Yum Yum Yoghurt!

Pace replied today about the home cure of eating yoghurt to get rid of the metallic taste of chemotherapy. Seems as if the chemo may upset the flora of the Gastro Tract causing the unplesant taste. Good thing they don't make yoghurt like this anymore!

Pace said, "Thank you for the tips! Intuitively, I've been eating a lot of yoghurt since Monday. I've been attracted to the taste. Like they say, listen when your body is telling you something."

Now if I could only get her to drink buttermilk, well I like this recipe!

Preliminary chemo side effects

Wow, Abraxane lives up to it's billing. I know this is just the first treat ment but the major side effects are that everything Pace's eats has a metalic taste to it, and she's tired, but that was expected.

A natural cure for the metalic taste in the mouth is to eat some yogurt or buttermilk containing live cultures. We'll see if this helps.

1 down 11 to go.

Chemotherapy starts today

Pace gets her first shot of Abraxane today at 2:00pm. Please keep her in your thoughts and prayers that the side effects are minimal.

Another Bioposy then treatment starts

Pace had another biopsy today (see the pic of the biopsy gun at the bottom of the post). In order to track the effectiveness of the clinical study they need a fresh tumor sample as the old one has been through a series of tests. This sample gets sent to the NSABP - FRP (National Surgical Adjuvant Breast and Bowel Program - Foundation Research Program), for testing in the future.

The tumor sample gets stored in a product called RNAlater which preserves the genetic material so it can be examined at a later date.

Gotta love their marketing message "Make Time Stand Still with RNAlater®." I'm not sure how much they use per tissue sample but RNAlater costs the hospitals $252 US for 500 ml or 17 liquid ounces. Kinda like paying $368 Euros for a 750 ml bottle of 1986 - Cheval Blanc, Saint-Emilion (Wine Spectator Rating 96) but not as much fun!

I'm getting a good understanding of why health care takes up so much of the governments’ budget.

the face of our enemy

Now I have an idea what our adversary looks like. It reminds me of a lionfish.

This is a breast cancer cell seen through an electron microscope.

(Image Credit: The National Cancer Institute)

Another Option from the Doctor

Pace’s invitation to participate in a Clinical Trial At our meeting with the oncologist, he gave us an option we didn’t foresee.

The doctor asked Pace to be a part of a clinical study for a chemotherapy drug called Abraxane for the National Adjunct Cancer of Bowel and Breast Program (NACBP). They would administer Abraxane for 12 weeks once week and then four doses of the chemotherapy cocktail FEC administered every three weeks.

Up until now Abraxane has been used for treating breast cancer in metastasis, FEC is in regular use for cancer treatment. The NACBP had experienced success in significantly reducing the size of the tumor, sometimes to nothing, both in a previous trial, and the one Pace has been asked to join.

Abraxane is a new form of the Taxol, a paclitaxel now used in fighting cancer which has fewer side effects compared to regular chemotherapy delivery of Taxol. It is the first drug available in a new form of cancer fighting agents called Protein Nanoparticle Chemotherapy, a type of cancer nanotechnology; I’ll explain what is and how it works in another post.

The complication is mostly logistical; Abraxane is administered weekly rather than every 21 days. As we were about to pack Pace up and get her back home for regular treatment, it looks like she won’t be coming home for at least 12 weeks maybe 24. However, if it results in a better treatment the sacrifice is worth it.

The definition of complicated

This is it, we've got a meeting with the oncologist Thursday morning at 8:30am.

As we have now got all of the tests completed. This should be a meeting where treatment decisions are made!

BTW, that's 11.5 hrs and 500 km after I wind up night class at the University, nothing worse than having no control over what's happening to Pace's health nor my personal agenda... God I love my wife!

Two words, Red Bull!

Now we're getting somewhere!

Today was another day of meeting with Pace's Medical Oncologist and running about getting more tests done.

The test of the day was another Breast MRI of dual purpose. One diagnostic is to determine if the questionable lesions in her left breast are affected by the rise and fall of Estrogen and Leutenizing Hormone levels from ovulation to menstruation. While there, they also imaged the right breast to track the growth of the known cancer.

Her Medical Oncologist was able to give us partial test results, some good news and some not as good. We also got an update on the what we're up against.

• The biopsy determined there are two masses in the right breast, one is cancerous and one is not.
• The MRI and biopsy together shows the cancerous mass to be 2.5 cm in diameter
• The doctor's examination room measurements of cancerous and non cancerous masses together are 5 X 4 cm
• The cancer is a stage IIb or a IIIa
• We will find out if it a hormonal sensitive cancer later when cultures of numerous biopsies are batch tested for estrogen or progesterone receptors, but this is not terribly important right yet.
• There is definitely cancer in the lymph nodes of the right armpit and probably the left as well

He also outlined some of Pace's choices based on subsequent test results and the upcoming meeting with the surgical oncologist on the 19th.

If the left breast has pre-cancerous cells Pace faces bilateral mastectomy, meaning she loses both breasts and then gets chemotherapy. Essentially, if the suspect areas of the left breast are precancerous, and given the cancer cells are the fast growing grade III type, Pace statically faces a high rate of recurrence within 5 years in the left breast.

If the left breast is clear they can start chemotherapy to reduce the mass and conduct an operation that conserves the breast later.

More info to come on the 19th after the meeting with the surgeon and a subsequent meeting the chemotherapy oncologist on the 23rd.

Some good news it seems

We had the echogram of the intestine, stomach and liver today. Preliminary report is all clear.

More to know after the meeting with the medical oncologist tomorrow.

The Waiting is the Hardest Part

The last 7 weeks have seemed like an eternity. We're being told that's fast and we're lucky as it usually takes 3 months and we're on a second opinion.

Monday January 9th, Pace is supposed to get another MRI that will determine if the left breast has precancerous growth or if it is related to hormonal changes in the milk ducts due to ovulation. We're not betting on anything but the hope is the later.

Tuesday January 10th she gets an echogram of her liver, intestines, stomach and kidneys to be sure that no cancer has spread there.

Next Wednesday the 11th we meet with the medical oncologist, he's the chemotherapy doctor, and we should get the results of the pathology of the tumor. At that time we should know at minimum if the cancer is:

• a 1 2 or 3 grade (1 is low relatively normal, slow-growing cells, 3 is very deformed, fast-growing cells)
• what stage the cancer is at (based on the books we're in a stage 2)
• if it is progesterone or estrogen receptive (probably genetic, will have to get the wee one tested in the future)
• they'll also measure the tumor again which impacts the stage of the spread

Then on the 19th of January is the meeting with the surgeon and we'll have a course of action.

By that time we will know if we are looking at chemo then a lumpectomy, or a radical bilateral masectomy followed by chemo, regardless they're both brutal choices.