Monday, October 23, 2006

Oncolgy Update

So I will start with the facts as I have understood them so far. I will try to fight the opposing urges to either paint too rosy a picture or, on the other hand, to sink into morose exclamations of gloom.

Dr Gordon showed us Rebecca’s CT scan on his computer. There were several small ‘lumps’ in her lung that are still very small, although apparently larger than last time. Dr Gordon said that these are not what worry him. He then showed us some lymph nodes in the area in front of, and between, the lungs that are inflamed that either were not on the last scan or have grown since the last scan; these, he said, worry him. Coupled with the fact that blood work done last week showed highly elevated ‘tumor markers’ leads him to be ‘sure’ that this is a reoccurrence of the breast cancer. The bone scan came back clear.

The doctor made it clear that ‘recurrent breast cancer is not a curable disease’ BUT that you can live a long time, with good quality of life, while undergoing treatment.

The next step is the hope that the interventional radiologist will say that he can biopsy one of the lymph nodes. The reason that the doctor wants the biopsy is not to check if this is breast cancer or not but rather to tell some characteristics of it. Rebecca’s original cancer was HER2 negative and Estrogen Receptor Positive. A recurrence after such a long time may or may not have the same characteristics. If Rebecca’s cancer is still hormone receptor positive then Dr Gordon feels we can try a course of hormone therapy to treat it. If it is not hormone receptor positive then there is no point going down that path and he would recommend going to a chemo therapy. If the cancer is now HER2 positive then they could add something to the chemo that would ‘help’.

All of this depends on whether a biopsy is possible. Because of where the involved nodes are they are hard to get to; one is nestled up against her heart and another is up against an actuary leading from the heart. The third involved node ‘may’ be far enough out in the open that they think they can get to it safely.

If they decide that they can’t biopsy then Dr Gordon recommends starting a course of hormone treatment and then monitoring the tumor markers and the size of the nodes to see if it effective. Because we have caught this very early he is comfortable ‘trying’ this less aggressive treatment first to see if it works.

If the hormone treatment is effective, and Rebecca tends to be very receptive to treatment, he said this treatment could be effective in keeping this in check for years. This is great as these drugs are not meant to have large side effects. Rebecca did try one of these in the past it didn’t go that well but we aren’t sure if those ‘side effects’ weren’t actually just a flue that was going around at the time.

If the hormone treatment proves ineffective then it’s time to consider chemo.

Rebecca is upbeat as always; she acknowledges that western medicine says that they can’t cure this. She is going to use the western medicine to buy her time she needs to find the healing tradition that can cure it. In the last week we have spent a day with a Tibetan Lama, gone to synagogue and spent an evening with some shamanic spirit channelers (one of whom brought forward the spirit of Hiawatha). It might cure her, it might not, but it looks like it’s going to be an entertaining journey… I’ll keep posting here.

1 comment:

dbd said...

Thank you so much for the clear facts. For all of us who deeply care about you, Rebecca and the kids, but don't want to burden you with phone calls, this blog business is a blessing.

Please know that you are loved by the Darby family and that your effort to keep us up to date is deeply appreciated.