(email update)
Hello,
Another update on treatment, a little sooner than expected. And again rather brief. Trying to complete a deeper blog post had simply brought on emotions; the kind which relieves the rawness of one’s heart, but clouds the needed clarity of one’s mind.
Firstly, thank you. For the thoughts and notes. And for just reading the updates, since I’ve only communicated treatment changes, and I don’t wish to sadden anyone’s day. Do know that you, your thoughts, words and actions bring us, and especially her, joy.
Well, to cut to the gist of it, that fifth line was a dud.
A scan a month ago showed the cancer pretty much resistant to the chemotherapy drug. Progressing primarily throughout the liver. She is however, not in a “visceral crisis”. Her liver is still functioning. Though she has been losing weight and appetite, she does still enjoy whatever deliciousness is in front of her once the eating begins! 🙂
Given that Annie has been exposed to all four primary classes of chemotherapy relevant to her cancer, it made the choice of next treatment a harder process when factoring in chemo resistance. She has prior exposure to an anthracycline, a taxane, an antimetabolite, two microtubule inhibitors.
When you persist in asking enough of the who/what/when/where/why/how questions, the acknowledgement is that there is no “standard of care” for late line treatments in her case. Be it in choice, or in sequence. In general clinical practice, there is a grab bag of standard treatments used at this juncture. So stick a hand in, grab two raffle tickets, and presto, two recommended choices for the patient. Pretty much the analogy the doc finally alluded to. In this case, two chemos; one from each of the four classes. One with harsh side effects, and the other, another microtubule inhibitor. It felt easy to just surrender to this process.
But would that mean compromising decisions around quality of life? And that led to many long nights. Because what if there was an option the doc would support, but just not recommended because it is yet a standard raffle ticket in the grab bag? And if this option is lost if either of the raffle tickets are chosen first, how would one weigh risk/reward?
Anyway, skipping the lengthy paragraph on the decision making process, she has started the sixth line of treatment. On a drug called abemaciclib/Verzinio. And is going through the process of adapting to the side effects.
We are still hopeful for days of good memories to be made this summer. Which hopefully include seeing some of you in person.
Thank you again for your friendship, the listening, the support, and all.
much love and wishing you wonderful days ahead,
–siang