Wednesday, June 4, 2008

What's Up With The Doc 5? - or 2 down ? to go


Chemo cycle number 2 is in the books with no problems. We're going to forego the Neulasta this cycle and just do Neupogen if my white cells get too low so hopefully I can avoid those two nasty days at the end of the week. I talked to the oncologist for quite a while about what to expect after the chemo is over. He's planning 6 cycles of the carbo/taxol/avastin (so July 1st would be my last). The only 2 things that would change that would be evidence of disease progression when we do a scan after the 3rd or 4th cycle (I don't expect that with the positive trend in the liver function tests but I have to know what the decision points are) or intolerable side effects - unlikely since I made it through the first cycle handily. The big question is what then? If the scan shows no evidence of disease (please) the options, as far as I can tell, include watchful waiting with no treatment, continuing the Avastin by itself, switching to Tarceva, or the clinical trial route. There was not enough tissue to run the test for the EGFR mutation so with Tarceva I'd just have to hope that I'm one of the 65% perent of nonsmoking women who respond. I'm still planning a trip down to Sloan Kettering after the 4th treatment to get their take. I can pretty well guess that there will be much gnashing of teeth and weighing of alternatives and I hope it doesn't come down to the old dart board method of treatment selection.

Mostly I hope for good luck to go with my good underlying health, good socioeconomic status and world class medical advice. I hope this is a really responsive tumor and my anguished decisions are all about keeping it gone. I really wish I had a crystal ball because all of this uncertainty sucks.

I'm likely not to sleep too much tonight thanks to the Decadron so I'll spend my awake time on cancer destruction imaging. I really appreciate more than I can ever say the cards and emails you are all sending. It keeps my chin up and the smiles coming. And, as always, thank you for every prayer and good thought you can spare.


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