last chemo session of the cycle. PET scheduled for 4/7, review results and next steps with Dr. Kocs on 4/14, follow-up MRI on 4/19, then the appointment to go over results with Dr. Cohen on 4/21. I am not expecting great news on the PET front, anticipating a change in treatment protocols (hello #6). I am hoping we get the all clear on the MRI. I will NOT be happy if more brain invaders show up. Not that I won't deal with whatever comes ... I will ... I just won't be happy about it. 

Okay, enough of the Debbie Downer cancer crap! Let's chat about what keeps me excited these days! I AM TAKING CHARGE!! 

If you read my last post, you know that I decided that if God is doing his/her part in watching over me, the least I can do is make life changes to help myself. I started these life changes on Monday. And I remain excited!

I started a 7-day Alkaline Detox, with the intent of following up another three weeks on the 21-/Day Alkaline Diet Plan by Laura Rimmer. First, I bailed after five days on the detox. I am still eating the smoothies and soups included in the Detox, just not in the order provided. For example, I have no desire to make and eat Carrot and Lemongrass soup. I will stick to the leek/fennel root soup and the lentil soup I made earlier. Both are delicious! I also have no desire to ingest a coconut and turmeric smoothie. Instead, I will sub for the Kale/Orange smoothie and the Chlorophyll Zinger. Technically, I am still on the detox through the weekend. 

To date, my favorites for the detox include:

• Vegetable Detox Soup (basic vegetable soup, plus a beet.
• Hearty soup - this is the leeks and fennel root
• Tomato basil soup
• Greens and lentil soup
• Keto alkaline green smoothie
• Kale/Orange smoothie
• Chlorophyll Zinger
• Keto blueberry blast

I also drink a glass of warm lemon water every morning.

Note on the Chlorophyll Zinger: This smoothie detoxes the liver and the blood cells. My cancer is considered "blood borne", plus I have three lesions on my liver, so this is one I will definitely repeat every week if not twice a week.

I am already noticing a difference. I have not aged well and I look at least 10 if not 15 years older than I am. Five days into this detox and I already look younger. My body is more hydrated from the fresh fruits, veggies, and alkaline water. In just 5 days!! I keep this up and any future face lift is off the table!

This is the perfect time of the year to start on this new life style change. The farmer's markets are full of wonderful fresh fruits and vegetables. Although my husband is not going vegetarian, he is committed to eliminating processed foods from his diet and using fresh whenever possible. What does this mean for the Bishop house? So much fresh produce that we needed to rearrange our kitchen a bit to accommodate our latest haul from the farmer's market. Our kitchen island was overrun with fruits and veggies. So we created a fruit/vegetable bar in the kitchen, complete with our new food processor, our new blender, and four baskets of fruits and veggies we need for the week. We still have a bowl for apples, pears, and bananas on the island. Going forward, our "grocery shopping" for the week really means a couple of trips to Eli's for more fresh stuff.

I have also stocked up on vegan/vegetarian staples: lentils, the seeds (flax, chia, hemp), the coconut and almond milk, the coconut and alkaline water, agave, pure maple, Tahini, and spelt flour.  I have a new vegetarian cookbook scheduled for delivery on Monday. Meanwhile, I am planning on eating the rest of my detox soups this week, plus cooking a couple of vegetarian dishes: Chiles Rellenos with Black Beans (hubby will eat this with me) plus I am going to try roasted sweet potatoes with Miso, ginger, and scallions, then roasted cauliflower, some interesting stuff with brussels sprouts for snack, and more. 

Now this may not seem like a big deal to anyone, but I assure you, my family is in shock! I do not cook. Correction ... I DID not cook; I do now. I am cooking almost every day ... and enjoying it, much to my surprise! I look forward to finding and trying new recipes every week. I am also looking forward to experimenting with vegan desserts that will satisfy my sweet cravings.

I am very blessed! I am excited about the path I am on. Why don't you join me?

Radioactive

Radioactive by Image Dragon I do not own the rights to this music.

The song is appropriate for the blog, but I purposely did not link the the video. It's a bit dark ... cute cuddly stuffed animals getting beat up. I'm probably being a bit of a prude, but I still find it violent, stuffed animals or not.

Thursday was zap the new tumors day! I wasn't sure what to expect other than my head would be held immobile via a mask snapped onto a board during the 45-minute treatment. My biggest fear is that my nose or face would start to itch ... and I wouldn't be able to do anything. Mind over matter techniques are a must for this. So I counted the songs they were playing in the room, thinking we would go through up to 10 songs. This would help me gauge where we are in the process. I also sang the songs in my head ... and dozed off. My snoring woke me up a couple of times. It was a bit embarrassing to be honest.

Here is a picture of the mask. Freaky, right?

Anyway, all went well. I start stepping down the steroid dose Friday and will be off them entirely by 4/3. Thank goodness! I hate steroids ... more on that later.

So what's next with my little brain invaders? Well, hopefully we sent them to the tumor graveyard. Dr Cohen ordered a follow-up MRI for the end of April, then every three months until who knows when.

Continued prayers that this chapter is behind us and we can focus on killing the invaders in my neck and chest. Sneaky and resilient little suckers!

Friday was chemo day. After labs were drawn, I head in to see Rachel. We went over bloodwork, the radiation, follow-up treatment, and overall general commiserating. One thing I realized is just how blessed I am. Rachel ordered the CT to find out why my arm was swelling and .that caught the first of two brain lesions quite by accident. We did an Ultrasound the Friday before to rule out a blood clot. Truth be told, most would stop there and not push further. Rachel pushed. And the radiologist just happened to see the lesion on the front lobe out of his/her peripheral vision. Had the tumor been elsewhere ..... it's scary to think of the repercussions had we not caught them now. Again, I am so blessed. Even though the news is not great, it is evident that my "grace" and God continue to look out for me. I don't believe in coincidences. How could this incident be anything less than divine intervention? This realization has given me a lot of peace and calm in the roaring storm. It has also strengthened my resolve to do my part to beat this disease (more on that later). I am happy 😇

I learned something else Friday that was disconcerting. My tumor markers from February are up by 40 points. How did I miss this? I suspect it may be due to the treatment interruptions during the winter apocalypse. Regardless, I am not letting this latest news pierce my newfound peace. Liver enzymes are in normal range. White blood cell and ANC counts are high, typically indicating infection; this is from the dreaded steroids. We stay the course. I have a PET on April 7th. Let's see what that brings.

Chemo was brutal on Friday. Not the treatment itself, but the appointment. It was a long one. Thank goodness I got there early:

• Labs
• Visit with Rachel
• Iron treatment (my last one) for one hour
• Chemo for 30 minutes
• Potassium for 90 minutes

I don't know what the caused the potassium to drop, but the nurse caught that the levels were way low, alerted Rachel, and the potassium drip was added. I also have a one-week prescription because the drip is typically 2 hours but we didn't have enough time for a two hour treatment. 

I got there at 12:30 and left after 5. Wore me out.

This is where I start doing my part: Alkaline diet.  I had always heard that cancer likes an acidic body. I am sure with all the sugar I ingest that my body is as acidic as it gets. I have resisted this path for a long time because I saw person after person after person eat "clean", avoid chemicals, with no impact on their cancer diagnosis or longevity. My mantra? Why give up Blue Bell Ice Cream if it wasn't going to change anything?

So what changed? Staring mortality in the face. And thinking my time is running out. I realize I can just sit here and let it happen or I can at least TRY to take some control over my own destiny. Will it help? Who knows. It can't hurt. 

I get my second COVID shot today. Expecting to feel horrible, I've decided to wait until Monday to start the one week Alkaline cleanse before I begin the 21-day Alkaline diet. I have purchased all the non-perishables I will need (this stuff is expensive) and will be sending Mike to the store for the fresh fruits and veggies I will need for soups and smoothies. I had previously purchased fresh veggies for the the soups I would need for the first two days. I made and froze one last weekend. I couldn't sleep, so I made my second soup at 4:30 this morning. I also ordered a food processor (chopping, slicing, dicing), ph strips, and spelt flour.

Although I can't eat bread on this diet for the first month, I am told spelt bread, in moderation, is okay. My spelt flour came in this morning. I am going to make a loaf today just to see if this is something we want to continue.

Wish me luck on this new adventure! I promised myself I would give it six months and see if  tumor markers and PET results improve. I don't expect any impact on the 4/7 PET. I hear week three on this diet is a major milestone, so I am anxious to get there.

Watch this space 😏

CT And MRI Results

 For those that are interested, here is the CT result and pictures to help you understand what they are talking about:

CT scan Exam: CT SOFT TISSUE NECK WITH CONTRAST

FINDINGS: Intracranial Structures: 13 mm x 8 mm enhancing mass in the right superior frontal gyrus was not included on the field-of-view on referenced imaging. Paranasal sinuses: Visualized sinuses are well aerated. Mastoids: Well aerated. Orbits: Normal. Skull Base: Normal. Masticator Space: Normal. Salivary Glands: Normal. Nasopharynx: Normal. Oral Cavity and Oropharynx: Normal. Hypopharynx and Larynx: Normal. Trachea, Aerodigestive tract: Normal. Thyroid: Normal. Lymph Nodes: Index nodes are as follows: The ill-defined left level IV lymph node conglomerate with invasion of the adjacent scalene muscles measures approximately 3.4 cm x 3.3 cm, 3.3 cm x 3.7 cm on 02/03/2021 and 4 cm x 4.8 cm on 01/31/2020. There is questionable enhancement of the regional brachial plexus. Left node of Rouviere measuring 9 mm x 9 mm, 9 mm x 11 mm on 02/03/2021 and unmeasurable on 01/31/2020. Left level Ia measuring 12 mm x 12 mm, 12 mm x 7 mm on 02/03/2020 and 10 mm x 6 mm on 01/31/2020. Left level IIa measuring 13 mm x 10 mm, 11 mm x 11 mm on 02/03/2021 and 10 mm x 11 mm on 01/31/2020. Small bilateral level I and left level V lymph nodes are stable compared to 02/03/2021 and mildly increased compared to 01/31/2020. For example, a right level I node measuring 8 mm x 6 mm, unmeasurable on 01/31/2020. Vessels: The carotid arteries and jugular veins are patent. Osseous Structures: No destructive changes are found. Small sclerotic foci in T3 and chronic T5 compression deformity are redemonstrated. IMPRESSION: 1. Several cervical lymph nodes are stable compared to 02/03/2021 but mildly increased in size compared to 01/31/2020. 2. The left level IV lymph node conglomerate is stable compared to 02/03/2021 and mildly improved compared to 01/31/2020. There is questionable involvement of the regional brachial plexus, which can be further assessed with brachial plexus MRI as clinically necessary. 3. Small right frontal metastasis, which was not included on the field-of-view on referenced imaging.

Here is the MRI:

MRI BRAIN WITH AND WITHOUT CONTRAST

 FINDINGS: Brain: Mild nonspecific signal abnormality in the deep white matter should represent old small vessel ischemic damage. 10 mm x 6 mm enhancing lesion at the depths of the right superior frontal sulcus and 3 mm enhancing lesion in the left occipital lobe. No significant associated mass effect. Incidental left posterior frontal opercular developmental venous anomaly. Midline Structures: The midline structures of the brain are normal. Ventricles: The ventricles, sulci and cisterns are within normal limits. Vasculature: The vascular flow voids at the base of the brain are within normal limits. Calvarium: The visualized osseous structures are unremarkable. Sinuses: Minimal scattered atheromatous calcification. Orbits: The orbits and globes are unremarkable. Mastoids: Partial bilateral mastoid opacification. Extracranial soft tissues: The visualized extracranial soft tissues are unremarkable. IMPRESSION: Small right frontal and left occipital metastases without mass effect or hemorrhage.

Cover Me In Sunshine

Cover Me in Sunshine by Pink, Willow Sage Hart  I do not own the rights to this music.

This song is a call to action for friends, relatives, and blog readers. I am struggling to remain upbeat and positive, so critical in this battle. Please take a minute and "cover me in sunshine"! Send all the prayers and positive vibes you can spare my way. Thanks in advance!! 

Here is what rocked our world this past week:

When meeting with Rachel pre-chemo, I showed her a lump on the inside of my elbow. Full disclosure, right? Is my arm swollen? When we compared the left to the right ... yep, the left was larger. So, while I was going through chemo, Rachel ordered an ultrasound at the hospital next door. We need to make sure I don't have a blood clot (same arm that had lymphedema at the beginning of this journey ... only to find out it was a symptom of the metastases).

Chemo done, I head to the hospital. They got me in right away. Thirty minutes later I'm done and headed home. I was home 30 minutes when Rachel calls, says no blood clot, but let's monitor over the weekend and see if the swelling goes down. So Mike and I measure my left arm.. and right arm for comparison.. all weekend. I send Rachel a note early Monday AM with the results. Later that morning I get a call from Rachel. We need to order a CT and see what's causing the swelling. I head to TX Oncology for my CT Monday afternoon.  Note: Rachel doesn't play!! Can you tell?

Can I stop for a sec and let you know something I've noticed the past few weeks? I don't stress test results anymore. Those of you that have gone through any type of serious illness, waiting for test results is typically torture. I belonged to that "torture" club for a long time. But I've found I no longer check the patient portal every hour or leave messages/notes for the doctor to post results ASAP. I have finally realized that all my stressing and hand-wringing isn't going to change the results. It's liberating! Only took me 7 years to get there. 

Fast forward to Tuesday afternoon, I get another call from Rachel with CT results. As with recent scans, the results were mixed. Some stability, some progression. But this CT showed something new we haven't see before. Seriously? AGAIN?! Turns out there is a possible lesion on my right frontal lobe of my brain. We need an MRI to be sure. Once again, Rachel springs into action. I am getting an MRI at 10:30 Wednesday morning. Rachel calls Wednesday PM with results ... we don't have a brain lesion, we have TWO brain lesions: one 13mm x 8 mm in the right frontal lobe and one 3 mm in the left lower lobe. That's the gut punch, folks! Now what? For starters, Rachel prescribed steroids to prevent brain swelling. And radiation. I am scheduled with the radiation oncologist for next week ... or so I thought. 

Once again, TX Oncology is jumping through hoops. The nurse called back and moved the appointment from next week to Friday morning. This may not sound like much, but Dr. Cohen doesn't work on Fridays; she came in today specifically to see me and get the party started! Now do you know why I love this place? 

Unable to sleep Wednesday night, I started checking on treatment options for MBC brain metastases. Typically, doctors use radiation to zap the tumor, then monitor. Sometimes more lesions show up, many times they never see them again. I vote for door number two! I also checked in with Breastcancer.org and checked out the brain metastases thread. The general consensus for most ladies mirrored what the doctors and other research had told me: this is an inconvenience and something we need to deal with and monitor, but it's not an automatic death sentence. Yeah, I asked that question. Told you I was in a dark place.

I met with Dr. Cohen, the radiation oncologist this morning. The plan is to zap both lesions at the same time with targeted radiation, then we followup with MRIs every three months until ... forever. This will take about 45 minutes. Once we finish the treatment ... one and done... she will start weaning me off the steroids. Thank you, Lord! But, before we can schedule treatment, they have to make a mask to hold my head still during radiation. 

I must say, this was a trip going through this process. It didn't hurt, it isn't scary. But here I am, lying on the CT scan "bed" and I have three people putting this warm mesh thing behind my head and they are are mashing it this way and that. It felt like a neck message! Once they get that part how they like it, they bring over a large warm mesh thing to put head and face, leaving my eyes and nose exposed. Again, I've got three people mashing this way and that to get it real tight. Apparently, I am tiny ... coulda fooled me ... so they were having trouble getting it real tight. They snapped it into place. There is no way my head or neck is moving once snapped into place. Once they were done, they took it off and let me up. I got to see the mask. It's pretty cool! The best part? I get to keep it when we're done. Nice! I'm going to embellish that sucker, put a wig on it, and put her in my office. I may even give her a name. Feel free to send suggestions.

Here is what a mask looks like. Do you see where it is snapped down?

Hubby is expecting me to glow in the dark so much that we won't need a light on to read in bed. Sure would hate to disappoint 😊

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!