I stopped in at the oncologist's office for my every 4 week follow up on Tarceva yesterday. There were two things on my mind leading up to this visit. First, I told the doctor that because I've been having weird right sided chest twitches and occasional left side pains and occasional back pain I'm pretty sure the cancer is progressing on Tarceva. This prompted my chemo nurse to roll her eyes and say, "You are such a cancer patient." The oncologist tried not to laugh at me. The typical cancer patient thing I'm doing is assuming the stupid thing is eating me because I don't have a scan yet after change in treatment to show me that it's not. There is absolutely no objective evidence that the Tarceva is not working. Even on the lower dose I still have a rash on my face, neck and chest. I'm in a great demographic group to get good results from Tarceva. It's just that until my scan on Election Day, I will have difficulty believing that its working. My chemo nurse called me with lab results today to reassure me that my liver function tests are still perfectly normal so I'm pretty sure I'll live until the scan, at least.
The second thing on my mind is that I'm starting to obsess about what next? and specifically that I really don't want to undergo third line treatment that's going to make me feel awful (when we find out the Tarceva isn't working on Election Day, right?). The doctor tried to convince me not to cross this bridge until we get to it but I was insistent. I told him I'm not even sure I'd go through whole brain radiation if I ever developed brain metastases (specifically, more than 3). He said, "Oh, yes you definitely would." And the chemo nurse was standing next to me laughing and saying, "Definitely."
The bottom line is that I guess I'm scared. My healthcare professionals are wonderful because they let me know when I'm being unreasonable but they also listen for the kernel of what matters at the heart of my craziness. They let me know that I'm off my rocker being worried about whole brain radiation, but they are very understanding about my wish not to undergo treatment that makes me feel awful by the time we get to third line treatment. And they gently remind me that it's likely we won't need to talk about those specifics for quite some time.
That's where things stand. I feel fine and dandy. My liver function tests are normal. Chest, abdomen and pelvis CT scans and a total body bone scan are scheduled for Election Day so I'm pretty sure my update is going to be lost in the uproar, but I'll send it anyway.
Hannah's volleyball season ends tonight. I leave for an educational program in NM the day after the scan. It is being a spectacular autumn in New England and we now have a functional zone control system on our HVAC system at home. Robert's recovering nicely. All is well in my world.