MBC Diary

MBC stands for Metastatic Breast Cancer which is breast cancer that has traveled to other parts of the body. The breast cancer that we thought was conquored in 2015 has returned. This time on the surfaces of my bones. The following is a journal of what I am going through on this second part of my cancer journey. My original journey can still be read here in my Cancer Diary.

(The earlier entries are found on the bottom of this page. Current entries are at the top.)

09/19/19

Well, I've had 2 weeks off of chemo and managed to regain a good deal of my strength back as well as fingernails. I've had 2 treatments since with no further complications. My heart rate has had a couple of irregular days. But we're watching them closely. The one thing I am finding difficult this time around is keeping emotions in check. For the first time since I was diagnosed in 2014 I finally have had a breakdown. I find myself getting very upset and even crying. I guess that is exceptable. I mean people have expected me to have done this back when I first learned I had cancer. Funny it should come so many years later. I guess it took myself being very physically run down to tap into the emotions. As time continues on this journey, it is harder to keep positive without some help. My husband helps me tremendously as do my parents. My mother takes me to my infusions every week and keeps me company for 3 hours. Our chats help keep my positive. Distractions also keep my mind from getting depressed. Getting out to work on craft projects for charity events or having an art student drop by for classes gives my brain something to focus on other than my pain. My newest distraction will be trying to regain some strength and endourance in my walking. I will be doing the Rays of Hope Walk this October 27. It is a 5 mile walk. Right now I struggle to go 1 mile. Good thing they have a 2 mile short cut on the walk. I am shooting to be able to do the 2 mile walk but would love to be able to make it the entire 5 miles. It would be a great boost of positivity considering just this past winter I was bed bound and in a wheel chair. If you would like to encourage me on my goal, please donate to the Rays of Hope on my donation site. A bigger boost still would be to have you walk with me on the 27th! Hope to see you there!

8/30/19

When I last met with my oncologist, my fingernails were starting to be quite sore. Not the fingertips mind you. If the tips were hurting or losing feeling all together, then chemo induced neuropothy would be setting in. I'm all right there so far. In 2015 I did have 2 of my toe pads go numb. This pain in my nails is nothing like that. My nails have become brittle and painful. Using them is difficult. If you ever broke a nail down below the tip, then you know the pain I refer to. I have a bruising developing under the plate. Touching anything with the fingertips is painful. Since I was able to skip chemotherapy this week, the nails are feeling better. But the worse of them, (the middle fingers) are still pretty bad. I get next week's infusion off as well. So maybe all of my nails will feel better before I return from my 'vacation' and start up on the Taxol again. Until then, I just have to be gentile using my nails so as not to bruise them further.

8/21/19

KEEP HYDRATED!!!! We are all about drinking water in our house. So it came as quite the surprise when I found myself in an ambulance heading to the Emergency Room for dehydration. I guess there was a perfect storm of mini events that went unnoticed but eventually compounded into something big. It's Summer hot and humid. Don't want to eat much - and therefore not taking in fluids at a meal. Humidity makes you not realise how much you sweat out fluids. I'm drinking to ease my belly after chemo. But the drugs make me tired. Can't drink when you are sleeping all the time. Day after day of missing little water sipped here and there adds up. Sunday, my heart started to race randomly with the Innoppropriate Synus Tachycardia I have. I could not get it under control. So by Monday morning, I felt cold and clammy and weak. I almost passed out. I went into the Cancer Center for hydration and a check up. But since we could not get my heart down out of 160s -170s, they had to send me to the ER. I was there for about 12 hours trying to find out what was wrong and why the usual tricks were not working. After almost 4 bags of liquids over this period, my heart finally regulated its beats. I passed my tests and was allowed to go home. It was a scary time. I was shocked to be so dehydrated. But the good of it all is that I now know to keep track of the little things and don't let problems compound. Water is really a miracle drug. Keep drinking it, my friends!!!

08/13/19

Quite a bit has been happening lately. My hair did fall out again from the Taxol. But at least the low dose is easier to handle this time around. I am sluggish and find it hard to eat, but this time last time my mouth was full of sores and systs lined my eyes. I'm happy with where I am. Expecially since the Taxol is working at stopping the progressing of the cancer. Every time I had a scan done of my bones, the disease appeared in new locations. Not only did it spread over my entire hip area, but it moved into the ribs, collar bones, shoulders, neck, and even on my skull. I have to admit, I was starting to get scared at how rapidly the cancer was spreading. But after doing a couple weeks of Taxol, we went in for a new scan. This time, the disease did not show any new progression. I actually teared up at the news and partied with a hot fudge sunday. 

     The reason the cancer was spreading so much in the past scans was because it had mutated to where it resists treatment and enhances spread of disease. This mutation is known as PIK3CA. We found out about the mutation when we had the bio-marker testing done on my biopsy samples. The Ibrance / Letrozole does not work on cancer with this mutation so we will not be going back on that after chemo is done. Fortunately, there is a medication that will attack this specific mutation. The government approved it only this past May! Talk about little well timed miracles! We will begin this medication (2 pills) after chemo finishes in September.

     My husband and I met with specialists on this PIK3CA mutation at the Dana Farber Cancer Institute in Boston. We learned about the mutation and treatments available. The specialists confirmed that the path my oncologist has me on is the right one. They also will be keeping my oncologist updated with any new information discovered on the mutation and its treatments.

     So, knowing the current scans show no new progression of disease and that there is a drug made to fight my specific mutation, I am feeling stronger about moving forward. We can not cure the cancer. It will be a fight for the rest of my life. But if we can keep ahead of this spread with the new medications, that life will be longer than I hoped for. 

07/03/19

Fireworks are flying this Forth of July. Scans have shown that my cancer is still spreading. The Ibrance has not been able to get ahead of the disease. So, I'm back on chemotherapy drips. Once a week I head in for an infusion of Taxol. I had this at the start back in 2014-15. But this is a much lower dose. We're hoping this will help us get ahead of the cancer. If we can stop it well enough to slow progression down where we can move faster killing the cancer than the cancer killing bone, then we'll go back on to the Ibrance. We have submitted my biopsy samples to a lab that will analize my specific cancer. A coctail of mediction will be created specificlly based on my disease. This will help us dramaticlly with our battle. Once we have this cocktail, we'll stop the chemo and do the specific meds. For now, we have stopped the Ibrance and Letrozole while we do the Taxol. It's day 14 of Taxol today and my hair has not yet fallen out as per normal dose. The low dose I'm on may not drop my hair. The Ibrance was making me shed quite a bit. That has stopped with the medication. So my head is happy. We'll take more scans in a couple of months to see if we're stopping the spread or not. I'll have to try to stay awake during the week while on chemo. When we switch to the personalised cocktail, I'll check back in here.

3/9/19

So, let’s sum up how I got to where I am now:

I stopped taking Tamoxifen when that drug started taxing my liver functions. The Type2 Diabetes I developed on this drug stopped immediately after the Tamoxifen left my system. My A1C numbers dropped from 'definitely diabetic' to 'nowhere near pre-diabetic’ normal. They have not risen since then. Tamoxifen was replaced with Anastrozole.This medication cramped my joints and gradually gave me muscle pain from head to toe. I put up with the side effect for about a year. When the cramping and pain grew to be constant and too much to handle, my Oncologist let me stop that medication. After 3 weeks of horrible withdrawals, all of my joint and muscle cramping and pain disappeared. That is, all went away but some severe pain centered in my right hip. My Oncologist suspected that this was not related to the Anastrozole and began a series of tests. These tests proved that my breast cancer returned and was eating away at my bones. I had a small lesion on my T1 spine, on 2 of my lower right ribs, 2 on my left hip, one on my center top and bottom hip bones, and a small bit on the right femur at the joint. The massive pain was coming from the entire right hip bone being covered in lesions. 
 
While going through the testing period, the hip pain continued to grow until I could no longer put any weight on the leg nor move without help. No pain medication seemed to work. I was losing sleep and having trouble focusing. I was bed bound. Finally, we found a pill that helped enough to let me sleep at night, but did not entirely manage all of the pain. We did 2 weeks of radiation focused on the right hip. At the beginning of radiation, I could not lay flat on the table because of the intense pain. By the end of the sessions, I could lie still and felt most of the pain in the central and left hip disappear. The radiation killed the cancer cells it was zapping. Unfortunately, the right hip was still unbelievably painful. We began physical therapy to strengthen the area weakened from a year of limping. The PT helped heal the rest of the aches and pains and get the right hip pain under control. I still feel like one particular spot in the right hip as not healing at all. My Oncologist has begun a series of more scan to see if something else could be wrong on top of the cancer. 
 
So that is where we are. Continuing scans to see if something was missed. PT is going well. I am regaining strength in my legs. I can walk with a walker but can not do stairs. Pain is under control with medication and diet. And my cancer? We began a series of new medications to kill and prevent cancer from growing. I take Letrozole on a daily basis. With that, I take Ibrance. To begin with, we took the largest dose for 3 weeks. Then we were suppose to take one week off before restarting the next 3 weeks of Ibrance. We test my blood every other week to make sure this drug isn’t causing any problems. Unfortunately, my white blood cell count dropped very low. We had to stop and wait until my counts returned to normal. When they do, we will try a smaller dosage for the 3 week on - 1 week off routine. We will see how my blood counts go as we continue. We may need to try different schedules for this drug until we find just the right dosage and routine that fits me. The Ibrance / Letrozole will fight my cancer and keep it from spreading anywhere else. This will be my ‘new normal’ for the rest of my life.
 
Anything I missed? Oh, yes. One more thing. Since my MBC is attacking my bones, we need to help strengthen and restore them. I will be going in once every 3 months for an infusion of medication that will draw calcium from my blood and focus it on the bones that need help. I already had one infusion. It went fine that day. But I awoke the following morning with a fever and severe chills. This lasted only a day. Nausea and a lack of appetite lasted 4 days. It could have been a reaction to the infusion. It could have been something I caught at the hospital. It could be my body having trouble starting both this infusion and the Ibrance at the same time. We’ll see how it goes when I go back in for the second dose. Until then, I am eating tons of prunes to keep up with the side effects of intense pain medication. Working out with hopes of being mobile again - or at lease be able to get out of bed without using a leg lifter tool. I’ll write again when the new tests are compete and we can see if I have anything new wrong or just a really long road of PT recovery. Thanks for putting up with this novel of an update. Keep healthy!

3/4/19

After 2 weeks of radiation on my right hip and a new medication, I do notice a difference in health. Most of my pain has lessened and even been eliminated. The only pain I have left is in one particular area of my right hip. The spot that has been the greatest pain right from the start is still bothering me just as much as it has from the beginning. My oncologist believes that this spot is something other than the MBC. If it was part of the cancer lesions, the pain would have gone down with the rest of the troubles. We are starting new tests to see what can be the problem. I am looking forward to finding out what this problem is so we can treat it properly and, in turn, eliminate the pain as we did with the others. Fingers are crossed that whatever the problem is, it can be easily fixed. I would love to be able to be mobile again. My niece has asked me to go see her new college in April. I am shooting to be able to walk by then. I am determined to be able to enjoy this experience with my niece. (FYI: During January and February I lost my ability to walk and could not get myself out of bed. With therapy, I am able to get into a stroller (walker with a seat) or a travel wheel chair (for distances). 

1/26/19

I had a follow up with my Oncologist and wanted to pass along what we learned.

 

First off: I had a full body CT scan to see if the BC had metastasized anywhere else. Good news! No new bits were found! Yay!

 

The new pain medicine we switched to is working. I still have tremendous pain and can not put weight on my right hip. But the new medicine combined with a steroid is helping me to control it. Hopefully, after 2 weeks of radiation, the rest of the pain will go away so we can gradually ease off these pills. It will probably take longer than the 2 weeks for that to settle in completely.

 

So as far as what is actually wrong (aka what is Breast Cancer that has metastasized in the bone):

Originally, I thought it was like what we had in the breast ; a tumor that gets shrunk until it is a size that can be removed. Not so. It is lesions - not tumors - that are basically cancer bits that are eating away at the bone making tiny holes. The radiation isn’t for shrinking - it’s for killing. It will kill the cancer which in turn will take away the pain the buggers are causing.

Some pain could also be from thin cracks starting in the bone where those lesions weakened the structure. When radiation is done, I will recuperate for a bit then begin a treatment for healing and strengthening the bone. That will be a drip I go in for once every 3 months until it looks like we can stop.

We are zapping only the right hip where there is the largest mass of lesions for fast relief. The tiny ones scattered on the central and left areas of the hip will be killed with the new cancer medicine I am now taking. (2 different pills - no going in for chemo drips this time. Radiation isn’t something one wants zapped when you can treat things with safer methods.)

After radiation is done, I will meet with a specialist who will start me on another new medicine that will keep future MBC from forming.

I will also be starting physical therapy in about 3 weeks to get this hip back into shape.

 

So it sounds like a lot, but I am feeling confident with this explanation. As long as I am careful with my hip bone health and don’t do any Irish step dancing or rock climbing, I should have no problem getting back to normal. So, ….Yay.

1/16/19

Well. Results are confirmed. I have Metastatic Breast Cancer located in my hip. I go in for a head-to-toe P.E.T. scan tonight to see if the MBC has spread anywhere else. We start radiation treatment on the largest area on the hip to shrink it down. Hopefully, shrinking will take away the pain and allow me to move again. My shoulders would greatly appreciate that! They hurt having to lift my big butt everywhere. LOL 

Thanks to my husband who helps me in and out of bed and waits patiently as I try to use stairs. Having an ocupational therapist as a husband is very handy right now. :) 

I received a Handicapped Parking Plackard and a ramp is being installed from the front door. I feel old. But not old enough, I guess. I am too young to qualify for many free services. We'll have to look into how to afford all the things I will eventually need as I lose more mobility. 

 

1/8/19

When I visited my Oncologist after coming off the Anastrozole she looked at my hip pain and said that it was not from the medication but something else. After a Bone Density Scan and an MRI, we see it definitely is something else. We are waiting on results from a biopsy, but first impression looks like it is Metastatic Breast Cancer.

 

The pain in my hip has grown to a point where I can not put weight on the right hip. I am using a walker to move about. But it is with great pain and effort. I had a fall on Sunday that aggrivated my shoulder muscle. So now, I can not use that arm to take weight off that side of the hip when I move. I'm not sure the pain medication is working, but I don't want to stop it to see if I am right in case I am wrong. This week, I am waiting for the results of the biopsy we had on Monday by resting my arm and hip. Praying for the best results to come in.

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