Chemo round 2, dose 2: thankfully easy

Chemo Tuesday afternoon was fine–and since it has been a month, I got the Xgeva shot too.  That’s an anti-osteoporosis treatment that has been found to be useful in slowing the progress of bone metastases.  Even though I only have one bone met, it seems worth it.  The side effects are “flu-like symptoms for 1-2 days” but I just felt a little achy the next morning.

We waved at my oncologist on the way out–he has an office on the main hall–and he called us in to talk about the study on intravenous Vitamin C that I recently sent him, and see how I was doing.

I said I was doing great, especially because I had this therapeutic cherry Jolly Rancher I got from a jar in the chemo room on the way out.

He told me they put Adriamycin in the red Jolly Ranchers.  “It’s good for you!”  After that I just put the thing in my pocket.  (Adriamycin, aka doxirubicin, is a very strong chemo medicine that is bright red.  It’s what I had the first time around; you can’t get it again because it can damage your heart.)

I showed him my head riddled with completely bald spots of various sizes and shapes from radiation, and he told me about “radiation recall,” when chemo re-activates the body’s response to previous radiation. So likely the completely bald spots are a combination of radiation and chemo.  The radiation effect will go away eventually.  The rest of my head has much less hair, but no no hair.  Eric buzzed it off for me.  I left some bangs in the front and in front of my ears because that part didn’t seem very fally-out-y yet.  We’ll see what happens this week.  In the meantime, I am enjoying having some hair to peek out.

He told me that his BRCA1 patient who has been on Eribulin for 3 years found that her hair grew back eventually!

Me: “That’s the best news I’ve heard all month!”

Oncologist: “You need some better news.”

Everyone always underestimates the importance of the hair thing…or is it just more important to me than to others?  I will have to distract myself from the many things I have due in the next few days and do some research on that via Google Scholar… 🙂

Before chemo I went to the chiropractor, then to midwifery peer review, then to the grocery store on the way home.  So it was a good, busy day.  After we got home I planted myself on the couch.  Then my fellow-Philadelphia-U student Jessica came to spend the night between her two days of clinical time in Troy!  That was fun.  I didn’t feel any side-effects from the chemo–having it later in the day (4 pm) seems to have dampened the crazy-hungry feeling I had the first three times.  (I ate like the green hotel-room-service-cart ghost in Ghostbusters!)  No nausea at all–hooray!  I could totally stick with this eribulin stuff for 3 years…if it’s working.  We will find that out when I have follow-up CT scans after another complete cycle or two.

Best practices in cancer treatment, 2012 & 2013

ASCO (American Society for Clinical Oncology) top 5 evidence-based recommendations for 2013.  Two are very relevant for me, one less so, two not relevant.

ASCO’s 2012 top 5 list.  Two might sometime apply to me, two others are about earlier stages of breast cancer.  An excerpt, from the one about when to stop chemotherapy:

Smith and Hillner15 suggested the simple rule that patients must be well enough to walk unaided into the clinic to receive chemotherapy. When oncology practitioners receive direct feedback about overuse and misuse of chemotherapy in the end-of-life setting, they quickly improve practice, with chemotherapy in the last 14 days of life falling from 50% to less than 20% in one quarter.35 Stopping anticancer treatment should always be accompanied by appropriate palliative and supportive care and referral to hospice, and the best practice would be continuation of palliative care started concurrently at the time of diagnosis for “any patient with metastatic cancer and/or high symptom burden.”

Interesting that so much of these latest recommendations center around breast cancer rather than other cancers.  (Lung & prostate are also mentioned often, but not much else.)  Reasons might include: so many people have it; it’s so often curable; treatment options are changing fast due to new drugs and lots of trials; high consumer pressure to improve treatment side-effects & efficacy (the effect of having mostly healthy patients, as in birth); more backward than other realms of cancer care?


I am having great fun watching these music-video parodies, which are knowledge translation about evidence-based medicine:

(Originally seen via Lamaze’s Science & Sensibility blog)

I “should” be working on my delayed paper for last semester’s Critical Inquiry class, which I am looking forward to digging into, but there is so much else to do right now that–imagine that–I haven’t done so yet.  I still don’t know when my appointment is, with the Albany Med Neurosurgical dept. and the interventive radiologist, to discuss, plan, and schedule the brain treatment.  Weird…the more serious it is, the less likely you are to have an appointment?  If I needed a wart removed I would surely have an appointment.

Meanwhile it’s New Year’s Eve and my family is going all electronic-gadget-programming-happy downstairs, it has started to snow, my desk is organizedly piled with things I need to do, and I really need to update my kanban board (see here for what this is if you want to know more than “a very organized to-do list”).  But I think I will go downstairs, have some food, and sit in front of the fireplace for a while.  There is a rumor of bagels.