Tuesday, March 9, 2010

Zometa, Faslodex and Avastin......Oh My!

Hi Everyone,

I’ve got another update for you. Many of you know some of this already so I will try to be brief. As you may remember, I had an MRI in January-it appeared to have “extensive bone metastasis in all of the vertebrae” but we were not sure if it was cancer or Zometa. On February 25th I had a PET and CT scan of my skull to mid thigh. We’re sure now, it’s definitely cancer.

We were fortunate to sit down with the radiologist, Dr. Bodeau, from LifeScan. Normally radiologists don’t sit with the patient to review the scans; they dictate a report and send it to your physician. But our dear friend Mary Rausch works at LifeScan and arranged for us to see Dr. Bodeau in person. He had my PET CT scan from July, which was clear except for L3 and L5, the MRI from January and the bone scan and bone survey results from December along with the recent PET CT scans.

The science part of a PET CT scan is very cool stuff. Now I know why these things cost an arm and a leg. Dr. Bodeau was very thorough in his explanation and what we were looking at. This just in, eye balls look really funny on a PET scan. On one view I was upright and spinning around, on another view we were looking at me from the top of my head and down through my body, pancreases look funny too. Then another view we were looking at me from the side, it was fascinating. I should have been a radiologist.

Here is the good news. There is no cancer in my soft tissues. Lungs, liver, spleen, adrenal glands etc. all appear normal. Those of you who gave me crap about smoking all those years, apparently I have beautiful lungs. Yes I do. You could see a faint Barcardi bat logo on my liver though. Other than that, it’s in perfect working order. I’m so pleased.

Here is the bad news. I have cancer on every bone in my body. “The skeleton demonstrates innumerable tiny sclerotic lesions throughout the visualized bones. These show intermediate to high metastatic activity which corresponds to the findings noted in the MRI scan - extensive bony metastasis.”

We focused on the spine during the meeting but I asked Dr. Bodeau if it was everywhere and he said yes. Every bone he checked looked exactly the same. Ribs, pelvis, spine, shoulders, everything.

We had a week to absorb the news from the scans before we could sit down with Dr. Bowers which was good for me because I wasn’t a mess when we met with her. She was at a breast cancer conference last week. We saw her yesterday afternoon.

So, what do we do about it all this?   In addition to the Zometa and Faslodex that I am receiving once a month, I will start a drug called Avastin. I will get this 2 times a month administered via IV. It will take about 90 minutes to infuse and has very minor side effects. High blood pressure (not worried about this, believe it or not my BP was 90 over 50 yesterday) and increased protein in the urine (hard on the kidneys).

Why? What is all of this going to do for me? Well the Zometa will keep my bones strong. I need this because as the cancer progresses it will make the bones weak. If they get weak enough they will collapse and cause paralysis. Sounds fantastic doesn’t it? My bones would be like looking at a piece of Swiss cheese. So we need the Zometa to keep doing its thing.

I receive the Faslodex to suppress the estrogen and progesterone production in my body. My type of cancer is estrogen and progesterone receptor positive so we stop the production to cut off the cancers food supply. I’ve been taking this one for 3 months now. This is the 2 minute injection in the butt I told you about. If you see me scratching myself, it’s the medication in the muscle, it makes me very itchy, but only on the left side. I don’t get it either.

And now I will add Avastin to the mix. What Avastin is designed to do is “bind to VEGF (vascular endothelial growth factor) which has been shown to be a key mediator of tumor angiogenesis”. What that means is that each tumor has its own little vascular system and the Avastin is supposed to restrict the vessels so the tumor dies off. Typically Avastin is given with chemo but since it takes 3 months to do its thing, we’re going to hold off on chemo and see if the hormone therapy and Avastin will do what chemo could do first.

Trust me on this one; I am not broken hearted to hear that we’re going to hold off on chemo. As a matter of fact, if no one ever mentions chemo to me ever again, I’ll be OK with that.

I’m sure your next question is “How are we doing?” Actually, we’re doing OK. Some days are better than others as you can imagine but in the grand scheme of things we are doing alright. The crazy thing is that I feel fine. I have some pain but it’s not unbearable. If no one told me that I had cancer I’d just think the degenerative discs in my back were getting worse and arthritis was finally setting in from the zillion car accidents I’ve been in.

I will be heading out to Aspen to ski with my Dad and Roseann this weekend and JR and I are looking forward to our trip to Italy next month with our friends Jim and Sue Edberg. I will step up my efforts to check things off from my bucket list too. I’ve got to get the real physical things crossed off sooner than later because I just don’t know how long I will feel good. I will still be training for the breast cancer 3-Day walk and The Hartford Breast Cancer Bike Ride here in Minneapolis this summer. My hope is that I will still feel good in August and be able to fully participate in these events. Dr. Bowers said the more active I am the better it will be for me.

If anyone wants to come visit us or go somewhere cool, we’re in! I’m going to spend what’s left of my life a lot like I have the first 43 years of it. Having a really good time. And for those of you who keep sending me these crazy diets and such, cut it out. As much fun as the “marijuana oil supplement” sounds, I’m not going to do it. I know it’s meant with good intentions, but this is not the time of my life to become a vegetarian or to cut out the cocktails. Send me the “eat whatever you want and drink till your heart’s content” diet please. That one sounds really great. : )

I hope this note finds you all well today. Thank you for listening to my update and for the many thoughts and prayers you send my way. I appreciate it very much. My life is better because you all are in it. Thank you for that.

Love to you all,

Jen