A Little Bump in the Road

Portland was awesome! I will post pics and talk more about it next post but right now I am posting on my phone and pics are a pain in the butt.

I got the results of my head CT and it turns out the spot found on my skull is a new spot of metastasis. Grrrrr. That means the spots on my spine that seemed a little brighter last time really are brighter and it is not just machine variation. On the plus side, because the contrast dye was used they can confidently say that my brain is currently not affected.
Still, that means a change to my treatment.

I saw my wonderful new oncologist on Wednesday.  We both commented how we felt bad for each other. She said she felt bad because I had just had 2 successful years of treatment in Vancouver then as soon as I was officially in someone else’s care all hell starts to break loose. I laughed and said that I felt bad for her, my new oncologist thought she was getting a stable unexciting patient, then as soon as she is in charge all hell starts to break loose. :-P
After that we did discuss my new treatment plan. Lucky for me the new plan doesn’t involve chemo.
I am continuing on the Herceptin IV every 3 weeks, the Zoladex injection every 4 weeks, and the daily Chlodronate pills. The daily Tamoxifen pill is being stopped and switched to Letrozole which is an aromatase inhibitor.

Yay! The hot flashes will continue……..and the insomnia…….and I might get joint pain……and my risk of osteoporosis goes way up. I’m so excited!!!

Basically, what the treatment change does is switch how the cancer is starved of estrogen. The Zoladex stops my ovaries from producing estrogen and chemically puts me into menopause. Other tissues in my body still produce low levels of estrogen.
The Tamoxifen worked by blocking the estrogen receptors so the estrogen had no where to bind. Now, the Letrozole stops the production of the rest of the estrogen so the receptors just hang out with nothing to do.
I wasn’t sure about switching to an AI, but a quick scan of some literature told me that it is pretty common for Tamoxifen to start failing after about 2 years. I was on it 17 months. A generally very successful route to go after Tamoxifen failure is AI with ovary suppression so it seems worth trying.

I am starting out with a trial month. The side effects can be really horrible and difficult to tolerate so there is no point in prescribing several months of the drug if I’m going to have to drop it in a few weeks. It has been 5 days and so far so good. Besides, I had my Zoladex injection on Friday and that gives me such brutal hot flashes and a few days of really bad insomnia that I wouldn’t notice any other changes right now anyway.

I was scheduled for my routine abdominal CT scan in mid September so it is going to be bumped up to some time in August to make sure there aren’t any more new spots or reactivation of the splotch in my liver.

The stupid spot in my skull is also giving me headaches now. In particular I notice it if I have to turn my head to the right very much or when I lie down on my right side. It was probably at it’s worst Wednesday, Thursday, Friday. It seems to have improved a little bit today but that might just because I didn’t do as much yesterday after having my Herceptin infusion on Friday. Maybe I’m getting a really awesome placebo effect from the new drug as I think it is highly unlikely that it is already causing the new met to shrink and stop causing pain.

Because I am now having symptoms I am going for a radiation consult at the beginning of September……I had to move our moving date around as the consult ended up being scheduled for the same time the movers were going to arrive, of course!
I am hoping that the new drug really does kick in and my headaches go away so they decide radiation isn’t needed.  Since my brain isn’t affected it wouldn’t be whole brain radiation but it would probably still hit at least some of my hair and I really don’t want to lose ANY of my hair right now.

I think that is all for now. I should have my CT some time in the next couple weeks, we get possession of our new house the end of August, and then radiation consult the beginning of September. All in all things just seem to keep carrying on.

I promise to post about Beerfest soon! Right now I think it is time to try and get a little sleep.

Have an excellent Monday, everyone 🙂

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