Brain Mets

Today I met with 2 doctors, one was a radiologist oncologist and the other was a neurosurgeon.  The two doctors often work together to come to an agreement about a treatment plan. Meeting with them, I was told and shown the images of the 5 tiny spots of tumors they saw on my latest brain MRI.  I met with Dr. G first and she really scared me about recommending whole brain radiation if they were to see more tumor spots on my brain. And then I met with Dr. Chang and he was alot more confident with recommending the Cyberknife radiation procedure. Both Doctors though agree that I should follow the usual procedure of first getting a more accurate, closer up CT or MRI done so that they can clearly see at a more precise needle point if there are anymore tiny spots. My recent brain MRI done a week ago were not at fine needle point imaging and so I have to get another one done soon, pending insurance approval.

So, yes, five tiny pencil dot size spots, except one is the size of about 3 mm. I hope they don't see anymore spots on the next close up scan and that I just get the Cyberknife procedure or else with the whole brain radiation, the side effects are huge, like loosing all of my hair, developing slight cognitive, memory, speech and much more serious damage besides the fatigue, headaches and loss of appetite.  Whew..this is all so scary and hearing all of this, it's devastating news.  But, Dr Chang is really positively leaning towards Cyberknife and that he says, most of the time, it gets rid of the tumors 95% of the time and it wouldn't reoccur, except I would have to get more routine 3 month follow scans for the year to monitor it's stableness. So, I'm keeping my hopes up that this is all they will see at the close up scan.

After my appointment, I went back to work and told the news to my team members. I try to state the facts and to stay mellow, calm and collective but I can almost see the tears silently breaking down on everyone. It's hard, living with this cancer and it's hard for everyone else too who cares about me to hear this news. Some days it's harder to endure but I have to keep my chin up and live life to the fullest and as normal as I can.
As for my nagging bone pain, the radiologist doesn't recommend doing any radiation on it at all and suggest pain meds. Hmm, so far, I'm starting to not like this new relationship with this radiologist. For now, it's not bothering that much and so I'll just handle one thing at a time.

I'm back to chemo this Wednesday. Augh, the constant poking with needles, scans, chemo, radiation, doctor appointments. I just wish all of this would just go away and I'm in good health again. Can you tell, I just hate all of this. I hate being sick, having cancer, and worst of all, I hate knowing that I'm going to die from this lung cancer some day and leave me kids motherless...this can't really be happening..but it is. Sometimes I forget that I am terminally ill.
The kids are well and my love for them is endlessly more each day. They are growing up so fast. I came home from work today and see that Ethan did all of his Kumon math homework by myself! He just completely did all of it, even the addition math part. And the girls, they're just getting super adorable and smarter each day, talking more and more. Lots of Love. 

Work, Coughs, Antbiotics

I've been back to work for two weeks straight now and I'm getting used to the routine. My family, my friends and my colleagues whole heartedly  have given me a warm welcome back to work. Everyone's glad that I'm back to work again.  And I am really glad to be back to be apart of a great, talented team.  I also feel blessed that I have an incredible, really understanding, warming and caring manager.

So far I've contributed just a little of help with validating some reports and learning the new system. But, with everyone knowing that I'm terminally ill with an incurable cancer, everyone is just extra nice to me and super kind and generous. It's nice that that everyone's so nice but in a way in, it just breaks my heart that I'm sick.  I shed these silent tears of sadness that I'm not healthy, like everyone is. I mourn and long for my healthy self again, for my normal, happy, healthy life full of future promises with goals, dreams before my diagnosis.

While the routine of work helps distract me from having to think about death, dying, doom and gloom constantly, I still just really sad that I have this terminal cancer diagnosis. I guess I can never really get over this but glad now that I have some work to help diverge me from falling into this dark hole of gloomness and hopelessness.

Cough
This week when I've suddenly started having these miserable dry, persistent, hacking coughing spells for a couple of days, I and everyone around me was concerned about me. I've had it since last week but over the weekend, it grew worse and worse. But luckily by Tuesday, after taking some antibiotics, I'm starting to feel better again. It's still no fun to be taking these big pills but I'm glad it's working to keep this cough away.

Radiogist Consultation Next Week
I still haven't met with the radiologist yet for my Cyberknife and radiation procedure for my nagging bone ache and the 3 mm spot on my brain. They've been off to some sort of big conference and so next week when I meet with them, I'll find out more on what their recommendations are.  I'll post an update once I find out.

The kids are doing well. I'm feeling better now that my cough is getting handled with the antibiotics. Lots of Love.

Results of MRI

After working for half day, I went in to see Dr. Neal yesterday and to also get my chemo Gemzar treatment.  The results of the latest brain MRI shows that the one tiny spot that they saw in the beginning a year ago and again in Sept FY11, has now grown into a 3 mm spot.  So, Dr. Neal has me scheduled for a Cyberknife radiation procedure to zap away that tiny spot away.  The actual radiation procedure will probably a few seconds but Dr. Neal says the prep work to get my head and all the imaging done to narrow it down to the one exact spot will probably take awhile, probably a few hours of prep work.  At the same time, he also put in a request to radiate the one spot to zap on the dull bone left hip area that I've been nagging about.   We're not even sure if I can get it done on the same day since it's 2 completely different areas and so will find out more from the radiologist next week or so.

This cyberknife procedure is supposed to be a quick, painless procedure and the side effects are minimal.  But, any kind of radiation to the brain is always scary and comes with some risks. I'm a little nervous about it but hope it'll go smoothly.
It was also nice that my good friend, Ramona was able to come with me too.  She's been an amazing friend and supporter and I really appreciate her friendship, care and concern.  I'm always glad to have her come for company and for a carpool buddy.  Time flies when I have company along to chat with and for moral support.  I did get my 6th round of Gemzar chemo yesterday. 

Work is coming along
I've been back to work for almost a week now and I'm glad to say it's moving along very well.  I'm actually enjoying being at work and it's nice to sort of focus on something else besides cancer.  The first couple days was a little hard getting used to getting up early, the commute, traffic, getting used to new faces, new procedures, but now I'm starting to settle down and warming up to the familiar routine of work again. It's still a bit early to see how I'll fit in and learn all there is know about the systems, procedures and compensation plans. But so far so good and it's sort of nice to "forget" that I have cancer for a few hours of the day.  And I'm working Part time for now, like 30 hours a week for now until the end of March.

Other than work, I'm feeling good and the kids are doing well. They've somehow gotten used to me working very easily and smoothly. I do miss them while I'm at work but it's nice to have some time to "myself" for a few hours..Lots of Love.

Back to work tomorrow

Yesterday after the kid's dance and gym class and then dropping them at home with my nanny, I rushed off to Stanford to get a brain MRI. Since I got a little lost trying to find the right cancer center, I had to wait a bit to be squeezed in. The brain MRI went smoothly but since it's been awhile since I got one, it took alot longer than I remembered. The whole procedure took about 45 minutes of loud knocking noises and you have to keep your head locked still in the same freeze tight position bearing this helmet while going in and out of the circular machine. I even got poked with a needle into a vein with contrast too..which I don't ever recall in the past..so this was new to me or maybe I've simply forgotten about it.

The good news is that I haven't been experiencing anymore nagging headache ever since I took that one Tylenol. So hopefully it will be good news from the brain MRI and that there's no tumor mets there.

Tomorrow will be my first day back to work. It'll be hard to get used to the long, traffic commute and having to get up early. I also was hoping to start work on a part time work schedule for atleast 90 days but it sounds like it's not going to happen. I'm going to still ask for it and see if it'll work out but for right now, until I work for atleast 2 weeks, it's hard to tell how things will turn out. It'll be a new beginning and will take some time to get accustomed to things and the routine of work again. It'll be good I think to focus on something else aside from cancer and get into the groove of being a contributor.

Another than keeping busy with the kids, I'm doing alright. Lots of Love.

1 Year

Today marks the exact 1 year date since my diagnosis. Time has gone by so fast even though I took time off from work and went on disability medical leave. What a milestone it is for me to be able to make it through this shocking year full of fear, at times full of sadness and hopelessness. I have to say I'm so thankful to survive this difficult year.
I'm so thankful for all my family, friends, coworkers, community and for everyone's support and love.  My dream now is keep beating and or keeping this cancer stable and stay progression free for years on. It would be wonderful if I somehow fall in that 15% of lung cancer survivors that live beyond 5 or more years. Ideally I would be more ecstatic if somehow Dr. Neal finds out the actual genetic marker that caused my cancer and magically, miraculously fits me with a perfect treatment that makes me cancer free! But that most likely remains to be a hopeful dream for now.

As for my headache, today, it's gone! It could be that I finally caved in and took one Tylenol last night and now, no more slight headache. But, it's still a good idea for me to get a brain MRI to rule out anything as I do feel a little headache here and there at times. I'll be getting it tomorrow and will find out the results next Wed.

Talactoferrin Trial
I've done some more reading on the latest Lung cancer trials and treatment and below are few more trials that shows promise in treating NSC Lung Cancer.  This article at http://www.medicalnewstoday.com/articles/235842.php discusses promising results from its phase II trial and mentions a talactoferrin Phase III FORTIS-M trial that is being carried out in individuals whose NSCLC has progressed after two or more previous treatment methods. It states that "Talactoferrin appears to provide anti-tumor activity without many of the common toxicities associated with other treatments for non-small cell lung cancer." So this talactoferrin trial is something to consider for patients like me in the future.

START Phase 3 trials of Stimuvax
Another promising Therapeutic cancer vaccines is the https://www.nsclcstudy.com/about-start-research-trial for those who have stage 3 inoperable NSC lung cancer. It's currently recruiting patients in the US and hopefully the results from this study will find a better treatment alternative that works for all NSC lung cancer. I don't qualify for this trial but thought to pass it along for those who do.

I'm still always hoping and dreaming for more better treatments that will someday cure NSC Lung cancer. And of course, keeping up my hopes for surviving this cancer for many, many more years to come. Lots of Love.

CT Results

Yesterday I went in to see my onc, Dr, Neal and found the results of my CT 2/3/11 scan.  And the results show that overall, everything is stable. But it does indicate from the report that "Numerous additional small pulmonary nodules are seen throughout the right lung, and the appearance is unchanged in appearance when compared to the 12/6/2011 examination. The left lung is clear." So it's good news that the primary tumor is still the same and stable.

But, the bad news is recently, for about almost a week now, I've been getting a nagging slight headache on my left side of my head that isn't going away followed by a two times vomiting episode. This is concerning for brain mets and so to be cautious, Dr. Neal has me set up for a brain MRI immediately. This is scary and we want to catch anything early on right away. Gamma knife or a certain radiation treatment is what will be done if it is says Dr. Neal. Along with that, he says he will recommend a slight radiation to my left bottom hip bone too for my dull nagging bone area that I've been having for awhile now that hasn't gone away.

So, I'm nervous for this coming brain MRI results but glad to get it screen to rule out anything and or to get it treated if there are any significant findings. Let's hope for good news.

As for my current Gemzar chemo infusion, Dr. Neal recommends for me to stay on this treatment for now as long as it is effective and he says it looks like it's helping keep the tumors stable. As for the headache, he says that most chemo treatments don't pass the brain barrier and so brain and or bone metastases can happen over time with most Lung cancer patients. Arrgh, here we go, all this is overwhelmingly scary, worrisome and I just wish I was healthy, but I'm not.

Well, that's all for now. Lots of Love.

Waiting for Results of CT Scan

Last week I didn't have Chemo but I did go in to get poked with an IV for my 2 month check up CT scan. I don't know the results yet until I meet with Dr. Neal this week. It's hard to guess what the results may turn out like, but I'm hoping it'll be good news of stability and also figure out what's causing this dull ache on my left bottom bone as it's constantly nagging me. I have a feeling it's the bone mets that causing it and if its, radiation is the palliative treatment to prevent from further spread.

I also was able to attend the Stanford Lung Cancer meeting too last week with one of the members who happen to live nearby.  It was really nice of her to offer to carpool together to the meeting. She has the same NSC Lung cancer as me and also didn't smoke either and unlucky for many patients like us, were discovered late stage. It was a good meeting and I'm warming up to getting to know everyone in the group. The connection, the support and the understanding that we are all facing the dire, inoperable terminal illness brings just a bit of comfort in that we're not alone in this battle. It's a club that I'd rather not be apart of to be honest but nevertheless now has become apart of my world.

Each time I do go to the meeting, I do learn of something new, like VeriStrat, which is serum test that doctors can order to identify whom among "NSCLC patients most likely to have a "significant survival benefit" from treatment with Tarceva. I was on the Tarceva pill for 4 months previously this past 2011 summer and had I known, I would have asked my Doctor to do this test first before starting this regimen even though Dr. Neal already knew I had tested negative for the EGFR mutation. Time, is of the essence when it comes to Lung Cancer, as when Doctors talk about its survival prognosis, it's in terms of months. Yikes!

Well, this is my last week off staying at home with the kids full time and starting next Monday, I will be heading back to work. I've put in my request to be on a Part Time schedule and hopefully it'll work out so that I'll be back soon enough to pick up Ethan from his Kindergarten class and also to keep up with chemo and doctor appointments.

The kids, myself and hubby are doing well. My nanny has been sick for a few days last week and so I've just been a little bit more busy. Let's hope for good news from the latest CT scan. Lots of Love.