Infusion Update

April 10, 2009

My fourth of four AC infusions was Tuesday and it was a doozey. I am so thankful that the next 12 are supposed to be much easier. I can’t imagine another going through more infusions like the AC. It hasn’t been terrible, but this last one certainly has been the toughest yet. The drugs tend to build up in your system, so the severity of the symptoms came as no big surprise. I hadn’t been too affected up until this point, but the nausea has been pretty constant this go-round. I am trying hard to remember that within a few days it will subside and I will feel back to normal again.

There’s been a slight change in the treatment schedule. I still have 12 sessions to go, but instead of taking the drug Taxol, I will be given something called Abraxane instead. The base drug is exactly the same, but the difference is the type of drug that accompanies it. With Taxol, a toxic solvent is used to dissolve the Taxol so that it can be effectively broken down and delivered to the cancer cells. This solvent can be pretty hard on the system, so patients are typically instructed to take massive doses of the steroid Decadron (to control nausea) the day before and the day of the infusion. Abraxane, on the other hand, does not require such a toxic solvent to break down the drug, so very little steroid is required. During the AC infusions, I have been taking Decadron for four days after the infusion, slowly tapering off by the weekend. I hate the effect the steroid has on me, and I have complained to my doctor about it. This is why he decided to switch me to the Abraxane for these next infusions. Apparently Abraxane is a newer drug than Taxol, but it has been showing very favorable results. I also have heard it is quite a bit more expensive than Taxol, but I expect that my insurance will cover it – they’ve been great so far with all the treatments and expenses.

I am really happy to have been switched to this different drug. By all accounts, this second phase (even if I was taking Taxol instead of Abraxane) is supposed to be much easier to deal with. According to my doctor, there will be no medications to control nausea, as it is rarely an issue. Many patients experience neuropathy (tingling) in the fingertips and toes. Both my oncologist and naturopath have suggested taking Glutamine – a powder that you mix with water and drink twice a day – to offset the symptoms. I have started taking this in preparation for the Abraxane infusions, which will be Tuesdays starting April 21.

Jason and I are celebrating the end of this first round of chemotherapy with dinner at Canlis on Saturday, April 18. For those of you unfamiliar with Canlis, it is considered the best restaurant in Seattle (http://www.canlis.com/). It will be a treat, but one that is well-deserved. It will mark the end of Phase I and the beginning of the countdown to the end of this entire ordeal.

Still a possibility once the chemo is through is radiation therapy, which is usually a cut-and-dried decision. Radiation is usually prescribed for breast tumors that are bigger than five cm with more than four cancerous lymph nodes. I do not fall into that category, but one of my two cancerous lymph nodes was 5 cm – almost twice the size of the breast tumor and a bit of an anomaly. My oncologist took my case to a board of his colleagues, who did not come to a consensus on radiation treatment. So, I have made an appointment to consult with a leading radiologist at Evergreen Medical Center in Kirkland on April 16. I am hoping he can shed some light on the subject. If radiation is recommended, I would be receiving daily treatments of radiation over the course of about six weeks. Each treatment is only about 10 minutes, but what a hassle! Radiation also causes some fatigue and burning to the skin. But if it is recommended, I will go through with it.

I want to thank all my escorts who have made my chemo treatments much easier by keeping me company! My next six infusions have been scheduled and I already have a terrific team signed up to accompany me on many of the days. It’s hard to put into words what a support you have all been for me during this time. I always knew I had a terrific group of friends and family. Things like this just make it all the more clear.