Post-Radiation Update

Hi all,

Just wanted to post an update now that Pam's been done her brain radiation for about a week.

The first week of treatment was pretty tough as Pam was in much pain and nauseated as well. However the second week was much better once her sense of taste improved so that she could drink lots of water. That really seemed to help. So drink your 8 glasses of water a day, everyone :-)

While she was undergoing the brain radiation, Pam was on a break from chemotherapy. This seems to have allowed some of the other mets to progress a bit, unfortunately. However, she's been accepted to a program for a new chemotherapy drug, this time in pill form. The drug is called Kisqali (where do they get these names??) and is new. It's intended specifically to treat metastatic breast cancer. Some of the other women at Pam's group are also taking it and it seems to be well-tolerated so we're hopeful of a result.

Other than that, Pam's been feeling OK, although her chest is bothering her a bit. She's resting at home today and waiting for the delivery of her new drugs.

So to finish this update with something cheery, here's a photo of our garden obelisk we built a few weeks ago :-)

 
Dallas

Update

Hi family and friends,

Just wanted to post an update with the latest.

As some of you will know, Pam's been on and off chemotherapy a couple of times this year. She happens to be "off" right at the moment. That's because the brain tumours (last actively growing in 2009) have become active again and been making tiny nuisances of themselves. So Dr. B. (radiation oncologist) has recommended that Pam have some whole-brain radiotherapy again to address them. They don't like to do whole-brain radiation more than once unless it's really necessary, as it can damage the healthy brain tissue. However Pam's noggin has had nine years to recover from the last round of treatment and the doc reckons it's important to treat the tumours at this point. This has necessitated taking a short break from chemotherapy.

So Pam has now completed four of ten scheduled radiation treatments. They happen once per weekday for 10 days and will be complete next Friday. Unfortunately yesterday and today were not five-star days, as Pam's oncologist told her yesterday that the metastatic disease has been growing somewhat. She also was in a lot of pain yesterday and today that didn't respond to her usual meds, as well as throwing up a bunch - very reminiscent of 2009 and not in a good way. The upshot was that we spent most of today at Health Sciences Centre for Pam to have an x-ray and get some new meds prescribed for pain and nausea. 

So I'm back at the office for a bit and Pam is resting at home. She's very tired but some IV medication helped ease the pain and she just needs to nap. Fortunately she's no longer working outside the house so she can concentrate on her health - although the many appointments and treatments take up quite a bit of time.

There is a glimmer of hope on the horizon though as Dr. T. has prescribed a new chemotherapy program to start after radiation is over. It's a newly approved drug for metastatic disease and we're hopeful that it will show some good results.

In the meantime, here's a picture of our neighbourhood turkey, "Kemal", sitting on our front step. :-)

Love to all,

Dallas

Post-Surgery Update

So Pam has been home for a couple of weeks after her surgery and things have been mostly OK. She is still having some pain in her side which bothers her in the evenings, and she gets quite tired still.

Dr. T., the oncologist, has recommended that she take a bit of a break from chemotherapy for now as the cancer seems to be moving pretty slowly. The most recent blood work bears this out as the markers are down slightly. They're going to keep a close eye on those markers as well as CTs to keep track of fluid around the lungs.

Homecare finally got themselves straightened out and are coming once a week to drain the pleurex catheter for the fluid around the lung. Things are reasonably stable for now so that's good. 

Almost home...!

Dallas here with an update...

So, Pam had her surgery last Wednesday (21/03) and it went well. Copious amounts of fluid were removed from her chest and while the middle and lower parts of her lung did not reinflate (and weren't expected to) there may be some improvement in the very upper part.

Pam had a slight complication in the form of some subcutaneous emphysema (basically air bubbles going where they shouldn't) but that seems to be clearing up OK. We had a walk today and Pam wanted to try some stairs just to see if there was any improvement in her "wind" so we went up an entire flight, which she managed without getting out of breath at all. This is great because it was actually an improvement over pre-surgery lung capacity. Also, the pains she was having in her side (which we suspected were related to fluid pressure) haven't come back either. Great!

At this point Pam is still in hospital and we expect that homecare for the chest drain will be set up in the next couple of days, then with any luck she should be on her way home. Yay!

Triennial Update

Pam with Tintin and friends in Brussels, 2015

Dallas here checking in with the triennial update. There is some news.

As many of you will know, Pam's been on "traditional" (infusion) chemotherapy now since before Christmas - three weeks on (two hours on Fridays) and one week off. Her new oncologist Dr. T. (Dr. B. has retired) had been mindful of the rising tumor markers and wanted to address this with some more aggressive treatment - hence the chemo. Pam had a "port" installed to allow the IV infusion to be done more easily, without having to find a vein each time. That's been very helpful.

The other thing that's been going on for some time is a pleural effusion on Pam's right side. This is a buildup of fluid around the lungs that is often associated with metastatic breast cancer. It causes shortness of breath and unfortunately, has gotten so severe that Pam's right lung has pretty much collapsed from the fluid pressure. The usual treatment is to drain the fluid in the office through a small catheter but unfortunately this was not successful - the respirologist was only able to get a small amount of fluid out and the lung did not reinflate at all. So we had a decision to make as to whether Pam will go for surgery to remove the fluid. We're told by the thoracic surgeon that it's unlikely that the lung will inflate again but there may be some improvement in breathing and relief of some of the pains Pam's been having. Since there is some prospect for improvement, Pam has decided to have the surgery. There is really no downside except for the usual anaesthesia and surgical risks. There will be a small catheter permanently left in situ to drain the PE fluid over time. The surgery is scheduled for 21 March and there will be a short hospital stay of 1-2 days after that, followed by recovery at home.

Although the PE does cause some significant shortness of breath and tiredness it's not terrible, Pam just gets winded when she has to walk uphill or climb stairs at all. Having said that we had a really nice skate on the Red River two weeks ago Sunday with her sister and girls, followed by a huge Chinese food dinner at a local restaurant, so things are not all bad. Pam's also reduced her working to mornings only. She is not expecting to return to work after her surgery, except for the odd day or two to finish things out.

So the chemo will continue for now (as it's been controlling the rising tumor markers) albeit with a short break for surgical recovery, the surgery might help address the pleural effusion. We'll keep you posted...