Side Effects

I am posting this Tuesday morning since some of you might be wondering how Marce is doing with her treatment. Things are not going as well as we had hoped, but we hope they will improve since most people have side-effects with this chemo on days 3-5, which would have been Friday- Sunday. On Thursday evening Marce started feeling significant side-effects from the chemo, which was pretty much per the "schedule". It started with an aching in her scalp, then moved to give her symptoms which would resemble a bad chemo "flu". Aches, pains, and a headache were the center of her side-effects. She has also developed neuropathy in her body, which usually manifests itself in tingling of the fingers. Instead she has what I call "voodoo doll" pains, where she feels like sharp knives are jabbing her all of a sudden. The episodes tend to come in clusters, and the sensations happen all over her body in an unpredictable fashion. She had had little improvement in the side-effects as of now.

We appreciate your thoughts and prayers that her side-effects will diminish quickly.

Thank You!
Marc

Successful First Chemotherapy

Marce successfully completed her first regime of chemotherapy. Following a blood test to establish her baseline, we first met with Dr. Kaplan who went over the specifics of treatment. Prior to receiving chemo, she received three pre-treatments to help minimize the side-effects. One of them, for example, was an anti-nausea medication. She then took her two chemotherapy drugs in succession rather than at the same time. The first one was Taxotere, which is a synthetic form of Taxol, which comes from the Yew tree. They administered all drugs via IV, starting out slowly to make sure there weren't any negative reactions. The second chemo drug was Cytoxan, which was administered at a faster rate. Marce had a few minor reactions but nothing major. A bit of a minor headache and blurry vision were the most significant effects. So what ended up being a 7 hour experience today should become a 2-3 hour experience the next time she comes in.

If she follows the typical course, she should feel fine tomorrow (Thursday) and then tired on Friday and Saturday, recovering Sunday. But every one is different and there are possibilities for more significant and severe reactions. We appreciate your thoughts and prayers that her side effects would be minimal.

Marc

Hunt for the Perfect Wig

Now that Mom has decided to move forward with chemo, we can’t have her going around bald for three months. So we set out on a couple of wig expeditions the last few days. With so many cute wig styles to choose from, I don't see why we all don't go bald and have perfect hair-dos in just seconds! Wouldn't that make life so much easier? The first hair salon we hit had a nice selection of wigs filling the wall. What do you think of these wigs?

Picture A)

First wig! But not the right color

Picture B)

Wow, Mommy in blond! Wouldn’t she get some funny stares if she walks into church with this one?!

I wonder if Madeline was having more fun than Mommy

The second shop we visited contained around 2,000 hair wigs! Imagine the excitement of five girls walking into a galaxy of perfection. We definitely liked this shop’s selection the best. Hmm, where should we start?

Picture C)

This one looks similar to Mommy’s hair cut

Picture D)

I have never seen Mommy’s hair so short before, but it won’t be the last. We all were a little surprised when she popped the wig on. Sorry, about Marina in the back. It’s one of her interesting poses!

Picture E)

Oh, definitely a possibility!

Picture F)

Picture G)

I think you will all agree with me that this is the perfect wig for Mommy!!! Won’t it bring out her sparkling blue eyes?? :-) Besides, she has always wanted curly hair and you can’t get curlier than this.

Michelle picks out Mommy’s new eyelashes. I wonder how they stay on. Yikes, they are WAY too long!

Picture H)

This is definitely my favorite!

Please vote for your favorite hair wig by using the letter above each picture and writing it in the comments. We would greatly appreciate your in-put!

Only one more day to go...

~Meagan

Chemo countdown

Well, after a week of countless prayers and petitions to God, researching into the "wee hours of the night", and many conversations with doctors, friends and family, the decision has finally been made. Marce starts chemotherapy treatments on Wednesday, March 26th and, if everything goes as planned, should finish up on Wednesday, May 28th.

As a reminder, the chemotherapy's purpose is to destroy any rogue microscopic breast cancer cells which may have spread someplace in Marce's body prior to her mastectomy. One of the things we have learned is the smaller the total number of cancer cells, the better chance the chemotherapy has of killing all of them. This is true because single cells have plenty of nutrients and oxygen, and divide more rapidly than larger cancerous masses, which have fewer resources to draw from. And it is during the process of cell division that the chemotherapy can destroy the cancer cells. But should Marce decide to wait and see if the cancer returns, it would likely be 1-5 years later until it could be detected. At that time any tumor would be much larger and therefore more difficult to obliterate with any treatment. Hence, now is the most effective time to take chemo. It is somewhat paradoxical that she is taking chemo for a cancer that might not be a threat because it it too small. But, given her relatively young age, we have decided to hope for the best but prepare for the worst. The worst is that there are indeed undetected cancer cells in her body.

A friend of ours from Australia had breast cancer almost two years ago, and undertook the exact same chemo treatment which Marce will take. It is called TC, which is short for 2 poisons (I mean drugs) called Taxotere and Cytoxan. She will take four intravenous treatments every three weeks, the first of which will take four hours to administer. Although TC is one of the less-aggressive types, our Australian friend has given us her blow-by-blow account of what to expect. It will not be pleasant, and will probably knock Marce out of commission for five days following the administration. She will lose her hair between weeks 2 and 3, be tired, and experience digestion problems. She may experience a metallic taste, darkening of the nail beds, numbness and tingling of hands and feet, muscle and joint aches, etc.--not a cakewalk!! In between treatments she should feel better, but it will likely be 3 months of living under a dark cloud. It is our hope that all of this will enable Marce to be around for decades to come.

This has been an unusually tough decision for Marce, as she rarely will take even over-the-counter medicines because of their potential long-term side effects. If an aspirin is like a bullet, she is about to voluntarily submit to a nuclear explosion. We have both wrestled hard with the modern medical treatments versus alternative treatments. While we think alternative treatments have much to offer, they do not have the statistics to back up their effectiveness. We are using our brains to decide on the facts and our hearts to trust God Who is our ultimate Physician and Healer.

We are thankful for your prayers and support!

5 days and counting...

Marc

Onco DX Test Results

Yesterday (Friday) we met with Dr. Kaplan who gave us the results of Marce's Oncotype dx testing. This test provides us with the likelihood that her cancer will reappear with and without hormonal and/or chemotherapy. This website gives a good overview of the test.

http://www.genomichealth.com/oncotype/about/what.aspx

While the test scores were not bad, they weren't as good as we and Dr. Kaplan had hoped. Prior to yesterday's test results, Marce's "recurrence risk" was estimated to be:

Do Nothing 15% chance of cancer returning in her life
Hormonal Blocking Therapy (i.e. Tamoxifen) 8%
Hormonal + Chemotherapy 5-7%

Based on that, Marce was mentally gearing up to take Tamoxifen, but not thinking chemotherapy since it would only provide an insignificant benefit of 1-2%. The new numbers from the Onco DX testing are:

Do Nothing 30% chance of cancer returning in her life
Hormonal Blocking Therapy (i.e. Tamoxifen) 13%
Hormonal + Chemotherapy 8-10%

Dr. Kaplan said we are in the 'grey zone' in his thinking about whether to do chemo or not. He definitely recommends Tamoxifen, but the chemo decision is a personal risk decision about the small but significant improvement provided by chemo. Its the old trade study of short term pain vs. long term benefit. This has significantly changed things to the point where Marce is now strongly considering chemotherapy. If she does elect chemo, the good news is that the specific therapies Dr. Kaplan would recommend are the most mild forms of chemo. There are two choices she has, which are:

Opton 1 - CMF http://www.chemotherapy-info.com/cmf.htm
Pros
- The least side effects, with tiredness lasting about 1 week per month for 6 months
- Only 30% chance of losing her hair
Cons
- 6 month treatment

Option 2 - TC http://www.breastcancer.org/treatment/chemotherapy/new_research/20060217.jsp
Pros
- Tiredness is typically shorter, around 3 days, rather than 7
- Half the treatment duration as CMF
- Similar benefits to CMF
Cons
- High probability of hair loss
- Side effects can be tougher than CMF, although still mild for any chemo

The other thing Dr. Kaplan said is that if the cancer does come back, regardless of whether she does chemo now or not, then it will be very difficult to beat. If she is ever to do chemo, now is the most effective time. Given that she is relatively young, we want to maximize her longevity. Plus it will be easier for her to recover from chemo now than, say in 10 or 20 years if it were to reappear. So, with all of that, we are both currently thinking that the small but significant 3-5% improvement in survivability is worth 3 months of the relatively mild inconvenience of chemo side-effects. Additionally, we have found a great naturopathic doctor who specializes in cancer oncology, and he has given us some good information and supplements which will further help Marce's survival.

So, where we find ourselves today is that Marce will definitely do the Tamoxifen, which is 5 years following chemo. While still uncertain about the chemo, we are leaning that direction based on the above information. We would appreciate your prayers that God would give us wisdom and peace about whatever Marce finally decides.

Marc

Genetic Jeans

It has been some time since our last blog entry, as life is returning to normal. This week we did receive good news that Marce does not have the mutant BRCA1 or 2 gene, which could have been a reason for her relatively early cancer. We are still waiting the results of the onco dx testing, which took a bit longer to get started due to bureaucracy. We should hear back on this in the next few weeks. But Marce's strength is continuing to improve, and we are continuing to research and pray about what lifestyle and natural methods she should follow to minimize the recurrence risk. There are certainly lots of options, so we are trying to wade through it all to see what makes sense.

Thanks for your continued thoughts, and we will update when we have more news.

Marc

Back to School

Well, I’m back in the saddle (so to speak) and actually corralled Madeline and Marina into completing a full school day. It was a fun and rewarding start to the week, for which I’m so grateful! I don’t know how seriously the girls took me, though, since I didn’t even have the courtesy to get dressed and just lounged around in my flannel nightgown (not a pretty picture!). Thankfully, that’s one of the perks of homeschooling. As you can tell, I need the routine of our normal schooldays just as badly as our girls.

I thought I’d share a cute thing that happened today. While I was working with Madeline on her history lesson, Marina busily occupied herself with the giant jigsaw puzzles. I praised her for the great job she did putting all those puzzles together and proclaimed she was the “Puzzle Queen”. She thought for a moment and said, “No, I’m not the Puzzle Queen, I’m the Puzzle Princess!” I stand corrected. She is truly blossoming into a beautiful young girl. She attends a Christian preschool (located only two blocks away) two mornings a week. It’s a wonderful arrangement and allows us to pack in quite a bit of school on those mornings. She usually bounds through the front door bright-eyed and beaming from ear to ear, eager to show us all her lovely art creations for the day. In my mind, preschoolers + preschool art projects = a big mess! That’s the reason I have an equally big grin on my face when she walks in the house—we only get her finished masterpieces minus the mess. Isn’t that nice?!

Thank you for all your prayers and many kindnesses to us these past few weeks! You have blessed us beyond measure. We realize that God mercifully guided us through a difficult stretch of this trial, for which we are so thankful. He is also using each one of you to minister to us in so many tangible and beautiful ways.

Much love,

Marce