Half way there!

GoodBye DOXOrubicin!  Last couple weeks have been tougher as the drug accumulates in Julies body.  Nausea has been by far the worst side effect as almost daily Julie has boughts where she feels poor.  Julie has also developed Hand-Foot syndrome or Palmer-Planter Erythrodysesthesia.  Here is the medical definition of what happens:
"Following administration of chemotherapy, small amounts of drug leak out of very small blood vessels called capillaries in the palms of the hands and soles of the feet.  Exposure of your hands and feet to heat as well as friction on your palms and soles increases the amount of drug in the capillaries and increases the amount of drug leakage.  This leakage of drug results in redness, tenderness, and possibly peeling of the palms and soles.  The redness, also known as palmar-plantar erythema, looks like sunburn.  The areas affected can become dry and peel, with numbness or tingling developing.  Hand-foot syndrome can be uncomfortable and can interfere with your ability to carry out normal activities. "

Getting rest is essential to keeping side effects managable.  Besides that, Julie continues to do amazing.  She continues to play ball and we hosted a a group of friends from work at our house this past Saturday where Julie was up and about, including watching the fireworks show!

The next drug DOCEtaxel is apparently a little easier, but biggest side effects are joint pain and water retension.  We are certainly looking forward to when all treatments are done, but are extremely appreciative of all the support and help we have received during this time.  Also we are always impressed with the nursing and medical staff.  In fact, Julies oncologist nurse won the Nightingale award 2 weeks ago - which is well deserved.

Half way there and remaining positive.

Mike

3 down, 5 to go

Only one more application of DOXOrubicin or AC (Adriamycin PFS) as the oncologist team calls it.  Julie is still doing amazing - still up and about and maintaining her weight.  A bit more feeling of nausea this time, but managable - mouth sores were bad after dose 2, so she has switched to using Biotene 4 or 5 times a day and chewing gum seems to help (so far so good as the sores hav stayed away).  We are told this drug is the harsher of the two she will be taking, so we are looking forward to the last dose then moving onto DOCEtaxel

Julies oncology nurse won the nightingale aware this week - which is well deserved.  Roy is fantastic and makes the 3 hours at Credit Valley Hospital go by quickly.  Actually, the whole oncology team is amazing.  We have been very impressed with the medical team at Credit Valley.

Julie has lost all hair now and is starting to see her nails crack - common side effects, but still difficult to take.  I think she looks amazing!  The Nuelasta (drug to stimulate bone marrow) causes pain in bones and chest if she pushes it too hard, so we are very disciplined about getting to bed early and getting lots of rest.

Finally, Softball has started and believe it or not, Julie got a home run in the first game.  Very emotional moment - all things considered.  Some ladies are suggesting that steroids may have been helping (Julie does take a steriod for appetite) - I think it is just natural ability and some payback!

We continue to remain positive.

Mike

2 down, 6 to go

We are now half way through the 1st round!  Julie is doing amazing.  For about 3 or 4 days after treatment Julie feels blah and lower energy, but luckly none of the less desirable side effects like nausea.  Unfortunately she has lost her hair, which while expected, is still hard to accept.  I think she still looks as beautiful as ever!  I like to focus on the positives of losing hair, like "hey the Chemo is working" or "Lucky you, summer is coming and bikini or legs will look great (Chemo is indescriminant with where hair is lost)".  It is also fun to come home from work and be surprised with redhead, brunette or blonde Julie!

We are also very fortunate to have access to Neulasta, which is a drug that stimulates white blood cell production by the bone marrow.  Julies bloodwork was perfect after the first treatment due to the drug (and it is only one shot) and this rapid recovery should allow her to continue on her training for the Half Marathon in August.

All in all, spirits remain high and we remain positive.

Mike

1 down, 7 to go

First of 4 doses of Adriamycin (Doxorubicin) was administered today.  Julies Oncologist changed the plan to now go every other week for 8 sessions.  It is called a Dose Dense approach and based on the type of Cancer Julie has and her fitness level, the doctors thought this would be the best method.  Bone scan came back clear.

Things have gone well.  Day started at 9am meeting with Oncologist and going over the plan and bone scan results.  We then moved to the Chemo treatment area where Julie first met our Chemo nurse (named Roy - great guy) who hooked up an iv and started a drip of saline and a steroid to help with nausea and loss of appetite.  We then met with the pharmacy and went over the multitude of drugs that Julie has been prescribed mostly to deal with side effects (we have now become our own pharmacy).  The chemo drug was administered and we were done by about 1pm.  Tomorrow Julie will visit the nurse to have Nuelasta injected which mimics the function of bone marrow and will help with the production of white blood cells. 

The expectation is now that for the next couple of days, Julie will feel kinda "blah" - but everyone responds differently.  The consensus is that hair will start being lost between day 10 and 14, so we have ordered some wigs - Julie agreed that we should have some fun with this, some I got to pick one and the color - lets see if you recognize her...

I'll keep people updated on how Julie feels over the next couple of days - but so far so good and we remain positive!

Mike

Chemotheropy starts April 4th

Treatment continues

While it was the news we expected yesterday, it was still difficult to hear.  We met with oncologist and radiation teams yesterday and discussed next steps for treatments.  The medical oncologist told us the tumor was essentially triple negative on the hormone test (slight reaction to estrogen, but essentially negligible) and the recommendation was for 6 treatments of chemotheropy.  These treatments will start on April 4th and continue every 3rd week for 6 sessions.

The radiation team told us they don't believe Julie will require radiation due to the successfull surgery and the margins and distance from muscles and bones all being good.  As a precaution, they are doing a bone scan next Tuesday to ensure that all bone structures are clear.

We will be attending a class on Chemotheropy on Friday and collecting all the drugs to help with side affects over the next week.  Julie will be shopping for wigs as hair loss can be immediately after the first session.  I have suggested a nice summer bob cut strawberry blonde...

We really appreciate everyones support and continue to remain positive.

Mike

Lymph node and Tumor diagnosis

Results from Pathology after Mastectomy

In summary - as good of news as we could have hoped!

All 4 sentinel lymph nodes tested negative for metastatic carcinoma - meaning the cancerous cells had not spread to the lymphatic system.  So negative for lymphovascular invasion.

Margins (normal cells around the tumor) also tested negative for invasive carcinoma (meaning the tumor was contained in at least 7mm of healthy tissue).

Tumor was 4.5cm large, and was poorly differentiated Grade 3 of 3.  All information points to a stage IIA breast cancer. 

Next steps:  We meet with Oncologist team in 2 weeks to plan next phase of treatment.  All indications are no additional surgeries are required and most likely no radiation treatment required.  Most likely the physicians will recommend some form of Chemotherapy as Julie is young and healthy and this would ensure long term success.

In the meantime, Julie will start preparing to participate in the Seawheeze half marathon in August (in Vancouver) and raising money for IronDames and Wellspring.  This will be a great accomplishment and both myself and Malcolm look forward to participating with her.

We continue to remain positive.

Wellspring Oakville

Julie, the IronDame

2 years ago, we travelled to Penticton, BC to watch, cheer and support, JoAnn Daxner complete her first FULL IronMan triathlon in 13 hours, 29 minutes and 37 seconds.  Jo trained with the IronDames who are huge supporters of Wellspring - a Cancer support group.  Julie was so moved by Jo's experience and the IronDames culture and cause, that she joined last fall and became an IronDame.

Ironically now she will be using Wellspring during her journey to recovery.

Many of you have asked how you can support Julie - one way would be to support the IronDames.  Julie has set up a website and a link is posted right below Julies picture at the top of this blog - simply click on the tab and if you want to support that would be very much appreciated.

We remain positive and thank everyone for the wonderful wishes.

Mike