take two

I see my oncologist every 6 months for an exam and routine blood work. My last appointment was in March (just before my trip to India) and everything was looking good. After I got back from India, I've had this nagging cough -- for over two months now. That is what sent me into the doctor's and what spurred me to follow up with my oncologist. A chest x-ray showed fluid in my lungs and a follow-up CT scan showed microscopic spots on my lungs -- but these are so small that it is unlikely that that is what is contributing to this chronic cough that I've had. The CT scan also happened to show the top portion of my liver, which was a bit more concerning. There were a few spots and a follow-up biopsy confirmed that the breast cancer has metastasized to the liver.

My doctor is quite hopeful because I haven't really had any issues typical of liver metastasis: jaundice, nausea, weight loss, etc... other than the cough, I feel pretty ok. This suggests that there is only a minor involvement in the liver, which would definitely be the best possible news. Any involvement in the liver is bad... but less is better. I go this week for a few additional tests to confirm this -- scanning my bones, my brain, and my abdomen. Provided those all come back ok, he recommends I start with hormonal therapy. That could mean no chemo! Because my cancer fed off of estrogen, many treatments are based on blocking estrogen in your body -- I was on tamoxifen for 4.5 years, which is a pretty long time. Given that success, he'd recommend an aromatase inhibitor (Arimidex, Femara, etc) + Lupron. The side effects of hormonal therapy are much more tolerable than chemo... so, he'd like to start there and, of course, keep a close eye on my liver.

What's next? I'm waiting to get all my follow-up tests scheduled. Hopefully we'll get that done this week. I'm also going to get an appointment for a second opinion -- either at Sloan Kettering in NY or Fox Chase in Philly. We'll take it from there. If all goes well, I could be maintaining a pretty close to normal lifestyle for the time being. Cancer is never good news when it comes back... but this is the best I could hope for.

While I've obviously been no good at updating my blog for the past two years, I promise to renew my diligence so that I can keep you all posted! More to come...