This is not news I was expecting, but life can send us curve balls...
Val and I spent most of Monday afternoon at CancerCare, meeting with an oncologist, his resident doctor and the oncology nurse. It was a very difficult meeting because the news was not good. There is no other way to put it, I'm afraid, so here are the "straight goods".
It turns out that the tumor is a recurrence of Val’s original cancer, but the July 12th surgery's pathology report showed that a percentage of the cells now carry a mutation called HER2. This gene causes the cell to over-produce a certain protein, which leads to more aggressive growth. One of the few cancer cells remaining after Val’s original mastectomy must have mutated because only cancer cells are capable of this mutation. The pathology report shows evidence of the tumor growing rapidly and cancer cells invading the surrounding area. The other cancer cells are what we expected to hear about: hormone-positive cells which can be treated by blocking estrogen and progesterone so as to reduce their growth.
The HER2 mutation has really screwed things up because the other type of cancer cell could have been handled by radiation and hormone therapy. But, now, there is a good chance that there are mutated HER2 cancer cells circulating in Val’s system as a whole. (Remember, though, the scans Val had pre-surgery came back clear – that’s good news to hold onto.)
This new situation calls for chemo, and the oncologist is recommending a strong chemo drug called Taxotere (also called docetaxel) in combination with Herceptin, which is a chemo drug that specifically targets the HER2 gene; it is one of the few cancer drugs that targets a specific cancer cell. So, the Taxotere will target all cancer cells (and any other cells dividing in the body), while Herceptin will focus specifically on killing the HER2-related cells. This treatment will be given over a 21-day cycle: Day 1= blood work; Day 2= chemo treatment; Day 3 to 21= recuperate. Day 1=start over. This will go on for 4 to 6 cycles. Thereafter will likely follow a regime of radiation plus some drug (can't remember the details of drug or length of time; plenty of time to sort that out later).
Val likes to gather all available information, so she spent the week consulting and talking with friends, health care professionals and reading a load of literature.
Yesterday (Friday), while understandably still shocked by the news and concerned about the aggressive chemo regime proposed, Val signed her consent to start the treatment. First up will be a MUGA scan to test the pumping strength of her heart, as Herceptin can, in rare cases, affect its function. Then Val will have a port “put in” to make the chemo sessions more straightforward (no continual poking around for veins for each required blood test and IV input).
In all this awfulness, there is some good news: (i) the scans were all clear and (ii) the oncoligist (Dr. Lorne Brandes) is confident that this treatment regime will give Val an excellent chance at longevity. He said that he didn't think any other treatment option would offer the same potential.
We are reeling from all this, but I’ve gone back to work at the College (classes start on Monday the 26th) and we are surrounded by knowledgeable and caring people and do not feel alone or isolated on this journey. We have come to terms with the decision and are resolved to make the best of it.
Send along your best fighting spirit and thoughts and whatever else...and stay in touch. It’s always good to hear from you. That Val has had a cancer recurrence is something we'll deal with privately, but it is not a secret or info for only an exclusive group. In-person visits are not possible at the moment, and phone calls can be exhausting, but communication by email or snail mail is always welcome. Thanks for understanding.
Love,
Amanda
