The Other Shoe is Dropping...After 13+/8+ Years

My oncologist's office called today. The neck node biopsy reveals metastatic breast cancer...ER+ / PR- ...same as my 2005 ILC Dx. I don't have the formal report in my hands yet, should get that tomorrow when I see the neck surgeon. I guess I am glad the Dx seems definitive and we can get started right away on treatment. Will see my Onc on Friday for more in depth discussion and treatment plan.

I was driving my husband to his own doctor's appointment when we got the call. I think he is taking it harder than me right now. We will both feel better when we get some questions answered and feel that we are doing all we can. I feel a sense of urgency now for so many things that will need to be done, but am trying to resist that knee-jerk response. Hoping my oncologist can alleviate some of my current concerns.

I will keep you all updated. Thanks for listening and supporting me.

Thanks again to you all for the good wishes and prayers.  

It has been a difficult night and morning for me.  After my appointment with the surgeon yesterday, who confirmed the biopsy results and verified my neck incision is healing, I came home to find that my precious but fragile 21 year old kitty, Socks, had taken a turn for the worse.  By early this morning it was apparent that it was her time to go.  I have just returned from the vet clinic where we freed Socks from this life and hope to see her again in the next.

The timing is so difficult for me and yet also seems for a reason somehow.  My 86 year old father just returned to his farm 2 weeks ago after spending over 3 months in my home recuperating from bilateral total knee replacements.  It was a labor of love for me to help guarantee he could maintain his independence working his farm and doing the things he loves.  Hopefully, he will have many more good years to do so with his new, strong knees.

My whole life I have been a caregiver and nurse.  My husband of 42 years, while the strength of my life and greatest friend, is wheelchair bound from childhood polio and now also depends on me to provide the physical assistance he requires.  I am co-guardian of my 58 year old sister who has suffered lifelong mental disability.

My husband and I have no children.  I know I must do my best to fight this disease and keep myself strong.  I know it is time for me to take care of myself....but I just can't help but worry so much about those depending on me.  Sorry, but I am full of many emotions this morning.  I will adjust....with time.  My pragmatic side will soon kick in and I will start making mental plans for achieving the best outcome possible.  I see my oncologist at 1pm this afternoon.  I will post more updates later.

Once again, I cannot thank you all enough for the prayers and encouragement!  

I met with my onc yesterday and came away with some strong impressions of both the seriousness of my Dx and the number of options available for treatment.  While both my previous Dx were grade 1, this new presentation on CT is worrisome in that I have widespread significant lymphadenopathy that was not present less than 8 months ago.  This in addition to the changes seen in the formerly "stable" adrenal mass and bony lesions indicates a more aggressive process going on.

Now that we have the formal Bx results my onc does not want to delay starting some type of Tx ASAP.  Her plan is to start with Faslodex injections and monitor my current palpable nodes on a bi-weekly basis when I come in for the injections.  A repeat CT scan will be done in 3 months.  She is willing to give the Faslodex 3 months to prove it can stabilize my disease but if progression is detected while taking it, she plans to move me on to chemotherapy again.

Here is the wrinkle to the proposed plan.  The cancer center I go to has recently become a participating facility in the new PALOMA-3 clinical trial which gives Faslodex + Palbociclib to post menopausal women who have ER+ breast cancer that has advanced to metastatic disease after hormone tx failure.  I seem to be a perfect fit for this trial and she wanted me to know it is an option, however, it will take some Herculean effort to get through the application and acceptance process in a timely fashion.  My onc feels waiting 3 or more weeks to see if I am accepted by the trial is too high a risk and wants me to get my first treatment dose within the next two weeks.  If I get a single dose of Faslodex before applying for the trial I will be rejected.

So, I will be getting the required bone scan and echocardiogram next week, plus the Her2neu path results should be in by then.  I will be signing releases for my current and old medical records, plus tissue samples from my recent bx to be sent to the trial researchers for review of my eligibility for the trial.  The difficulty will be pushing all the paperwork fast enough for me to get an acceptance to the trial and the first Faslodex + Palbociclib/Placebo injection within the next 2 weeks.  If the researchers can eliminate me as a trial candidate early in the process, then I will start just the Faslodex injections ASAP.

So it is back to the "hurry up and wait" merry-go-round for now.  I trust that whatever is meant to be will be, so I will continue to make the best plans I can, yet know it is still always just one day at a time!

I will keep you updated.

P.S.  I suspect at some point very soon I will make my introductions to the Stage IV forum members.  I know I will benefit from the wealth of expertise and insight to be found there.  I still want to stay in close touch with my longtime Stage III friends and of course all my wonderful Lymphedema cohorts, but I think much of my future treatment related posts will eventually be relegated to the Stage IV forums unless I feel they will serve a purpose in the other communities.  I so appreciate everyone's concern and wonderful support and encourage those who desire to stay in closer touch to feel free to PM me or read directly from any of my Stage IV posts.  I will certainly still be posting on my usual forums as appropriate, it is just that I have concern for other member's sensitivities regarding the subject matter in their forums.

Thanks barbe!  Actually in the PALOMA-3 trial, two thirds of the participants get the Palbociclib with Faslodex and only one third get the placebo with Faslodex.  This is a phase 3 trial and apparently results have been so positive in the earlier trials that they have increased the odds of patients getting the active drug.  Either way, even if I end up being in the one third on the placebo, I will still be getting just the Faslodex injection which is all my onc is planning to do at this time anyway.  I can leave the trial anytime and if I progress on their regimen they will remove me to pursue other treatments. The trial will offer the drugs for free, close monitoring and multiple types of testing for determining my status.  So I am hopeful to make the trial but also ready to accept whatever happens.

Thanks for the prayers barbe and yes I will still keep you all updated!