The past 3 months, since my last update, has been a busy one for Sally and, as always it seems, there is a mixture of both good and not so good news.
The good news is that for the most part the cancer seems to be very slow growing. In fact, some of the small tumours in her lungs could now be considered gone. The fact that the doctors are prepared to actually say it is very slow gives us hope.
Sally has done 9 cycles of tablet chemotherapy (capecitabine – see details here) now and given the good news above it does seem to be working… or at least it was. The first part of the not so good news is that although the previous tumours are reducing Sal has a new tumour on her lung. I say “on” rather than “in” because it appears to be on the surface of the lung not embedded inside it. To the doctors this is an indication that the current chemotherapy is no longer working and so it is time for a change.
Her new tumor is about 1cm in size and so far is not causing any symptons as far as we can tell. So the plan is now to change chemo. This is standard practice in stage 4 cancer. Once it is in stage 4 and has spread to other parts of the body it is considered incurable and so the focus switches away from cure to one of maintenence and holding it at bay. Chemotherapy never works permanently. The cancer adapts and eventually a particular chemo stops working. That is where Sally is now and the course is to switch chemo.
As with most types of chemotherapy there are significant side-effects and Sal is rather suffering at the moment. She has very sore hands and feet, tiredness, headaches, taste changes and it is starting to get hard work.
Sally would typically go on to one of the other many other chemotherapy drugs but one of them is being trialed alongside other drugs to guage their effectiveness. Sal has been offered a place on this trial. This is good news. When on a trial you get to the front of the queue when needing scans and doctor’s time and your scans are read and assessed more quickly. It is a serious decision to take part in a drug trial as you are not sure it will be effective or not or even if you are getting the most effective drug combination… that is the point of the trial! However, in this case, the base drug is Fulvestrant ( see details here) which Sal would probably go on to anyway and the other drugs are not likely to make Fulvestrant any less effective but just might be more effective so there is little to lose. Sal has been preliminarily accepted on the trial.
So this week and next Sal is being subjected to even more baseline scans and tests before starting the treatment in a couple of weeks if finally accepted. This will leave her about 4 weeks off chemotherapy – she needs the break to be honest.
So that is the cancer update. There are a couple of other issues to report. Her issue with her spine, bone cancer which has collapsed a couple of vertibrae, is not getting any better. Her walking is now even more limited. She does get around OK but any more than 100yds and she struggles. This is perhaps her most disabling and distressing component.
Finally, as if this isn’t enough, she has another pulmonary embolism. She had one a while back but it went away. It is probably caused by the chemotheraphy. She has been a bit breathless and this is probably why. So she is now on blood thinners, one injection every day for at least 3 months which she administers herself. It never just rains…
Well that is about it. Look out for future updates.