Wednesday, November 24, 2010

PMH Update (Good news)

by Michael

Last time I did an update from Princess Margaret Hospital (PMH), Kate told me: "Don't sugar coat it."

Not need for such direction this time; the news was all good.

Kate and I went to PMH this morning for two purposes:
  • Kate's pre-chemo #2 blood test
  • Meet with the oncologist
Last week Kate had a port-a-cath installed in her upper-right chest, the new gateway for the chemo drugs and the output site for blood work. Unfortunately, no one told us Kate needs to visit the ambulatory services to flush the port-a-cath before blood can be taken. So this morning they did it the old fashioned way: needle to the arm.

This was frustrating, but onward we moved to the breast cancer clinic, where we expected to hear the results of the just-taken bloodwork (doctors needed to confirm that Kate's white blood cell count had bounced back from chemo #1, so that chemo #2 could proceed). We weren't sure what else the oncologist was going to do today.

We expected to meet with Dr. Warr, but met instead with Dr. Buckman, author of Cancer is a word not a sentence. He also reviewed a new book about cancer in last Saturday's Globe and Mail. Kate read the review and bought the book on Sunday.

So ... "I read your book review this weekend," Kate said.

"Oh, what did you think of it?"

"I bought the book."


Discussion about the book and the review. In short, the book is subtitled "A biography of Cancer," but there is no such thing as cancer; it is really a bunch of different diseases. Dr. Buckman said, "It would be like having a book called INFECTION and lumping in the common cold with HIV and implying it was the same thing."

But back to Kate!

Dr. Buckman wanted to know how Kate was post-chemo. Complaints? Yes!
  • nausea
  • bone pain
  • constipation
"No need for nausea these days," the doctor said. He prescribed an additional medication and said if the nausea was troublesome again, "Call the hospital. We'll figure out a regime that limits the discomfort."

Bone pain? Ibuprofen/Advil.

Constipation? Milk of magnesia. Plus metamusil. Both. As required.

  • White blood cell count: "terrific."
  • Response to chemo #1: "obviously doing good."
The doctor asked Kate how she felt. She said that post-chemo her breast felt "in overdrive."

Doctor said, "That's a good description. It's exactly what is happening. The chemo is mopping up the cancer cells and carting them away."

Proof? The doctor pulled out a plastic ruler, lay Kate on the bed, and measured the cancer. It was smaller.

His words were: "The boundary is softer and hazier than the previous descriptions by Dr. Warr and Dr. McCready." He measured the cancer in the breast at 2.5 cm.

Kate said her lymphodema was gone, and the doctor said: "Delightful. Very good."

Onward we go. Green light to proceed with chemo #2 on Friday, Nov 26. Next after that would be Dec. 17.


Discussion with doctor. Any questions?

We weren't clear on HER2 and ER and genetic test results.

In short, Kate is
  • ER positive (most with breast cancers are)
  • HER2 negative (most with breast cancers are)
Dr. Buckman said, This is all good. ER+ and HER- both mean Kate's cancer is "more gentle."

Specifically, the doctor said, "These are the results we want."

About genetic testing, they haven't done it. It would be done if Kate was ER-. If Kate were ER-, then there would have been a decision about whether to do drug treatment (tamoxifen) before starting chemo. But this decision was moot, since she is ER+.

Finally, did you know that you have a CTZ? Apparently we all have one, a Chemo Receptor Trigger Zone. It's in your brain, and it determines how nauseous you will be if you ever have chemotherapy.

Knock on wood.

And yes, we are very happy today. Good news all around.

Thanks again to everyone for your tremendous support. It means everything to us. Words cannot describe how supported and loved we feel.


Anonymous said...

Best. News. Ever.

Anonymous said...

I could have told you that by your kick ass comments at bookclub. g

Anonymous said...

We did what you asked, it was such a chore! Actually drank two small glasses of wine felt that one didn't quite cover our celebration at your wonderful news! See you soon,luv uknowwho!

mandy said...

Awesome news....we too will drink to that.....big hugs
Mandy xxxx

Anonymous said...

Fantastic fantastic FANTASTIC! SO pleased to read your latest news. We will all be thinking about you tomorrow - and hoping the new regime helps minimise the yucky factor. LOL that's Lots of Love from the McKays xxxxx

Anonymous said...

Fannn tastic. You go girl!

Anonymous said...

Awesome...really really like that! Guess all the love and good vibes being sent your way are working..sending more your way!