My Treatment Plan

So today was my visit with the oncologist to go over everything. It was nice to finally hear what the plan is so that I can prepare and just know when this is getting started (probably 10-14 days). I am officially a Stage 2B, the B has to do with the tumor size. Some people were surprised that I have to do chemo because my other lymph nodes were clear and the sentinel lymph node was removed. The reason is that the lymphatic system pumps fluid through your body to clean out invaders, so whatever is in the lymph has potential to go elsewhere in my body. Since cancer (and only a small amount) was in the lymph it could have gone elsewhere, but we are declaring that it DID NOT! IV chemo is systematic and goes throughout your body, which means that it should kill any "rouge cells." Also, even without the lymph node being positive, they would still do chemo because of my age and the aggressiveness of the cancer. Better safe than sorry kind of thing. Recurrence is not any fun, so the plan is to eliminate the possibility as much as possible.

So the chemo they choose is dependent on the cancer markers. Like we have said before, my cancer is HR/2 neu positive, which means that there is a protein in my body that feeds a cancer gene and allows it to keep growing. This is the aggressive part of my cancer and on a scale of 1-3 in severity, I am a 3. Another tumor marker is estrogen receptor positive, which means estrogen presence fuels the cancer growth. It is considered weakly estrogen positive, which is good, but they still want to stop my body from producing estrogen for a while.

One part of my treatment is IV chemo. My surgeon put a port just below my collarbone that is accessed with a needle every time I go in. This lets the drugs go right to the central part of my body, rather than through a vein in my arm which can be both uncomfortable and cumbersome (especially every three weeks). I will be going in every three weeks for 6 treatments, which will be a total of 18 weeks. I will receive two therapies. One is called Carboplatin, the other is called Taxotere. These are the typical "harsh" chemo drugs that make your hair fall out, make you feel tired, and can make you feel sick. In addition to that, I will receive what is called a targeted therapy for the HR/2 neu marker. A targeted therapy means the drugs go after the specific tumor marker and won't kill all the fast growing cells (hair, blood cells, etc). This is where the research trial comes into play.

I am eligible for a research trial specifically for my diagnosis. The only way that it differs from what the doctor would treat me with normally is the part that deals with the HR2/neu factor. Most women are treated with a drug called Herceptin which is very effective at treating this kind of cancer marker. Some research shows that younger women may do better with a drug that is called Tykerb, I have actually done my own reading about it and apparently in other trials it has been a good alternative without some of the potential cardiovascular side effects that Herceptin might have. So...I am going to sign up for this trial and they will send my pathology to the board of research for approval which takes about a week. If I am approved I will start soon after that, if not, I will start treatment using Herceptin. Being part of the research trial doesn't mean I will definitely get the new drug. 25% get just Herceptin, 25% get a combo of both, 25% get a different combo of both, and the last 25% get only the new drug. My doctor assured me that this treatment would always be just as good if not better that what I would do anyway. Another reason why I am doing this is that without research participation, they cannot make progress with research. In a way I am helping my own cause and the cause of future generations by participating, and that feels like the right thing to do. I will need either Herceptin through the IV with or without a combination of the clinical drug in pill form every three weeks for a year. Like I said before, this is much more mild than traditional chemo.

Last but not least I will be taking a drug called Tamoxifen which is a pill for 5 years. This drug stops you from producing estrogen so that any "rouge cells" will not get the fuel they need to grow. The good side is stopping cancer of course, the bad side is menopausal symptoms for that time.  Some women have no problems and others do.

Monday I was in Rochester seeing a very knowledgeable and experienced doctor who practices naturopathic and traditional medicine. She is very familiar with all of the chemo treatments and has tons of experience with cancer patients. She talked to me about nutrition during this and gave me supplements to help me stay healthy and detox some of the yucky chemo stuff. Not only that, one supplement in particular detoxes and makes the chemo more effective! This is all cool with my oncologist as well. Hopefully it will help me stay as healthy as possible. I am also looking into acupuncture which for some unknown reason is very effective in treating the fatigue and nausea that chemo patients experience. I am very excited about how these alternative therapies are going to help me to feel as good as I can for my family and myself!

The next major hurdle that we are praying about is telling the kids about all the treatment stuff. I know shaving the head has the potential of being pretty weird and scary. Thanks to the Smees for sending the amazing books! Another plan that a friend told me about is another mom had her kids cut her hair and her husband shaved her head. She told the kids to just have fun and cut different shapes. I think this will make it less scary and more fun. I am also going to buy them some fun kids fabric and let them make their own bandannas to wear with me. I am hoping this helps, but prayers are welcome!!  

Well hopefully I covered it all. It is a lot to swallow and we do have a trying time ahead of us. So once again, thanks for all of your support! Thanks to all of you who are making delicious meals for us! It is so nice and on those days that I am feeling pretty gross, it is going to be nice to just pull something out of the freezer! We really appreciate it! Thanks to everyone who have been willing to watch our kids. They are having so much fun and getting so spoiled that I think they are going to handle the chemo news well.  We are looking up and trusting God to continue to use this all of good, just as He has already!