During the past month or so I have still been recovering from the spinal surgery. Recovery has been progressing quickly and I am feeling much better and I started on the oral chemo Xeloda. It was great to be able to take it at home and to go into the clinic less. The side effects were surprisingly strong and I felt a lot of nausea, fatigue and headaches. I was not completely optimistic about these scans due to the complications of the last few months. The cycle of scans that I complete every three months are a full body bone scan, thoracic CT and brain MRI.

Unfortunately, scans showed there was growth in both my lungs and my brain. My lungs had no new metastases but the pre-existing mets grew significantly. In my brain, the MRI showed one new met and two of the small spots in the last scan had grown. In the last scan we were not sure if they were cancer mets but with this new growth my oncologist is almost certain they are tumors. They are still too small to measure. This growth will dramatically change the plan going forward. 

First, my oncologist let me know that this means we will be changing treatment due to Xeloda failing. We had discussed previously that perhaps the next treatment would be a clinical trial that was currently recruiting and for which I met the criteria. Unfortunately, with the development of the brain mets, I likely no longer qualify for this clinical trial. My fantastic oncologist is still applying on my behalf but is not optimistic. Also, because I have had significant amounts of brain radiation in the past, radiation is not currently an option for me. This leaves a few chemotherapy options.

Enhertu is the first potential option. It is typically used to treat cancers that are HER2+, which mine is not. New research shows that even if there is a small trace of HER2 this treatment could have an effect. They are re-testing the samples of the tumors they took from my body to see if there is any trace. This is a very effective drug that can penetrate the blood/brain barrier so it could help with brain mets. 

The second and most likely course of treatment would be Doxil. This chemo would be only one time per month. It is very strong and would most likely have more side effects than the last couple of chemotherapy drugs I have had. Hopefully we will get the information soon from the clinical trial folks and from the lab reassessing the tumor samples for HER2, then we can make a treatment decision going forward.

One more complication this week was that I began having chest pain that made it difficult to take a full breath. At my appointment with my oncologist Monday, she assessed me and sent me to the emergency room. My team was worried that I had a pulmonary embolism or a broken rib. Chemotherapy, cancer in general and surgery can increase risk for these issues. After 9 hours in the ER, the staff ruled out a PE or broken ribs. They gave me an EKG and my heart was acting a little abnormal but nothing urgent. They discharged me and scheduled me for a full echocardiogram for the 25th of this month (tomorrow). I will update as soon as I can! 

Thank you for the outpouring of support and love!