Monday, May 27, 2013

Beast is Back.....

When I am dancing with NED (no evidence of disease) you may notice that I don't post very often.  While I am living my life I don't always  relay all the good things about living life to it's fullest.  Things like the warm sun on your face, the smell of fresh cut grass, the look on your dog's face when you ask if it is time for a walk, the taste of a well crafted cocktail, the thrill of an upcoming vacation, a good laugh with family and friends, good food, etc, etc,......

These are the things I love and try to experience and enjoy everyday.  Then something comes along to knock you down.  And I hate to sound like a downer but sometimes it just pisses me off.......

The Highline
My last follow up appointment with the oncologist was April 25th.  My bloodwork indicated the CA 125 marker came back elevated.  This warranted a CT Scan which was scheduled for May16th.  By the way on May 17th we headed for New York with Dylan for the long weekend.  We had a great time and although the weather did not cooperate we did not let that stop us.  Unfortunately, Corina did not come with us.  She has finished her college program and is looking for work.  Anyone know of a health administration job opening?
Freedom Tower
Near Battery Park and NJ in the background
Dylan 

On May 22nd my oncologist let me know that the cancer was back once again.  There is a 3.5 cm tumour on the upper left hand side of my abdomen and some nodules through out the peritoneum.  Next we had the discussion of treatment which she wanted to begin right away.  I also wanted to start right away because we are leaving for Europe on June 7th and I want to have some semblance of health to enjoy ourselves.

My treatment protocol has been Taxol/Carboplatin regiment.  Very common and widely used for ovarian cancer all over the world.  However, like many people the Taxol has been debilitating to my body and so it is no longer an option.  It has left me with neuropathy in my hands.  Thankfully not my feet like some people.  Having more Taxol would only ensure further nerve damage in my hands and then my feet.  Not a good thing!  The treatment of cancer involves toxic chemicals that build toxicity in the body.  Major drawback...

Another factor in the treatment discussion is the length of time since my last treatment.  Last time I had chemo was September 2012.  In the chemo world the treatment is considered ineffective if there is less than 6 months since the last treatment.  I am at the 7th month mark and my oncologist had to decide whether to give me Carboplatin alone or with something else.  In addition you may recall from my earlier post that I reacted to Carboplatin the last time.  The answer to this is an extended infusion period to mitigate any reaction.

We decided together to go with Carbo only and very next day I had a call from hospital at 2:30 pm to ask me to come around 4:00 pm to be admitted so chemo could be administered all the next day.  How to make a dull situation a little more lively?  There is not much that can be done.  When I was not passed out from the benedryl I was fully awake and able to read.  I had several room mates during my time at hospital but I know from past experience that other cancer patients are not that chatty and I was not either.  I finally got to go home @ 9:30 Friday night.  Good news is that I did not have any reaction.  Just bored out of my mind.....



Tuesday, May 14, 2013

Genetic Testing

I just read a news article about Angelina Jolie and how she had a double mastectomy and reconstruction surgery.  She was found to have the BRCA1 mutation.  To me this just shows how she was proactive to get the testing done and take action to protect herself from breast and ovarian cancer.  I think this is awesome!

In my situation I had genetic testing after my treatment ended after my first bout with ovarian cancer in March of 2011.  Genetic testing is very easy.  It is a simple blood test.  It is sent to a special lab and the results come back within a couple of months.  Before any testing I sat down with a genetic counsellor at the cancer centre.  We discussed my family history and all incidences of cancer within the family.  There are actually very few incidences in the family but I qualified for paid genetic testing by our provincial government because of my recent cancer and my age.  I was found to have the BRCA2 mutation.


Some background info:

90% of all breast and ovarian cancers are considered sporadic, due to a combination of factors such as age, lifestyle, environment and chance.  The average woman's lifetime risk of breast cancer is in the range of 8-12% or about 1 in 10, and the average woman's lifetime risk of ovarian cancer is about 1.5% or 1 in 70.  The remaining 10% of breast and ovarian cancers are considered hereditary, due to an inherited mutation in a cancer-related gene such as BRCA1 or BRCA2.  Mutations in the BRCA1 or BRCA2 genes are associated with a high lifetime risk of breast cancer and ovarian cancer in women, as well as male breast and prostate cancers and possible other cancers to a lesser degree.  For individuals who carry a BRCA1 or BRCA2 mutation, each of their children will have a 50% chance of inheriting this mutation and also be at increased risk for these cancers.

A POSITIVE result indicates that a mutation has been identified in BRCA1 or BRCA2 which is known to be associated with increased lifetime risk for breast (40-85%) and ovarian (20-40%) cancers, male breast and prostate cancers, and possible other cancers. Genetic testing would then be available to blood relatives.



This means my chances of breast cancer has greatly increased and with this information we can take preventative measures like Angelina Jolie.  We had several meetings with the genetic counsellor to discuss what this all means and you can imagine how stressful this is.  I have not chosen the same route as AJ but my screening for breast cancer has stepped up a couple of notches.  I have an annual mammogram and a MRI.  This is the standard for high risk screening.

What this also means is that I inherited this mutation from one of my parents and it was found to be my father.  It also means he is at higher risk for certain cancers.  This also means he is now screened more frequently than before.  It also means my siblings may be at risk as well. And my children......

With this information it also means that my father's siblings and their children and their children may be carrying this gene and this gives them the opportunity to have meaningful discussions with their own physicians.  But I know that even though the information is out there it does not mean that people take action.  This is why I am so impressed by what Angelina Jolie did and at her age.  It is a brave thing because it is human nature to deny and therefore delay.