Tumor Gone

I had an MRI, mammogram and ultrasound this week. The tests show that the tumor is gone. There is calcification and/or possibly DCIS (pre-cancer) where the tumor used to be. 

My oncologist thinks I should have surgery. There could be cancer cells remaining that the tests are not sensitive enough to catch. We didn't even discuss radiation, which like surgery, I'm hoping to avoid.

I see my breast surgeon again on Monday. She will probably recommend at least a lumpectomy followed by radiation. Both the surgery and radiation are supposed to get rid of the microscopic cancer cells, but it's not 100% guaranteed.

This afternoon I called UCSF to get a second opinion from a breast surgeon who is studying whether women are being overtreated. It will take them a couple of days to review my case, then they'll call me to set an appointment. 

When I went for my MRI on Tuesday, I thought they'd be able to use my port for the contrast dye, but they could not because I had to lie face down during the test. The nurse inserted a needle in my left arm but could not get past the valve in my vein. She tried my right arm. Same problem. Third time's the charm. She switched to a smaller butterfly needle and successfully started the IV using my hand. I thought it would really hurt but was no worse than using my arm.

Because I thought they would use my port, I applied EMLA cream to numb it up and covered it with a bandage called Tegaderm. When I removed the Tegaderm later, some of my skin came off with it. Ouch. It really stung for a couple of days. I had never had a problem with Tegaderm before. Maybe my skin came off because it has gotten so thin and dry, and I used Tegaderm two days in a row.  I'll have to remember to let the nurses know next time I go for an infusion. They also use Tegaderm on my port during my infusion, and there is another type of bandage they can use for those who are sensitive to Tegaderm.

Infusion Without Chemo

Monday I got Herceptin and Perjeta. It was the first time I got the two targeted therapy drugs by themselves without a chemo drug, so I'm just now learning what side effects they'll give me without chemo. Looks like Perjeta gives me diarrhea. I'm not looking forward to getting diarrhea every three weeks till December.

My potassium was still low on Monday, so my oncologist told me to take 40 mg of potassium pills twice a day until today when I got tested again. It's now back to normal. However, she said to take a dose every time diarrhea starts.

My WBC is also back to normal. I'll feel safer going to the farmers' market and Trader Joe's. I've been avoiding both places and all other stores.

I had been taking Prilosec for heartburn. The 14-day course ended on Monday. On Wednesday the heartburn came back. Doc said to keep taking Prilosec daily for three months. That's how long it typically takes the body to recover from the damage done to the stomach by chemo.

Visit with Surgeon

My surgeon, Dr. Wapnir, saw me Monday immediately after my chemo. Since I haven't had my follow-up tests yet, she didn't have a recommendation for me. But she did want me to consult with a reconstructive plastic surgeon. I have an appointment with him tomorrow.

Next week I have an MRI, mammo and ultrasound scheduled. I see my oncologist at the end of the week, then I see Dr. Wapnir again the following Monday.

I told Dr. Wapnir I didn't want surgery if at all possible. The idea of being cut up scares me. She thinks I'm being unreasonable. 

MD Anderson is conducting a study to see if women who achieved pCR (pathologic complete response) after chemo can avoid surgery. They will receive radiation without surgery instead. The goal is to see if patients are being overtreated. 

The Stanford study I'm participating in where my drugs were reduced from four to three and the duration from six to four treatments (although the number of treatments changed when I switched to Taxol) -- it has the same goal to see if women are being overtreated.

Chemo #8

Monday was my last chemo. Note that I still need to take Herceptin and Perjeta every three weeks till December. Those are classified as targeted drugs, not chemo drugs.

My potassium is still low, and they gave me potassium pills again. But instead of two giant pills, they gave me six slightly smaller pills that were easier to swallow. 

The nurse noticed rashes on my arms. I thought they were due to dry skin, but the nurse practitioner who stopped by didn't think so. I was prescribed a corticosteroid cream called triamcinolone acetonide to be applied twice a day.

Chemo #7

Had another chemo on Monday. I think I have to take Ativan for at two days whenever I get dexamethasone. I've noticed that it gives me insomnia for at least two nights, and Ativan helps me sleep.

Pepcid hasn't been working all that well for me. I switched to Prilosec yesterday, and it seems to be working better.

Next Monday will be my last chemo. I have an appointment with my surgeon the same day.

Not much else to report except I'm losing my eyelashes. 👁

Chemo #6

I had my 4th round of Taxol yesterday along with Herceptin and Perjeta. My appointment for blood draw was at 7:10 AM, which meant I had to get up at 5 AM to EMLA cream on my port to numb up the area.

Again I managed to get a private room for my infusion. My appointment started at 8:10. It didn't take long for the pharmacy to prepare my drugs this time. By 9:20 I was hooked up to Perjeta. That took 30 minutes, then another 30 minutes of observation. Herceptin also took 30 minutes. Taxol started at 11:00 and was done an hour later. 

Before being discharged, I had to take two potassium pills because my potassium level was below normal due to diarrhea. The potassium pills were huge! Horse pills! And I have trouble swallowing pills in the first place. The first pill took me only two attempts to swallow. The second pill took four attempts. By that time it had disintegrated, and I was able to add a bit of water to the cup that held it and swallow it. Thank goodness it didn't taste too bitter.

Taking Pepcid twice a day improved my appetite, and I managed to gain a pound since Friday. I was at 97 lbs. yesterday morning. My WBC is below normal. I'm definitely immunocompromised now. My RBC is also below normal, making me anemic. 

My friend Sindhu gave me a ride at 6:30 AM. Cousin Nancy gave me a ride home. Thanks, ladies!

Echocardiogram and Doctor's Visit

Last Friday I had to get another echocardiogram because my treatment can cause permanent heart damage. The tech would make me hold my breath occasionally, and sometimes she'd forget to tell me when I could breathe again. When the test was over, she told me I could hold my breath like a 22-year-old. 😛

I saw my oncologist afterward and complained of fatigue, loss of appetite, and heartburn. I thought she would prescribe something to stimulate my appetite, but she thinks the loss of appetite is due to the heartburn. I would get full after just a few bites, and it was also due to heartburn (bloating?). She told me to take Pepcid twice a day, and if that's not enough, take one in the morning and two in the evening. 

The fatigue is a side effect of chemo and is cumulative, meaning it will get worse with subsequent chemo rounds. Anemia is also making me weak.

I'm down to 96 lbs. I was 114 lbs. before I discovered my tumor.