Treatment Update (chemo break!!)

My CT scans were updated on Monday and as many of you have already heard, the results brought good news.  The spots on my liver continue to shrink and the micro-spots on my lungs continue to be stable.  What does that all mean?  Dr C wants to give my body a break from the weekly chemo and feels comfortable that the tumor is under control for the time being... enough to allow us to explore the use of a hormonal agent to try to maintain things while my body rebuilds itself. 

To give you all a sense of what this means, I've crafted a summary of "what's out?" and "what's in?" under the new treatment plan...

Out:  Chemo-induced menopause      In:  Lupron-induced menopause
Out:  Night sweats from chemo          In:  Night sweats & hot flashes
Out:  Blood thinners daily                  In:  Aromatase inhibitors daily
Out:  Avoiding bumps and bruises      In:  Lacing up my cleats again
Out:  Managing my Vitamin K intake  In:  Managing my Calcium & Vit D
Out:  Abraxane IV every week           In:  Lupron IM every 4 months
Out:  Bald head                                  In:  Chemo-curls
Out:  Oncologist visits every Wed.     In:  Me-time every Wednesday

The plan, in a nutshell:

• Taking a break from the weekly Abraxane (chemo)
• Switching to a hormonal medicine called Femara As you may remember, my tumors feed off of estrogen, so one way of treating them is to try to block the estrogen in my body.  I had been on tamoxifen for 4.5 years after my initial diagnosis and treatment (and had the recurrence while on that medicine) so I can't go back on that.  The next best option is a class of drugs called AIs or Aromatase Inhibitors.  These drugs only work in post-menopausal women (tamoxifen is the only hormonal that works in pre-menopausal women) so I'll need to take a shot to suppress my ovaries (Lupron -- had the shot yesterday).  The ovarian suppression shuts down ~97% of the estrogen in my body... the AI will block the remaining ~3% that is generated from your fat and muscle (the drugs work by blocking aromatase, which is used to create estrogen from fat and muscle).  Side effects of the Lupron & Femara include night sweats, hot flashes, mood swings, weight gain (typical menopause type symptoms), as well as fatigue, joint pain and risk of bone loss (again, related to the lack of estrogen).  For most women, the side effects are manageable, but some women have real difficulty with the severity of the side effects.  I had to stop the coumadin in order for them to give me the Lupron shot, so I am also at risk for another blood clot from my port (will have to watch that carefully).  Oh... and being an "educated consumer" paid off... my copay for Femara would have been $130 for 90 days... but I had a coupon from their website and it was only $10 (Novartis pays the rest!)...score!
• Follow up with Dr C in 6 weeks He'll do an exam and flush my port (with heparin... to keep it from clogging)
• CT scans again in 3 months If all goes well, we'll stay on the Femara... if the tumors start growing again, we'll have to go back on chemo

My body is still really worn down form the chemo, so for the time being, I plan to try to work from home on Wednesday's and continue to work a bit of a reduced schedule (funny that 40-45 hours/week is a "reduced schedule", right?)  Most of the pressure comes from within... I'll just need to make sure that I don't take too much on my plate and that I focus on staying healthy (enough time for sleep, exercise, etc)

Thanks to all for the prayers, hugs, notes and mojo... this last set of scans has been very encouraging and I am really looking forward to a break from the weekly drip!