Time To Pivot - New Chemo

In the imperfect world of medicine, patients are given advice based on population statistics and advised on the best most successful treatment plans.  However, when that statistically popular plan does not work for you, you have to consider multiple plan Bs in the face of uncertainty and the remaining longevity of your life.  Today was the day for that conversation.

On the current Gem/Cis chemo regiment, I experienced 6 good days for every 15 day cycle (40%).  And that's if you count staying in bed all day without pain or nausea, but such intense fatigue you can't even stand to brush your teeth, a good day.  Another piece of information we had today was my recent CT scans which revealed progression of the disease - more in the liver, lungs, and bones.  However my lab counts for my liver functions seemed to have stabilized.  Armed with this information, we made the decision with my doctor to stop the current Gem/Cis treatment and pursue another drug with less toxicity.  This "plan B" came in a couple options - 1) stay on Gem only, 2) switch to Xeloda or another single IV drug, or 3) pursue a phase 1 clinical trial.  While Gem scored high on the cancer response test, it has been very toxic so we ruled that out.  We got the literature and are reading up on the Phase 1 trial, however a phase 1 is the initial phase, you will be the first patient to experience the effects good or bad.  It's also randomized 50/50 so you may be driving in/out of Boston every day and not even get the drug.  In lieu of that, we chose the Xeloda because it held the disease during my radiation treatments with little side effects.  I also have a stockpile at home.

With the switch to Xeloda, I would not need a chemo infusion today.  However I did receive my first treatment of Zometa which is a drug used to promote bone strength and ward off cancer growth in the bones and prevent other issues (fractures, etc).  It is also used to treat people with osteoporosis.  We will see what the next 24 hrs brings, but possible side effects are flu like symptoms with 103 deg fever and bone pain.  Some patients experience nothing, sure hope I fall in that category.  I will receive Zometa once every 3 months.  I am also not allowed to have any major dental work while on Zometa.  

After the Zometa side effects pass, by the weekend, I will be able to take Xeloda again.  This regiment will be 14 days on, 7 days off with 3 pills taken 2x/day.  Side effects of Xeloda are hand foot disease.  Thankfully I didn't have to battle that before, hopefully won't again.

Looking forward to feeling more myself again so I can enjoy Easter, T-ball, the Boston marathon, and birthday parties with my boys.  I've got a lot of living to do!