Already Missing 2009 - Bad Scan and MRI

Hi Everyone,

Here we go again. The cancer is back. Apparently with a vengeance. On Wednesday December 30th I went in for a bone survey and bone scan for the clinical trial I’m participating in. I had no reason to think that it would not turn out well because everything was fine in December, but as life is so apt to kick one in the ass when you’re not looking, this was not to be that time.

On Monday January 4 I was called with the news that there were some spots that showed up on my bone scan. In the past, bone scans have not shown much for me for some odd reason so three spots appearing was not good news. The scan showed lesions in T11, a spot in my clavicle / sternum area and our personal favorite, the right side of my skull a couple inches above my ear. On Tuesday when I went in for Zometa, we saw Dr. Bowers. The plan at that time was to keep me on the clinical trial and switch my hormone medication from Aromasin to Faslodex. What’s the difference? Well one is a pill, one is a monthly shot, and the biggest difference is the Faslodex is a more aggressive way to shut down the estrogen and progesterone production in my body, which feeds my cancer. By the way, the shot is in the butt and is a 2 minute injection. Fun.

I wouldn’t have been so worried about the scan results since Zometa  has been known to look like lesions while it’s healing bone. However, when I got the CA 27.29 tumor marker test results back, that changed. Last month they were in the normal ranges of 0 -35, I was a 25, and here we are 30 days later and I’m back up to a 58. So now I’m worried. On Friday January 8 I had an MRI of the cervical and thoracic vertebrae and the news was much worse than the bone scan had indicated. The results read like this:

Findings: All of the thoracic vertebral bodies demonstrate a mottled appearance. On the scout view, the cervical vertebrae also appear to be diffusely infiltrated. There appears to be diffuse infiltration of the bone marrow. This is consistent with extensive bone metastasis. This is much more extensive than what is apparent on the bone scan. No epidural tumor is identified. No cord compression is seen, the spinal cord appears normal. The central canal is normal.

Impressions: Extensive bone metastasis.  All of the vertebrae in the cervical and thoracic spines have a mottled appearance.  The pattern is consistent with extensive metastatic disease.  The bone scan underestimated the extent of disease.

So what does this mean? Well it means despite many possible variables, things aren’t looking very good. There is still a lot we don’t know. Could some of this be from Zometa activity? Yes it could. That would be a very good thing. Can the doctors tell which is which? Not at this point. We asked about a CT / PET scan and about another bone biopsy and we’re not going to do either one of those at this time. The reason they are not going to do the biopsy is that there is so much "metastatic" activity, which one would they choose? And there is a chance they could choose a spot that is Zometa related and not cancer. They know I have a new cancer occurrence, the tumor markers tell them that, so there is no reason to do a biopsy.

So what are they going to do? Well I’m coming off the trial so they can make sure I am getting Zometa every month, and keeping me on the Faslodex. In 3 months they will scan me again. In the meantime, they have a plethora of scans (bone scans, bone surveys, CT/ PETs and MRI’S) from the last 6 months to look at and compare and hopefully get more information for us.

The good news here, if you can say there is any good news, is I feel fine.  I do not feel sick and I am in no pain.  That is frustrating, because through all of this I have never felt sick until a test result, scan or blood test told me I was sick and the meds to "fix it" really made me feel sick.  On the plus side, no one mentioned chemo or radiation to me this time and that makes me very happy. If I were experiencing new pain, which I am not, then they would send me for radiation. If you are concerned about the spot in my skull, traditional treatment is Zometa and hormone therapy.  The spot on the skull is no more or less risky than any other bone occurrence on my spine.

So that’s it.  It is business as usual for the next three months when hopefully we will have enough information to determine the true breadth of the metastasis and a clear plan of attack. I will report more when I know more. If you are wondering how I’m doing otherwise, I’m doing surprisingly well. The last time I was really sad and afraid, now I’m just pissed. J.R. has been my rock, as usual, and right by my side the entire time. I don't know what I would do without him or the girls right now, they help make this unbearable situation tolerable.  I'm so blesseed to have them in my life.

I really don’t know what to expect in the short or long term but I will continue to live my life the way I want until I can’t do that anymore. I really don’t know what else to do other than fight like hell and enjoy the life I have. We will make great use of my new ski's that J.R. got me for Christmas, and we will start planning for our Italy adventure in late April - Early May.  I know many of you have been praying for us and we really appreciate that. Keep them coming please.

I hope that you are all well and that life is good for you today.

Love to you all and God Bless!

Jen