Good, but Complicated

Finally some good news


Hurdle #3 this week was the meeting with the oncologist.  We met with Dr. Kim at 10:00am this morning.  The good news: Negative PET scan, meaning no cancer detected anywhere else in the body.  Huge high five!  Also, pathology from excision last Friday showed negative, so no more cancer in the original tumor area. Another high five!


So, we are feeling very blessed that we now have a complete clinical diagnosis and that there currently is no cancer in her body that we are aware of. Praise the Lord!


Decision time.  


The question that remains is treatment going forward. Julie  has decided to do chemotherapy (and endocrine therapy later).  The statistics for recurrence without chemo are too high to not do chemo. Dr. Kim has recommended a "moderate" (if you can call any poison moderate) chemotherapy treatment plan that includes two main drugs, Toxotere and Cytoxan. It will be administered every 3 weeks for 6 cycles, starting on September 8, 2011. More good news, she will not be taking Adriamycin, affectionately called "Red Devil". (remember the song - you are the devil and you are bad...?)


Big Decision number two. Clinical Trials.


As of right now, she is technically approved for a clinical trial, although she needs to do more tests to finalize her acceptance, including a blood test and an echo-cardiogram. (Apparently, one side effect is that the left ventricle stops pumping blood like it should so she needs a super strong heart.) Hmmm. 


Clinical trials are used for research purposes. You are, in a real sense, a lab rat. This trial is looking to see if adding the drug Herceptin can decrease the recurrence of cancer in a group of patients that are technically HER2 negative, but have a few cells in their clinical pathology that show +1 or +2  positive for HER2. Julie happens to fall into this category. So, they get a group of women who fall into that category, randomly draw 50% of them that get standard chemo treatment plus Herceptin, and 50% just get standard treatment. They (the FDA) then follow them for 10 years to see if the ones that got the Herceptin had a lower recurrence rate.


So, why do clinical trials? Good question. They can't and won't tell you if taking Herceptin will increase the likelihood for survival. They hope so, but don't know so. So, other than helping future patients, there's not much in it for the patient in the trial. Another negative, and a BIG negative, is this: standard treatment for Julie under the current plan is 18 weeks (6 cycles every 3 weeks - see kids, you do need math so stay in school). If she goes in the clinical trial, she would have to have the Herceptin treatments for a full year. Port stays in, co-pays for every visit, side effects. Yeah.


So, a specific prayer request is for wisdom regarding if should she participate in the clinical trial, you know, for the good of mankind. Or womankind. Or something like that.


Another specific prayer request is for emotional stability and minimal side effects from chemo. Its overwhelming what this stuff can do to you. Tired, cranky, swollen, metalic taste, tingling, swelling, (and a list of about 300 other things that "might" happen. Gotta love the FDA). She will have to take steroids (and a bunch of other stuff) to counteract the negative effects of the Cytoxin and Toxotere. Steroids are bad you say. Yes, they can be, and they have side effects, but not as bad as the side effects of the chemo apparently. Sounds like that TV commercial for Restless Leg Syndrome medication; it helps your leg but "....may cause internal bleeding, hemorrhoids, blindness, shortness of breath, heart palpitations, stroke, and in rare cases, death..." "...If you have any of these symptoms, call your doctor that prescribed it for you..."


We have an appointment next Friday to go over the whole chemo process, the side effects, the medicines she will be on, the schedule for medicines, etc.  The side effects work like a wave - the chemo crashes her body, white blood cells, bone marrow, immunities. The low point is 2-3 days after treatment, then she slowly recovers. The bad news about her start date is that it will be 3 days before Race For The Cure...so, we will have to sort that out later. If she can't make it, we walk in her honor!


Sorry for the length - but wanted to share some of the details.


Blessings to all. Thank you for your prayers, they are making a huge difference. Glory to God in the Highest.