Wait and See

We met with Dr. Kotz on Wednesday to discuss possible changes to my treatment plan. I'm feeling pretty good, in general. I have more energy. I'm tired, but not exhausted. The joint pain, however, has not improved. In fact, it hurts now in my lower back/hip region, a constant pain that seems worse than the other joint pain. We've changed pain meds and the new stuff (a low dose of  Dilaudid) is helping more than any of the former options. It doesn't make me feel wacky and it knocks out more of the pain than the Vicadin or Percoset ever did.


There are some concerns that have put us in "wait and see" mode, as I call it. I'll have my MUGA scan later this morning to determine if the Adriamycin ("Red Devil" part of my chemo) has caused any heart damage. I scored 61.3% (normal range) on my first MUGA, the baseline I did in January. I'm told there is usually some variation in the scoring based on the technician performing the scan, and as long as my score remains at least in the 50-55% range, chemo is still an option. We are hopeful that results will be available tonight. We'll have them Monday at the latest. Dr. Kotz also wants to see my pain get better/go away before we do more chemo. We're hoping that the pain is truly just a side effect of the Taxotere, but he's been lowering the doses and the pain has been worse, not better. Dr. Kotz mentioned that the pain could be a sign that the cancer has metastasized to my bones BUT it's highly unlikely. If the cancer metastasized while I was going through chemo, it would mean that the chemo didn't work at all, and bone cancer is incurable. If it's bone mets, we stop everything and work to extend life/manage pain/minimize spread. We all agree that it's NOT that. Got it? Dr. Kotz thinks the chances that it's bone mets are VERY low. Anyway, here's what Dr. Kotz offered as options, in order of his preferences:

1. Delay chemo #6 by a week. I haven't delayed or missed any treatments yet. Delaying the last would give us time to see if my pain resolves. If it does, yay! If not, I go for a bone scan.
2. Don't do chemo #6. That would move me into the radiation phase of treatment the week of May 5.
3. Further modify chemo #6, dropping the Adriamycin from the "TAC" regimen I'm on and having TC only.

For now, I'm leaning toward treatment #1, mostly because I want to be aggressive with treatment to improve my long term survival stats. I want to be in that 63% alive after 5, ya know?! Right now, though, there are no firm decisions. Right now, we wait and see, for MUGA results and for pain to go away.  I'll update you all on the results soon. 

Update: What doesn't kill you makes you stronger....   MUGA results are in & its good news. My ejection fraction is BETTER than when I had my baseline done. 67.4% today. Woohoo! No heart damage here. Tachycardia & difficulty catching my breath were/are likely from the cumulative exhaustion from chemo. This makes me feel even more confident that the pain will also resolve & end up being just a crappy side effect. Hopefully it goes away in the next 10 days so I can make some decisions about treatment & keep moving forward. 


It's going to be a busy weekend for fellowship and fundraising!  I'll be headed to Relay for Life tonight, St. Baldrick's Shave for Sean tomorrow & Spring Festival at Old River Farms Sunday. I may just sit around and smile at people, but at least I'll be out of the house!!