We met with the oncologist on September 1 to review the biopsy results. Based on the biology of the cancer cells, the doctor recommended hormone therapy to be my first line of treatment. The regimen will be as follows:

(1) Zoladex injection (monthly) – to suppress my ovaries. This will put me into menopause and reduce the amount of estrogen my body produces. This is the same injection I received for 3 years back in 2004-2007. I hated the injection back then because of the humongous needle (though I never saw the needles in real life. I chose to close my eyes while receiving the injections). I’m obviously not thrilled that I need to get re-acquainted with Zoladex.

This is a subcutaneous injection done to the abdomen. In the US, nurses would give me a lidocaine injection first before giving me the real deal. In Korea, they don’t do that, as it’s also painful to receive lidocaine shot. But the nurse still numbed my skin with topical lidocaine before jabbing me. The nurse giving me the shot was very skillful. I like how fast and decisive she was.

There are times to be thankful for tummy fat, saved for moments like this.

(2) Fulvestrant injection (monthly) – this is hormone therapy for post-menopausal women with metastatic breast cancer. The drug is administered by injections to the buttocks (into the muscles). One shot on each butt cheek. The needles are of normal size (according to Siang, I dare not look), but the drug is thick, so the needles need to stay in for a longer time for the drug to be slowly pushed in. The nurse was patting my butt while injecting to reduce the pain level. Afterwards, she massaged my butt a little, and then instructed Siang to continue the work. The massage apparently would reduce bruising and pain level.

(3) Ibrance – oral pills (daily) – this is a relatively new drug. A recent clinical study shows that using Ibrance in combination with Fulvestrant would greatly improve efficacy. The drug just got approved in Korea a few days ago. The current plan is to start Ibrance at the end of this month. At this point, we are not sure if our insurance will cover Ibrance. If not, it will cost $11,000/month.

I’m not too psyched about more pain in the butt and I HATE needles!! But I’m thankful that I do not need to start on chemo just yet. The doc is saving that for 2nd line of treatment if/when 1st line fails.

Prayer Requests:
(1) Insurance coverage for ibrance
(2) Effectiveness of hormone therapy treatments – the doctor will monitor treatment progress in about 8 weeks.