March 30, 2011 - Test and Scan Results.

Another early morning, up at 5 am and over to the MRI out-patient screening.  The MRI was easy, just the position seemed a little strange.  Good thing Elsie put the IV for the drip in the outside top vein of my right arm. Of course, their main concern is that no metal gets anywhere near the machine.  Hey, I’m concerned about that too.  Down to my underroos and a set of scrubs pants,  I had to climb up on the table knees first (always a challenge with my old knees).  Now Brandi  explains to put my chest into a frame (reminiscent of an utter frame for a milking cow, oh joy) and my face into position above with my arms stretched out like superman flying thru the sky.  Now the boobies are tender from the 9 core biopsies from yesterday and it is a major concern of mine not to be bumping ANYTHING against the sides or center of the “utter frame”.  Brandi further explains how I am supposed to remain perfectly still in this position for 45 minutes , and by the way, she will also be injecting some room temperature fluid in my arm during part of the process.  I figure I can do this, no problem.  It turns out that I have my mother to thank for all those pinches in church to be still, go figure.

While I am finishing up my test, Libby is moving us over to the Rotary House, the hotel owned by MDA but operated by Marriott.  Bless her heart; we have a ton of crap.  Lesson number 925, pack less.

 We get to Dr. Alvarez’s office at 3 pm and they call us in for the vitals and stick us in an exam room.  Dr. A comes in and tells us that all the reports look “berry good”.  In fact, he is smiling and explaining that my IBC looks pretty isolated to the left breast only, no wall cavity involvement and that just a couple of my lymph glands are showing any signs of the cancer.  He says that this is proof of early detection proceeds to walk us thru all of the tests on the screens of his computer.

 He goes further to explain that this makes me a perfect candidate for a clinical study that is in phase two for a combination of chemotherapy drugs that Charla will tell me about. My main concern is that this is not his study, when I ask why he is not considering me for his study, he says “you do not want to be a part of my study, those candidates are much sicker”.  OK, so now it is finally sinking in that the tests and scans really are giving me GOOD news.

Dr. Alvarez introduces me to Charla Parker.  She is dark headed, thin and an RN with a bold way of speech and a big heart. Hmmmm, Libby thinks "she's you in another skin" and "how many more of these will be meet in this place1". Charla explains the purpose of the study is test the combination of both panitumumab, nab-paclitexal, and carboplatin (PNC) and fluorouracil, epirubicin and cyclophosphamide (FEC) used before surgery for the treatment of IBC.  The goal of the study is slow down the growth of tumor cells by blocking the proteins on the surface of the can cell, kill tumor cells by binding a chemotherapy drug to albumin, a protein made by the liver, the albumin gets into the cancer cell and releases the paclitaxel directly to the tumor. Also to stop or slow cancer cells from growing by damaging the RNA or DNA that tells the tumor cells to grow. The FEC each work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.   As complicate as all this sounds, it breaks down to a few simple facts:  1) I can get weekly attention from the top IBC team in the US (maybe the world),  2) I get a combination of FDA cancer approved drugs in a new combination delivered with the main goal of stopping the growth of IBC at its current location much like HER2 does for regular breast cancer patients, 3) further the drugs begin killing the cancer cells in preparation for surgical removal.  The very nature of IBC, makes it's removal difficult, and after all this explanation I feel sure that if the insurance is good to go, then so am I.
Picture of Leah and Charla:

This will mean that I travel to Houston for my chemotherapy over the next 6 months.  The first 12 weeks, on subsequent  Mondays, I will be in Houston taking the clinical trial drugs and seeing the team doctors. Then the remaining 3 months of my chemotherapy is at 3 week intervals also in Houston with the same team.  It’s going to make my work schedule crazy, but I believe I will have a better chance to beating this damn thing with the team that I have met and with the drugs they are going to use.