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Update on my lung
As you know, I had radiation treatment to the cancer in the lower lobe of my right lung. My last session was October 3. At the time the radiation oncologist said if I get a scan for any other reason before December 3 or so, we should ignore the right lower lung. She also told me I might develop radiation pneumonitis, an inflammation of the lung that can look like pneumonia.
I've been on Kadcyla since June. First I tried using Tykerb with it, but that was far too toxic for me, so we dropped the Tykerb. For one reason or another--the pneumonia, the radiation therapy, seeing just the NP and not my oncologist for about the last 10 weeks--I've never had a scan to see what's going on with the Kadcyla. I'm tolerating it well, and I feel good.
Starting just over a week ago I noticed I was having a terrible time catching my breath on the slightest exertion. And the aching/diffuse pain I've felt off and on in the right side of my back is getting a bit more intense. Yesterday I saw my medical oncologist and she asked me about my breathing. I told her about shortness of breath on exertion. She listened to my lungs and didn't hear any breath sounds in the lower right lung. They tested my O2 saturation (which they don't routinely do), both resting and walking around. It was a little low, especially while I was walking. There was talk of ordering supplemental oxygen. Resting was 91. While walking it dipped down to 88.
I bought my own little pulse/ox gizmo ($40 at Walgreen's) and my results are the same. I got a high of 98 this morning while sitting up in bed drinking coffee. When I move around and do things it's around 87.
My medical oncologist said I should get a PET/CT next Friday and come see her the following Monday. It's probably a good idea to look at the other lung, my upper chest, and that one spine met, and see if there are any new lesions. But, if that's all OK (and even if it's not) I'm thinking I might need treatment for pneumonitis (steroids--yuck.) I do hate what steroids do to my mind and body, but of course I'm willing to be ravenously hungry and prone to "roid rage" in the interest of preventing permanent lung damage. I sent the radiation oncologist a heads up about my scan, and I will ask them to send her the report.
So stay tuned, folks. I still think the local treatment was a good idea and hope to get the other lung done if Kadcyla hasn't knocked it back. I think this is just a bump in the road. I hope so, anyway.
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Amy
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4/19/11 Diagnosed invasive ductal carcinoma in left breast; 2.3 cm tumor, 1 axillary lymph node, weakly ER+, HER2+++
4/29/11 CT scan shows suspicious lesions on liver and lungs
5/17/11 liver biopsy
5/24/11 liver met confirmed--Stage IV at diagnosis
5/27/11 Begin weekly Taxol & Herceptin for 3 months (standard of care at the time of my DX)
7/18/11 Switch to weekly Abraxane & Herceptin due to Taxol allergy
8/29/11 CT scan shows no new lesions & old lesions shrinking
9/27/11 Finish Abraxane. Start Herceptin every 3 weeks. Begin taking Arimidex
10/17/11--Brain MRI--No Brain mets
12/5/11 PET scan--Almost NED
5/15/12 PET scan shows progression-breast/chest/spine (one vertebra)
5/22/12 Stop taking Arimidex; stay on Herceptin
6/11/12 Started Tykerb and Herceptin on clinical trial (w/no chemo)
9/24/12 CT scan--No new mets. Everything stable.
3/11/13 CT Scan--two small new possible mets and odd looking area in left lung getting larger.
4/2/13--Biopsy of suspicious area in lower left lung. Mets to lung confirmed.
4/30/13 Begin Kadcyla/TDM-1
8/16/13 PET scan "mixed," with some areas of increased uptake, but also some definite improvement, so I'll stay on TDM-1/Kadcyla.
11/11/13 Finally get hormone receptor results from lung biopsy of 4/2/13. My cancer is no longer ER positive.
11/13/13 PET scan mixed results again. We're calling it "stable." Problems breathing on exertion.
2/18/14 PET scan shows a new lesion and newly active lymph node in chest, other progression. Bye bye TDM-1.
2/28/14 Begin Herceptin/Perjeta every 3 weeks.
6/8/14 PET "mixed," with no new lesions, and everything but lower lungs improving. My breathing is better.
8/18/14 PET "mixed" again. Upper lungs & one spine met stable, lower lungs less FDG avid, original tumor more avid, one lymph node in mediastinum more avid.
9/1/14 Begin taking Xeloda one week on, one week off. Will also stay on Herceptin and Perjeta every three weeks.
12/11/14 PET Scan--no new lesions, and everything looks better than it did.
3/20/15 PET Scan--no new lesions, but lower lung lesions larger and a bit more avid.
4/13/15 Increasing Xeloda dose to 10 days on, one week off.
7/1/15 Scan "mixed" again, but suggests continuing progression. Stop Xeloda. Substitute Abraxane every 3 weeks starting 7/13.
10/28/15 PET scan shows dramatic improvement everywhere. All lesions except lower lungs have resolved; lower lungs noticeably improved.
12/18/15 Last Abraxane. Continue on Herceptin and Perjeta alone beginning 1/8/16.
1/27/16 PET scan shows cancer is stable.
5/11/16 PET scan shows uptake in some areas that were resolved on the last two scans.
6/3/16 Begin Kadcyla and Tykerb combination
6/5 - 6/23 Horrible diarrhea from K&T together. Got pneumonia.
7/15/16 Begin Kadcyla only every 3 weeks.
9/6/16 Begin radiation therapy on right lung lesion that caused the pneumonia.
10/3/16 Last of 12 radiation treatments to right lung.
11/4/16 Huffing and puffing, low O2, high heart rate, on tiniest bit of exertion. Diagnosed as radiation pneumonitis. Treated with Prednisone.
11/11/16 PET scan shows significant improvement to radiated part of right lung BUT a bunch of new lung lesions, and the bone met is getting worse.
11/22/16 Begin Eribulin and Herceptin. H every 3 weeks. E two weeks on, one week off.
3/6/17 Scan shows progression in lungs. Bone met a little better.
3/23/17 Lung biopsy. Tumor sampled is ER-, PR+ (5%), HER2+++. Getting Herceptin and Perjeta as a maintenance treatment.
5/31/17 Port placement
6/1/17 Start Navelbine & Tykerb
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