Sherryl saw her oncologist on Monday and began a new chemotherapy today. Docetaxel will be administered intravenously once a week for three weeks, then there will be no chemo on the fourth week. The other news Sherryl received is that her tumor marker is 553. This high number does not come as a surprise because chemotherapy is suspended during radiation treatment, so Sherryl has had no chemotherapy since before she was in the hospital. Once radiation was completed, Sherryl's oncologist needed to determine if Gemzar should be resumed or not; the decision was to try another therapy.
Sherryl's oncologist explained that, although there is "a lot of disease in the bone," it is not overtaking her the body and it has not spread to any organs. He explained some of the side effects of the new drug, many of which are similar to side effects Sherryl experienced on the first chemotherapy.
After her first dose today, Sherryl says she feels tired, but it's a good tired. She has returned to day care and continues to slowly but surely push herself in order to optimize her strength.
Special thanks to those who continue to send to RaRa prayers, good thoughts, and hopes for good health. We so appreciate every thought and every gesture you express for our sister.
Following the "we're running out of options" appointment Sherryl had with her doctor and the subsequent case review by the tumor board, Sherryl placed a call to her doctor and he called her back on Saturday morning. Here is a summary of what he told her:
Overall, the disease is looking better. There is a "slight" spot on the humerus of both arms and a very small spot on the clavicle. The new chemotherapy that will be administered is Gemcitabine, also known as Gemzar. Sherryl will receive 1 infusion per week for 3 weeks and then will have 1 week of no chemotherapy. There was discussion, too, of the original fracture to Sherryl's back and a procedure that will strengthen that area in her back is being considered. The cancer is "not worrisome," and all areas where the disease is present will continue to be watched closely. A new tumor marker will be ascertained within the next week or two.
Sherryl told her doctor her energy is good now, that she was planning to take a week of vacation, and that she'd like to feel good while on vacation. Her doctor agreed that the new chemotherapy treatment can begin after her vacation.
So, Sherryl is currently enjoying a week of good energy and free time. She's spending most of her time at home since nesting is one of her favorite things to do. She has not forgotten the phrase "we're running out of options" and intends to have a very direct conversation with her doctor the next time she sees him. Two words: Go RaRa!!!
Special thanks to all of you for your continued support and concern for Sherryl's health and well-being. Her spirits are buoyed by your thoughts, prayers, intentions, and actions. Whether you see her often or hardly at all, please do not underestimate the power of your love for Sherryl.
Disappointing news, Sherryl's tumor marker increased from 107 on May 14 to 160 as of this past week. Another PET scan, which is due about now anyway, will be scheduled for this week. Sherryl will receive Nupogen shots next week and the next appointment with her oncologist is the first week in July.
Although Sherryl has been tolerating CMF chemotherapy treatment relatively well, she has felt much fatigue the past several days. As usual, she is paying close attention to her energy level and resting whenever necessary.
When Sherryl does have some energy during her free time, she spends a bit of time on the computer reading email or playing one of her favorite word games. We know she loves Scrabble, and she also loves an AOL game called Word Zen.
And when her energy is higher than expected, as it has been today, she talks a mile a minute, sounds as perky as ever, and takes on projects the likes of which would exhaust most of us. Today, since her laundry room painting project is finished, she is cleaning out the very huge craft closet at home.
A very Happy Father's Day to all of the fathers who are RaRa fans!
Sherryl met with her oncologist today and learned that her tumor marker has dropped from 168 in February to 107 today. This is great news! Sherryl's oncologist also told her that she is anemicagain, so a course of shots were prescribed to boost her red blood cell count.
The timeframe for the next bone scan was also discussed today; the next one will probably be scheduled for 8 weeks or two chemotherapy cycles from now.
Except for some fatigue, Sherryl is doing well. Her appetite is good and she feels OK. She experiences no nausea and, in general, is thrilled to be able to function fully under the current treatment plan.
Sherryl needed to stop into the clinic yesterday and one of the nurses approached her to tell her she had a "message from a friend." Nancy, who has moved on to her new job, had asked the nurse to tell Sherryl hello for her. Sherryl was truly touched that Nancy had thought to send her that message.
Sherryl continues to work at Day Care every day and this weekend will entail attending Austin's last Little League game, a massage, and spending time with family.
All things considered, life is pretty good right now and we're all grateful for it.
Sherryl saw Nancy on Friday and learned the results of Thursday's PET scan. The overall outcome is best stated in Sherryl's words. "I do not, do not, do not have any cancer in the liver or any other major organs. There's only a slight, and Richard and I are focused on that word slight, increase of cancer in the spine and both hips." Nancy explained that the bit of pain Sherryl sometimes feels in her lower back is probably muscle. Nancy gave to Sherryl a copy of the PET scan report, which she poured over to absorb every last detail. The test was summarized in impressions; numbered below are the highlights.
Note: Just double click on any word to see its definition.
Mixed response to most recent therapy w/decreasing activity seen throughout a large portion of the thoracic spine with multifocal regions of increasing activity, most notably at T2, T11, L2, and right anterior superior iliac spine. Remaining bony activity is relatively stable. Stable L compression deformity.
Ill defined right upper lobe parenchymal opacity mildly increased in extent since prior exam suggests possible inflammatory disease although neoplasm cannot be excluded.
No other evidence of new visceral metastasis.
Nancy next explained that she and Sherryl's oncologist discussed two chemotherapy options and decided that, given Sherryl's preference to stay active, a cocktail combining oral and intravenous medications is the best treatment at this time. The new chemotherapy treatment is called CMF.
The C in CMF stands for cyclophosphamide, the M stands for methotrexate, and the F stands for fluorouracil, which is also known as 5FU. Sherryl will take 1 pill per day for 14 days. And during those 14 days, she will go to the lab twice a week to have her blood drawn. On the day after she has her blood drawn, she will go into the the Marin Cancer Institute (where she receives most of her care), for the IV portion of the chemotherapy.
After those two weeks are completed, no oral or IV medication will be administered. So, the CMF cycle for Sherryl will be 2 weeks on and 2 weeks off. Side effects may include fatigue and nausea, but another oral medication will be prescribed to offset nausea. And there will probably be no hair loss as a result of this treatment.
Sherryl was so disappointed when she learned the tumor marker had spiked that she was bracing herself for some bad news in hearing the results of the PET scan. She didn't have a good feeling about it, so she was more than relieved to learn there is no cancer present in any organs and that it has spread only slightly in the spine and hips. Resilience returned immediately and, after her appointment with Nancy on Friday morning, Sherryl returned to Day Care to finish the day. She had dinner with a friend on Friday night, and spent most of Saturday out and about. By Saturday evening, she was home and ready to nest for the evening and all day Sunday.
But there is that small matter of the transition to Daylight Savings Time. . .
The day we turn our clocks ahead one hour is and always has been RaRa's least favorite day of the year. Because she just hates losing that hour. Whether she is at work, out and about, or at home, RaRa is highly productive. And while she has added required sleep as a new measure of productivity, she really hates to lose any time at all. With all that RaRa can accomplish in 60 minutes, an hour is a terrible thing to waste. We'll just have to watch to see how she makes up for that lost time, because we know she always does.
Since it has happened in the past, we were all hoping the lab had made a mistake in processing Sherryl's blood and that the tumor marker of 168 was wrong. Nancy had the lab re-check their processing, and it was confirmed the tumor marker is correct.
Sherryl had responded well to the current treatment plan, so there was no reason to schedule a PET scan since the previous one was done last October. Given the spike in the tumor marker, Sherryl will have another PET scan on Thursday, March 5, and she will probably learn the results the following day. Then Sherryl's medical team will determine the next course of treatment, which will include a change in chemotherapy medication since she has stopped responding to the one currently administered.
The spike in the tumor marker feels like a major setback. The only pain Sherryl feels is very low in her back, but the pain is not constant. And she is so good about getting as much sleep as her body tells her she needs. The new tumor marker comes as a blow and Sherryl has not felt this disappointed in a long time. She said, "This is the best I've felt. It's so disappointing to find out this chemo isn't working any more."
She went on to say that it feels like a roller coaster, driven by the tumor marker highs and lows. Each time the tumor marker spikes, a new plan is needed. Her body response well, the tumor marker drops and all is well, then her body stops responding and another change is needed. One step forward, two steps back. Nancy has reassured Sherryl that there are many, many options available relative to chemotherapy medications and treatment plans.
Through this entire journey, there is one thing that Sherryl says she's learned to do that brings her great pride. She has a new way of crying, and she's really excited about it. She's able to cry without her face contorting. What Oprah calls "the ugly cry," Sherryl calls "contorted face cry." In the two years she's had cancer, Sherryl has learned to relax the muscles in her face and now just lets the tears roll down her cheeks. No facial contortion. At all. She doesn't cry often, but when there are setbacks like this one and tears well in her eyes, this new way of crying is great progress.
The "new way of crying" story doesn't translate well without Sherryl's voice. She explains it in a way that has her audience in hysterics. And ultimately, she's once again found the proverbial silver lining in the looming cloud. Even with a spiked tumor marker, pending PET scan results, and a to-be-determined treatment plan, RaRa is laughing. But we've seen this attitude surface in the past. Lesson: Never underestimate RaRa's resilience.
Sherryl learned today that thetumor marker is 168, up from 78 on January 23. Sherryl is disappointed, but for some reason she had a feeling the number would be higher this time.
Sherryl did not see Nancy today, but will see her on Thursday. Discussions will involve whether or not Neupogen injections are influencing the tumor marker.
Aside from this disappointing news today, Sherryl's spirits are good. She is tired this week, so she is going to bed early every night.
We will let you know more information as soon as it becomes available.
Sherryl was scheduled for a round of chemotherapy today, and popped in to see Nancy prior to receiving her "cocktail." Blood tests indicated that her white blood cell count was marginally low, so a slightly lower dose of the chemotherapy was administered.
As Nancy was studying the other numbers that came back from the lab, she said, "Hmm. 78." When Sherryl asked what the 78 meant, Nancy told her that was the tumor marker. Sherryl couldn't believe her ears: the tumor marker has dropped from 127 mid-December to 78 today!
Sherryl told Nancy that, although she's getting far more sleep than she used to get, she's feeling better now than she did before she was diagnosed nearly 2 years ago. For those who have not talked to RaRa, you should all hear the lilt in her voice tonight. One of the sweetest sounds in the world. . .
Our cousin Marie is doing better these days, too, so we're happy for that reason as well!
In honor of Sherryl's birthday, the new year, and other changes underway, we've freshened up the design here with help from the talented Jo-Lynne over at DCR Design. The hands in the banner at top are littler than they used to be in order to make room for more hands and more white space, and we picked a different font for the title. We also made a few minor changes to the purple background, but not very many. Those little hands finger-painted that background, after all, and, well, art is art.
There will never be too many thank yous from us to you for all you have done to support Sherryl. We are so very appreciative of every thought, prayer, and gesture of kindness you send her way.
Monday morning: Sherryl received a call from Nancy this morning and learned that her tumor marker has dropped from 283 383 to 127! Her tumor marker has not been that low in a very long time. (To follow the history of Sherryl's tumor marker, click here.) She is thrilled beyond words, and so are the rest of us! And now it's on with our lovely holiday season!
* * * * *
The following update was written before Nancy's call to Sherryl.
RaRa is feeling so great these days that she just keeps going. In fact, she is wearing us all out! Her level of energy could not be more perfectly timed as there is always much to do during the holiday season. Decorating, gift-buying and wrapping, and food preparation are on the docket for both home and day care this week, and RaRa is on schedule to finish it all in time for the big day. Hurray for her!
Sherryl saw Nancy last Thursday and, after learning Sherryl's experiences over the past couple of weeks, a few options are on the table relative to chemotherapy treatment. The dosage can be lowered or the schedule can be rearranged. For the latter, what is currently 3 weeks on and 1 week off would change to perhaps 2 weeks on and 2 weeks off.
Sherryl and Nancy also discussed Zometa, which is causing some havoc with Sherryl's knees. Based on new information Nancy learned at a recent conference, changes in the prescribed treatment plan are being considered here, too.
As for blood work, tests show that, although she is not anemic, Sherryl's white blood cell count is low. She was told this is not uncommon and she only needs to continue prescribed therapies; there are no related proactive opportunities to improve the count. Sherryl had her blood drawn last week, too, which she has come to refer to as "giving blood." She should learn very soon the most current tumor marker.
She has two appointments scheduled for next week: "giving blood" on Christmas Eve and a round of chemotherapy the day after Christmas. In the meantime, be assured that RaRa is making spirits bright!
Our cousin Marie is doing a bit better, so thank you all for the prayers you're sending her way. They are working and very much appreciated. And, thanks to connections our Auntie Pattie makes with just about everyone in the world, Sherryl received an email from one of our cousins in Ireland!
For those of you visiting from "the old country," lest you think we've forgotten our roots, we've not! We're queuing up an Irish version of our mother Anna Mae's favorite Christmas carol, we're handing out hankies to Auntie Pattie and a few of us cousins who are known to cry at the drop of a hat (ahem, we'll start with Arleen, Nadine, Marie, and Jeanette, then others will join us!), and we're wishing an early Merry Christmas to those of you across the sea!
In honor of our relatives in Ireland, here are the Celtic Women performing "Oh Holy Night."
Richard took Sherryl to the hospital this morning to have a port inserted into the right upper chest area as scheduled. Although her mouth was dry due to fasting since midnight last night, her mood was chipper as she headed for the operating room. The doctors' plan included partial sedation, full sedation if necessary, for the 2-hour procedure. One of Nadine's friends who works in the hospital had told the surgery staff to treat Sherryl "like a rock star." And they did.
Sherryl tolerated the procedure well, and then headed to the cancer center to receive her first dose of the new chemotherapy medicine. When she arrived in the chemo room, the three nurses who had each struggled on various occasions to find a vein in Sherryl's arm, were ecstatic to see that she now has a port. It makes their job easier and they know having a port is far easier on patients like Sherryl.
Tests results were revealed today, too. The x-ray of her leg shows nothing is present on the femur. And all blood tests look good relative to red and white blood cell counts, etc. A new tumor marker will be ascertained in about 5 weeks.
Once home, Sherryl felt groggy but good, so she spent the remainder of the day resting and sleeping. She plans to return to day care on Thursday.
Thank you all once again for your love, prayers, and support. In case we have not said so lately, we are so grateful for you and your setting good intentions for RaRa.
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