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 is feeling pretty good this weekend. She's just begun the "2 weeks off" segment in the second monthly cycle of this chemotherapy course. A new tumor marker will be ascertained in about 2 weeks.
She has taken advantage of feeling well by spending time with family and friends, and by attending Austin's Little League game. This weekend, she also bought a farewell gift for Nancy, which was a good reason to head to one of her very favorite stores, Anthropoligie.
Nancy, Sherryl's favorite nurse at the Marin Cancer Institute, is making a career change. Her knowledge, skills, and caring ways have been recruited by the University of California at San Francisco, and she has accepted a new position with UC in the area of lymphoma and leukemia. She told Sherryl it was a hard choice to make and that the thought of telling Sherryl she is leaving was devastating.
Sherryl is deeply saddened to learn Nancy will no longer be seeing her on a regular basis but understands the career choice she is making. She told Nancy she will miss her gentle ways and expressed her appreciation for "always making [her] feel safe." Sherryl will see Nancy once more before the transition in jobs occurs. There will be lots of tears and, in typical RaRa fashion, we have feeling Sherryl will be in touch with Nancy in some way.
On Saturday, Sherryl enjoyed watching Austin's late-afternoon Little League game. Below are a few photos of our favorite little slugger at play.
Sherryl is in Month #2, Week #1 of the latest chemotherapy. So far, she doesn't like it because of the side effects. Fatigue, puffy eyes, and some hair loss make for a combination that would challenge anyone's resilience. She's missed a special event or two as a result, which is more than disappointing. She pushes herself when she can, and she also rests as much as necessary.
It's too early to know whether or not this particular chemotherapy is working. Sherryl has an appointment with Nancy next week; perhaps she'll learn more then relative to how her system is responding.
Our family had a nice Easter, and we'll soon be celebrating Jonathan's birthday which was on April 9. Mother's Day is right around the corner, too. Spring is definitely here. We hope you're enjoying this season of new beginnings.
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."
Sherryl is adjusting to the new chemotherapy and is noticing it is making her very tired. She's tired when she gets home from work, so she goes to bed and has had what she calls "one of those weird chemo sleeps," which she describes as just keeping her eyes closed even if she's awake. An appointment with Nancy last week revealed some reasons for this sleepiness.
Sherryl's white blood cell count is down from the chemo medication, plus anemia has surfaced again. There is a non-cancerous spot on the upper lobe of the right lung that, for some unknown reason, becomes inflamed from time to time resulting in a cough. Sherryl was prescribed a cough medicine to take at night as well as a very strong antibiotic. Unfortunately, antibiotics have always resulted in fatigue.
Sherryl also learned that her iron is low, so, rather than taking iron tablets, she'll look to iron-rich foods to increase the count.
Sherryl didn't expect to experience this fatigue, but was assured by Nancy that this is a common symptom for this course of treatment. As a result, the frequency for this chemotherapy has been changed to 3 weeks on and 1 week off. Sherryl is feeling a bit better as of this morning and is optimistic her energy will return in the next couple of days.
In an email from day care mom and friend, Michelle, Sherryl received the following photograph and thought how great it would be if little girls wore T-shirts like this one. Thank you, Michelle!
Sherryl and Richard met with Nancy today as well as with Sherryl's oncologist. The PET scan shows the cancer has progressively worsened, cancer cells are significantly active in numerous areas, and there is new disease present. Active cancer cells were found in the skeletal system, specifically in the pelvis, hip, thoracic spine, right rib, pubic bone, and right leg.
The new treatment plan will be as follows:
Sherryl will discontinue oral chemotherapy.
An x-ray was taken today of the right femur (leg); Nancy will call Sherryl when results are known.
Chemotherapy medication has been changed to Adriamycin, which is administered intravenously weekly; she received her first dose today. This form of chemotherapy is not a drip. It is given via syringe and is accompanied by saline. Total time to receive chemo in this form is approximately 30 minutes. Side effects might include some nausea and thinning hair. It does not cause fatigue; fatigue may be experienced due to cancer.
An echocardiogram (ECG) is ordered for this Wednesday as the heart will need to be monitored with this form of chemo. ECGs will be performed every couple of weeks or as deemed necessary by Sherryl's doctors.
In order to ease the process of drawing blood and administering chemotherapy through an IV, a port will be inserted next week in the top right chest area. This procedure will be performed by 2 radiologists, will be done under partial sedation, and will last approximately 2 hours.
The tumor marker will be measured in 6 weeks.
Physical therapy to the arm will occur as frequently as possible to reduce the edema.
There is also a lesion on the liver, but it is not positive for cancer. The radioactive dye, injected for the purpose of the PET scan, was not drawn to the area which indicates no cancer cells are present. This lesion was compared to one that appeared under Sherryl's arm several months ago but did not appear in a subsequent imaging test.
The spiked tumor marker was an indication of change. Although old cancer cells are dying off, new cancer cells are immune to current treatment medications, an indication that the old treatment plan has run its course.
Sherryl has been experiencing some pain and muscles tightening in her back. She was recalling that the news she heard today was very different than the news she heard following her PET scan in July. Those results indicated only L1 was resistant to treatment, so 2 weeks of radiation treatment was prescribed. And it was in July when she heard that her bones were getting "better and stronger."
After hearing the news today, Sherryl looked at her doctor and Nancy and asked, "So is this it?"
"Absolutely not!" Both jumped to ensure Sherryl that this is only her third treatment plan, and that there are other patients who are on their eighth and ninth plans. She was reassured that there are many, many treatment options and they will continue to evaluate what Sherryl needs on a weekly basis. Each treatment plan is continued until it stops working at which time all factors are reevaluated, then changes are made accordingly.
Sherryl is disappointed the news is not good, but she is relieved to know the results as it's sometimes more difficult to not know and have to wait. When she got home today, Sherryl made a couple of calls, went back out to the grocery store, then came home again to rest. She has not shed any tears today, but she knows they will probably come at some point. Because even in her incomparable resilience, sometimes there are tears.
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