Last, last chemo

Yesterday was my last, last chemo. Although we thought that chemo #8 was the last. Dr. Gray promised me that #12 is the last chemo. My friend Kathy picked me up at 10:00 to go to chemo. Shortly after we arrived at Dr. Gray's office, Janice, my coordinator for the bone strenghening medicine drug study arrived. I was randomized into ARM 2 of the drug study which means that I will be taking 1600 mg of Clodronate Disodium every day for the next three years. Janice explained the medicine and all the tests and appointments that I will need to do over the next 3 years then she gave me 4 - 5 1/2" x 6 1/2" x 7" boxes of pills. That is a four month supply. Part of me wanted to be in ARM 1 which was the IV drug Zoledronic acid. That is the one that was studied in Austria and decreased the risk of recurrence in the bones by 36%. The other two pills are also bisphosphonates which strengthen the bones but they have not been studied anywhere at preventing the cancer from metastisizing to the bones. Part of me is glad that I am in ARM 2 because it has less side effects and I won't have to keep my port for 3 more years. I am hoping to have it taken out soon. My next appointment with Dr. Gray will be November 6th so hopefully he will okay the removal of the port. ARM 2 has the least known side effects. Nausea is the most likely effect. Vomiting, diarrhea or constipation, rash, alterations of liver enzymes in my blood, and alteration of serum calcium in my blood which can result in numbness and tingling sensations in my fingers and toes, muscle cramps, irritability or depression, seizures, and symptoms of heart failure or less likely side effects. Rare but serious side effects can be abnormal kidney function or failure or osteonecrosis of the jaw which is permanent damage to the jawbone. Hopefully all I have to deal with is the nausea and hopefully not every day. If the side effects are too disruptive I can always stop the drug study at any time. When we got back to the chemo room Janice also took some blood that will be used in other research studies. Luckily they could take the blood through me port before they started the chemo.

Dr. Gray and I discussed more about my upcoming schedule. I have an appointment with the radiation department at Ogden Regional Hospital on October 21st so that they can make a treatment plan and then I should start radiation on Monday October 27th. If everything goes as planned I should finish radiation on December 5th give or take a few days depending on their schedule for Thanksgiving. As soon as I finish radiation Dr. Gray wants me to start the hormone treatment, Tamoxifen. It is an antihormonal therapy which block the body's ability to use hormones that fuel a tumor's growth. I originally thought that I had to start the hormone treatment at the same time as the drug study. I am glad that I don't have to because then if I have side effects then I will know that they are from the Clodronate not the Tamoxifen. I will take the Tamozifen for 5 years unless I decide to have my ovaries removed so that I can take Femara or Arimadex which are aromatase inhibitor and which can only be taken by post-menopausal women. They work by stopping an enzyme called aramatase (found in the body's muscle, skin, breast, and fat) from producing estrogen from other hormones. Studies show that these medications significantly reduce the risk of breast cancer recurrence and increase survival time - in many instances more than tamoxifen.

I will be on the tamoxifen for two weeks before I meet with my OBGYN for my yearly physical. This will be the first time I have seen him since he found my cancer. I can't thank him enough for his thoroughness and for not brushing aside the symptoms because I am young. Many doctors still believe that young women don't get breast cancer so they don't listen to their patients when they have concerns early on then when the cancer is found it is often in the late stages. If you have a doctor that doesn't listen to you when you find a lump or something else or who doesn't think you need a mammogram, GO TO ANOTHER DOCTOR. You life may depend on it. I am so grateful that Jed found the mass that I hadn't even noticed. As I hear more stories from other cancer survivors, which I am now officially a survivor now that I have finished my LAST chemo, I am finding more women who's tumor was like mine, a gradual hardening of an area of the breast. Not a lump, just a hardening or thickening of the breast. That is something that I don't remember anyone telling me to look for. Anyway I will be forever grateful to Dr. Jed Naisbitt for saving my life. I may not be here today if it wasn't for him.

When I see Jed I need to talk to him about having my ovaries removed so that I can take an aromatase inhibitor. I don't think I will schedule it right away because I want to take the Tamoxifen long enough to determine if I can stand the side effects of not having the estrogen in my body. If the hot flashes, mood swings, etc. are too bad I definitely don't want to make them permanent. Time will tell. Regardless it will be January or February before I would do the surgery anyway.

Chemo went about the same as the last 3 treatments. Kathy and I went out to lunch at Applebee's afterwards. It was very delicious. I ate a lot which is good because by the time we got home I wasn't feeling very well. I ended up going right to bed and slept until 5:00. I wasn't up to eating much after that. My angel friend, Sherri brought dinner for the rest of the family. It looked good but all I wanted was some cornbread. Later I tried some rice pudding and then some ice cream because I was having a bad hot flash and wanted to cool off. Another angel in my life, Shannon came over and did the reflexology on my feet. I was able to get to sleep easily and slept until 9:00 this morning.

Today I am feeling okay. There is some nausea but it isn't too bad. I definitely feel A LOT worse nausea when I am pregnant. Basically I just don't feel very good. I am going to get up and start moving around to see if that helps. It usually does. That's all for now. I will try to write more often now that I am not swamped with planning two big events.