A kitchen sink approach

Dr. Kenyon is recommending that I go on Xeloda and Tykerb. Xeloda is a type of chemotherapy given in pill form. It causes diarrhea and sometimes redness and swelling and pain in the hands and feet. Tykerb is much like Herceptin, although it targets cancer inside the cell, not outside like Herceptin. Apparently, Tykerb doesn't affect the heart. Tykerb is also a little pill, that costs $23/pill and the usual dose appears to be 5/day, so it's expensive, about $3,000/month. See Jeanne Sather's blog, http://www.assertivepatient.com/, related to Tykerb and other treatments. Jeanne's blog has a wide readership and I find what she has to say very helpful. She's also gathered a lot of other cancer bloggers to her and gives their blog addresses. It's been good for me to read them all as it seems an effective way to communicate about side effects, treatments, how to cope, etc.

Dr. Kenyon said that, at this point in my treatment, he more or less wants to save the heavy arsenal for a later date (i.e., stronger chemo drugs) just in case we need them. So, he wants to go with drugs that are less strong, are usually effective, with less side effects, because now he's decided to treat me for the long term and not with the expectation that we can rid me of the cancer NOW. In other words, if I understand what he's saying (by reading between the lines), he is more or less expecting that cancer will be a chronic disease for me. In that case, give me the weaker drugs, allow me to keep me stronger and healthier since it seems that it's going to be a long-term kind of fight.

My parents, my sister, and my partner all went with me to see Dr. Kenyon. At one point, my sister, Rena, wanted to have Dr. Kenyon comment on my prognosis. His answer is that he doesn't want to say; he wants to wait about a year or so to see how I'm doing then before giving any estimate of prognosis. He wants to see if Xeloda and Tykerb are effective or whether or not we spend the next year or so putting out new fires as they arise. We are taking a "kitchen sink approach" - xeloda kills breast cancer systematically (throughout my body), Tykerb attacks cells that overexpress Her-2 (which my cancer does), and once we are certain that Zoladex has shut down my ovary production, I start taking aromatase inhibitors since my cancer is also estrogen-positive.

Hopefully, I start Xeloda and Tykerb this week so that we can begin stopping the spread of the cancer via the lymph channels in my skin. Later today, I plan to use a magic marker to outline the redness in my skin; this way, I hope to be able to monitor whether the drugs are doing what they should be doing to shrink the cancer in my skin. Hopefully, we will see it shrinking in the next month, and once we see that the redness is gone, then we go back to the rad onc and start radiation. I need to talk to the rad onc this week and see how she wants to time the radiation: before expansion, during expansion, or after expansion.

In the meantime, I started some visualization last night: my acupuncturist has me taking mushrooms via pill form, three of which have anticancer properties. She also started me on some other herbs that act to strengthen the heart, my blood, and my immune system and these also have anticancer properties. So, my visualization is this: the mushrooms are like archers, shooting at the cancer (especially that area where it's manifesting on the skin) and killing it; then since the herbs strengthen the blood, I'm imaging them as bulldozers that clean up the dead cancer and transport it to a place where they can be swept away as waste - sorta like a sewer system. Whisk that #*@* away!

Yesterday, I was relieved that I would take chemo as a pill and not intravenously. But I read about side effects and while they are less severe, I will still be uncomfortable. Also, last night, I had a bit of insomnia because the idea that I'm now a chronic cancer patient is still new - whereas before, I was operating on the assumption that I was rid of the stuff and now I was just doing things to make sure it didn't come back, now I may have to change my thinking to the fact that I have to live with it for the rest of my life and hopefully keep it from metastasizing. Well, I shouldn't be pessimistic, but taking a realistic view is good. So, hopefully these less invasive treatments work!