Wednesday, April 17, 2019

Moving on a New Med

I know it has been a while. I’ve been on something like an extended vacation from blogging, mostly because I’ve had so little to say that’s news, and partly because my energy wanes of late.

But I’m back with an update: I had a PET scan last month. My soft tissues remain clear but my bones are worsening. I may even be feeling it. So my bones were biopsied. That was fun; the fentanyl had me hunting coffee cups on a nonexistent black market. My doctor and his team were amused.

My bones have the same estrogen positive (ER+) breast cancer. Interestingly, it is no longer progesterone positive (PR) at all, and it remains Human Epithelial Growth Factor (HER) negative. 

Worse, my antigens -- the telltale measure of cancer markers in my blood -- are back in the 2700s (see the charts.) I also had a new set of symptoms: I was fatigued, sore like the flu and little feverish -about 99º to 100º. These last symptoms really slowed me down. 

The fevers may have been an infection; they seemed to disappear with antibiotics, but they would come back as soon as I completed them. My blood work mostly showed that I’m anemic, nothing more serious. But my symptoms might be a response to too many antigens in my blood. The last time I felt this way were the dates of the peaks on those charts. And they were up again. Sigh.

An historical chart of my 27.29 antigens, showing a peak at 7500 in 2017, falling to a few hundred, but more recently climbing to 2700s. Normal is 32.
My CA 27.29 antigen history. Normal is under 32 or so.
An historical chart of my 15-3 antigens, showing a peak at 7000 in 2017, falling to a few hundred, but more recently climbing to 2700s. Normal is 32.
My CA 15-3 antigen history; note how similar each are.

If you've been tracking, you know that I have been on Lynparza, for better and worse, for over a year. And it has been quite the mixed blessing. I cleared my soft tissue, but not my bones. And the side effects were not simple. I was not alone in my difficulties with Lynparza: the gas, the acid reflux that twists my tummy in knots, the fevers and even UTIs were all part of the picture for others. Well, my UTIs were extreme. I had sort of a handle on those, treating for UTIs with every dose. But it did do some good, and I wanted to keep trying. 

I began my doctor week with my primary care, and then the oncologist. I didn’t want to change my medications; but mentally and emotionally, I was prepared. I got bloodwork. Ok, maybe another UTI. More antibiotics. But no real answers.

The oncologist was ready as she walked in. We're moving on. As soon as insurance approved, I was to start Ibrance and Letrozole. Ibrance inhibits certain cancer amino acids by blocking their receptors on each cell. The Letrozole is an "aromatase inhibitor." It prevents my body from taking common androgens (a hormone) and converting them to estrogen to feed those greedy cancer cells. The one-two punch causes them to die.

Lots of women are on Ibrance/Letrozole. I'm reading lots of positive stories. I can expect a new round of side effects, among the two most common, fatigue and soreness. I may get low on white blood counts again, so I'll need to use precautions for infection.

Today is my first day. I handled it well, but I am experiencing the soreness. But my tummy is happier and I have no sense of those other issues. Stay tuned. With some luck, I'll have good news.

I sure hope so. I'd like to enjoy this summer. In my "feeling that I was doing OK" arrogance, I have planned a big summer, even though I always fear to plan, with good reason. I need to be ready to be happy just snapping photos from a tour bus; or from sitting outside listening to the Big Thompson River roll by, rather than doing anything remotely strenuous. My femoral head (top of my right leg) hurts like crazy. Let’s hope some of that comes back. 

Here's hoping the new med does the rest of the job for at least a long while.