The visit to M.D. Anderson last week was full of pluses and minuses. It is never all good or all bad. First, the scan results: Lungs showed some progression, but it appeared to be small – from 0.7 cm to 0.9 cm. Liver appeared stable. So did the bone metastases on the CT scan, but the bone scan showed some progression – so we’ll say the CT scan is right! The primary growth is in the right adrenal gland and right ovary. The ovary has grown from 5 cm. to 7 cm., or from about 2″ to 2.8″ for those of us who are metrically challenged.
Doc’s main concern is the ovary and the possibility of problems since it fills almost all of my right pelvic area. So I’m meeting with an oncologic gynecologist – or is it gynecologic oncologist? – on Tuesday back in Houston. This is to discuss whether he thinks surgery is a good idea. I think the MDA onc thought so, and the more I think about it, so do I. Let’s just say I’m beginning to think some of those possible problems he mentioned are already surfacing.
We then met with the Integrative Medicine doc (we really like this guy), who, among other things, suggested considering radiation on the right hip since I’m having so much pain with it. As long as I’m off chemo for surgery, this would be a good time.
So here’s the plan (assuming the doctor Tuesday agrees): surgery as soon as they can schedule it for removal of right ovary. Then some time during recovery, 10 radiation treatments on the right hip. My local onc said as long as you can get up on the table, you can do radiation while recovering from surgery. I guess that’s reassuring. Once that’s done, I start on a new drug called Stivarga, which is a pill. Yay, no infusion and no pump!
Finally, they have started the screening process for clinical trials. This is pretty cool the way they do it. They request tissue from my initial cancer surgery (that part’s not so cool), and test for genetic biomarkers that correspond to those identified in studies that are underway. The latest thinking in cancer treatment is to genetically match treatment to cancer cells. I’m not sure what all that means, but it sounds good. So, hopefully, they will discover some studies I qualify for, and if/when the Stivarga stops working, try those.
Whew! That turned out to be much wordier than I planned. But let me just tack on a couple of positive/humorous moments – there are always some. First, at breakfast in the motel, a young woman came over to me, and said, “I don’t want to be too forward and tell me if this is offensive, but you’re a cancer patient?” I was wearing my headscarf, so it was pretty obvious. Anyway, she was really sweet and supportive, a breast cancer survivor herself. She assured me everything would be fine – I only wish I could share her total optimism. I also had several positive talks with other patients at the clinic – one a young woman who couldn’t have been over 30 with Stage IV colon cancer. (That’s just wrong!) She was very matter of fact about it all, even though she’d been through more drugs that I had, and at one time was on 15 different prescription drugs to control chemo side effects. (That’s wrong too!)
Humorous note – I was determined, based on the insistence of all of you, that I would use the wheelchair if/when needed. It turned out not to be needed. The long walk between buildings I was dreading was covered by a mini-shuttle that made it all easier on me and the husband. However, there was still an entry in the Forget Your Foolish Pride Department – can you say barium enema?!
Then a couple of downer notes once I get home. While at the local oncologist’s office, I stopped into the infusion room. All of my nurse friends wanted to know the latest and when I told them – basically what I just wrote above – you would have thought I was near death. They all hugged me and gave me these sad faces. I’d like to think that they just didn’t understand, but they’re oncology nurses. Do they know something I don’t?
Second, I checked the patient notes from the visit Monday. The physician’s assistant posts them online within a day or two. She commented that “we have very limited options at this point for treatment.” She also said re: clinical trials that “her options may be a bit more limited because of the KRAS mutant status.” Maybe not a big deal, but it brought up the possibility that none of the clinical trials will match. Then what?
Well, got to stay positive, right? …Sigh… Bring out the Armitage files!!!