Time to catch up, but recent events aren’t moving in a positive direction. There have significant complications, some related to the cancer, and some influencing the cancer in unfortunate ways.
Update: I got to feeling better and the doctor and I met. She was feeling more optimistic and felt that, after hitting the chemo hard, we might at some point return to the inhibitors
Unfortunately, being off the inhibitor means that bone pain I felt earlier is back. If it weren’t for bad luck.
About a month ago, I began to notice that my stomach wasn’t handling things well. I’ve struggled for years with a hiatal hernia, but fixing it meant putting my treatment on hold. It seemed too big of an ask, and it would not last long, in any case.
I think that may have been a mistake. About a month ago, I was eating wearing a tight costume. All of a sudden, the area below my ribs felt like the guy in Alien must have felt — like Alien itself was attempting to claw its way out. The pain was so intense. I wasn’t throwing up, precisely, I was doing what infants do — spitting up my food. This lasted for several hours. I several more attacks before I saw the doctor. She sent me for an endoscopy.
The endoscopy found a huge paraesophageal hernia. The GI doctor noted an ulcer and a polyp, both of which were biopsied. Neither looked all that bad, but I figured it would be the ulcer that would be a cancer problem. The polyp didn’t looked pink and healthy-ish.
When pathology came back, the ulcer was not caused by cancer nor by the usual h. Pylori bacteria. It seemed mechanical. Maybe it would heal with prescription omeprazole.
But the polyp was cancerous. Dammit! The same metastatic, ER/PR positive cancer I have been fighting. This represented progression. Even though I had barely started the latest treatment, Kisqali, it was evidently failing.
The Cancer: Back to Chemo
Time to move to chemo. My oncologist wants me to try Eribulin.
Eribulin is another in the line of cytotoxic (cell-killing) chemotherapies. But it has been noted to extend lives for up to a year. And I’m not quite ready to give up. So, fine, let’s see how it goes. If I can maintain a reasonable Quality of Life, sure. I will lose my hair, maybe be nauseated, have low blood counts. Again.
Meanwhile, the hernia! What to do?
I wanted to waste no time consulting a surgeon. It wouldn’t have surprised me if no surgeon would touch me. But I found a well-experienced surgeon and he found something no one else did:
My hernia pushes my stomach up above my diaphragm. That’s all hiatal hernias, though. But this one is much worse. It pushed the stomach up, and forced a piece of it, the antrum, against the esophagus. This can be life threatening. That explains the feeling that Alien is trying to get out.
I can’t predict when these attacks will happen. Sometimes I eat just fine. Sometimes, the pain is so intense, I go to the ER. I’m told to go, in order to measure whether the tummy is, indeed, strangulating or incarcerating.
Back to the Cancer: CAT and Bone Scans
In preparation for the med change, my oncologist ordered a CAT and a Bone Scan. None of that was particularly great, although I will argue that it could have been worse. Explanations in the parentheses.
1. No findings of concern for new or worsening metastatic disease to the chest. (This is good)
2. Diffuse hepatic metastatic disease, mildly worsened from prior exam with reference lesions detailed above. (My liver is still an issue, and getting slightly worse, maybe.)
3. Diffuse extensive osseous metastatic disease, grossly unchanged by CT but warranting correlation with whole-body bone scan to be performed and reported separately this same date. (Lots of bone involvement. See the bone scan.)
And the bone scan:
Significant heterogeneous activity throughout the femurs, pelvis and sternum, consistent with known metastatic disease / most consistent with mixed lytic/blastic. Focal activity within the left distal femur, left sternum near the sternoclavicular joint and within the humeral heads are consistent with osteoblastic metastatic disease. (Well, crap. My legs, near my knees is new, the left sternum is new, and my humeral heads — the rounded arm bones, are all new and heavily involved, along with the hips, spine and chest.)
None of this is good. And let’s add to the fun: I have a UTI, and kidney stones.
I will see the oncologist tomorrow. Surgery is scheduled for November 30. Pray that COVID doesn’t close the ORs again. I need this surgery.
MAID for Me
Colorado has a law called Medical Assistance in Dying, or MAID. That will be the subject of my next post.