the whole truth

As many of you know, my first set of follow-up tests were last week and I received the results today.  While they brought mostly good news, they also brought a new reality... one that I've known in the back of my mind for some time now but I have been reluctant to face or to share.

CA-27/29 tumor markers are lower
CA 27-29 is a blood test that checks for a specific tumor marker.  They don't use it for general tracking or diagnosis because the markers do not always appear elevated with the presence of cancer and sometimes they can appear elevated due to other reasons... basically, they are super finicky!  They are, however, commonly used to determine whether a cancer is responding well to treatment, particularly in advanced disease.  Dr Cairoli ran this test after we confirmed the cancer had spread to my liver this past June.  At that time, my markers were over 200 (the normal range is 20-30!)  At my appointment two weeks ago, he checked the marker again and the result came back with significant improvement.  This is a sign that the chemo is working!

CT scan of liver & lungs look better
The first test that Dr Cairoli did when I called him in June was a CT scan of my chest/lungs.  Based on the chronic cough and the results from the chest x-ray, he was initially looking for problems (read: cancer) in my lungs... and he happened to find the tumors in my liver.  My lungs at the time showed no tumors, but they did appear a bit cloudy.  Just to be safe, he scanned both my lungs and my liver last week to check how things are going. 

The lungs look much clearer, which is not surprising, since my cough went away 2-3 weeks after I started chemo!  This suggests that my cough was very much related to my breast cancer -- and that the early activity in my lungs has responded very well to treatment. 

There are no new spots on my liver and some of the larger tumors appear to have gotten smaller.  Again, very good news and a sign that the Abraxane is doing its job.

I have Stage IV breast cancer
While many of you probably realize this, I know that I haven't been as blunt about my diagnosis as I could be.  Once cancer spreads from one organ to another, it is considered to be Stage IV.  My initial diagnosis in 2005 was Stage IIB.  My diagnosis this June was Stage IV.  Stages I & II are commonly referred to as "early stage"... this is what you hear a lot about in the media.  With improved testing and awareness, early detection has increased significantly, particularly in the US.  This is great news because early stage breast cancer is considered extremely treatable. 

Stages III & IV are referred to as "advanced stage".  Sounds scary, I know.  Nobody wants to be Stage IV.  All the rest of the cancer patients give thanks that they are not Stage IV -- I know I sure did.  There is no "cure" for Stage IV cancer.  If you go online and start googling you will see all sorts of scary statistics about Stage IV cancer.  I recommend against this.. but if you decide to do it anyway (many of you, I'm sure, already have) please remember this... I have never been one to let the statistics hold me back.  I am a female engineer-turned-consultant who joined ROTC and a sorority in college, has worked for the same company for 11 years, plays ultimate frisbee in her freetime and lives in NJ... what are the odds of any of that?!?!  (especially the NJ part for those of you who knew me when I swore "when I grow up I want to live somewhere in the northeast... anywhere but New Jersey") 

I fully intend to be an "outlier"
As I've said -- I've never been content to be just "average".  This time is no exception.  From day 1 at ZS I was taught that outliers could totally skew your analysis... that in real life, data is messy.  We would typically "pull the outliers out of our analysis"... and so for many years, I tossed the outliers aside.  But now... I fully intend to become one of them.  (once your done reading this, please go and read this NY Times article about an outlier I hope to emulate: "17 Years Later, Stage 4 Survivor Is Savoring a Life Well Lived")


Of course, the reality of this is that "treatment" will be a part of our reality for the rest of my life.  It's kind of like having diabetes or some other chronic disease.  If you ignore it, it inevitably gets worse (yes, Nancy... this was my public service announcement to warn people not to sit on public toilet seats!). 

Abraxane is currently my best friend and will be indefinitely
My tumors are responding well to the Abraxane and my body is holding up well to the drug. The side effects have been tolerable and we are getting into a rhythm with it.  This means we will continue with this chemo for the foreseeable future.  3 weeks on... 1 week off.  Hopefully, the response will continue. 

We will run tests again shortly after Thanksgiving to see how things are going... and we will take it from there.