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Started Rads to chest for SVCS
Hi my friends~
Thank you for keeping me lifted and focused while enduring the chaos of last week. After a very frank converstion with my new/old Rad Onc that involved a lot of negotiating, desperately trying to preserve any semblance of a normal Christmas, let alone the one I had planned, she said it was not safe for me to delay rads, take a break from rads after only a few treatments, and ultimately, it's not safe for me to fly as I'm already having symptoms of increased pressure in my head, neck & chest due to the SVCS. I was fighting so hard, and I could feel her trying to find a way to help me - help me have Christmas and help me stay safe. I finally said to her, through my tears, "Dr.G - I need to hear you tell me "No", because I'm going to keep negotiating with you, weighing the risks in my head and bargaining, even though I know what the wisest decision is." And she said, very calmly, "If you need to hear me say it, then the answer is "No." And in that moment my mind, that had been swirling with speculation and problem solving, chaos, frustration, anger and fear, instantly became quiet. Not resigned, but strangely relieved. Relieved that the responsibility for my health and safety was placed confidently in her hands. So I started 15 rounds of rads on Thursday. Today was 3 of 15, now a 3 day break for Christmas, then back on track. I was also able to talk to my IR who had done my chemo-embo in 2010. He confirmed that stenting was not the best option and that radiation was the best course of action, and that reponse to rads for this condition is pretty quick. He assured me that he would be available for the next week, but then would be away, and asked if I still had his cell (from when he gave it to me in 2010) and gave it to me again. He said he was available to me even while on vacation if I needed to ask a question. Now, that is the care, compassion, concern & experience that I am more familiar with than the dangerous combo of arrogance & inexperience in the young RadOnc (I call her Dr.Newbie) that I initially consulted with. Incidentally, my IR asked me "off the record" why I switched Rad Onc's and I told him in no uncertain terms why. I was also very clear with my Onc how unpleasant & inappropriate Dr.Newbie's "bed-side manner" was. She's got a lot to learn and at least I feel confident she's surrounded by a lot experts and wisdom, just hope she absorbs it - quickly. It was difficult to tell my family, knowing that not only were my plans to surprise my LA family on Christmas day annihilated, but their holiday would be twinged with sadness. I'm heartbroken over that. But, I have an amazing family, who immediately made changes in their travel plans to come and be with me for Christmas. My mom is going to stay through my radiation treatment. My sisters are coming in shifts, up to New Year's and then after, to celebrate my birthday. So with a plan in place, we press on. I'm even finding a way to participate in the hustle & bustle of Christmas, running to the mall after morning rads, and even taking a photo with Santa. He asked me what my Christmas wish was, and I told him "Health & happiness for my loved ones, and to be Cancer Free." Keeping the Faith~ Jessica Dx-5/17/02 - 33 yo; Stage IV - L IDC w/single liver met 1) Herceptin + Navelbine x 8 weeks - No response; progress to innumerable,immeasureable liver mets 2) ISIS 2504 + Herceptin - 6 mos, partial response 3) Taxol + Herceptin x 13 weeks to NED! NED for 1 year 9/04 - Single liver lesion recurrence Taxol + Herceptin - on/off to beat back lesion 12/05 - R Hepatectomy; Liver NED until 2009 3/06- Local recurrence - Left breast, IDC & DCIS, but holding treatment while continue to heal from Hepatectomy. 12/06 - L mastectomy + reconstruction through 8/07 10/07 - Recurrence - supraclav nodes 4) Gemzar + Herceptin - on/off controlling nodes thru 9/08 - 7wks Rads to supraclav nodes 10/08 - Acute Renal Failure - nodes in belly stricturing kidneys. placed permanent ureteral stents Back on Gemzar + Herceptin, but no longer responding. 5) 05/09 - Tykerb + Xeloda - partial response x 5 mos 6) 10/09 - Xeloda + Herceptin - no response, disease progresses 7) 2/10- Ixempra + Herceptin - partial response x 12 wks. Discovered single brain lesion x 4mm & liver lesions growing while screening for TDM1 + PI3Kinase study. 6/10 - Novalis to treat brain met - SUCCESSFUL! 8) 6/10 - Chemo-embo w/Adriamyacin to de-bulk liver lesion. 9) 8/10 - Screened & Started TDM1 EAP Immediate response, disease in belly responds dramatically. 2/11- questionable progression of lung nodules Discontinue TDM1 10) 3/11 - PI3Kinase + Herceptin - intial good response in 1st 6 weeks but LFT's elevated. 11) 7/11-Discontinue PI3Kinase + Herceptin study; Disease progression - 2 small lesions in colon – docs have never seen this before in BC 11) 8/11 –Start new combo Halaven+Herceptin 10/14/11 -Completed 3 cycles (9 wks)Halaven+Herceptin... 10/18/11 - Scanxiety time -1st scans since starting this regimen Good interval response, continue on H+H! 10/25/11 – new 2mm questionable spot in brain? Due to Novalis or new disease? Re-scan in 8 weeks. 1/3/12- Disease progression; 50%increase size & SUV-R lung, middle lobe 6cm lesion. R supraclav node multiple, miscellaneous nodes in belly. Colon lesions fired up. 12)Herceptin+ metronomic Cytoxan + Methotrexate. …on a hope & a prayer. Only chemo I haven’t been on is Taxotere. Hurry up Pertuzumab & TDM1! Follow Up Brain Scan on 1/18/12…pleasepleaseplease be okay. I can’t take much more. 1/18/2012- 8 new spots in 8 weeks since last Brain MRI one 2cm spot in brain stem, one 2cm spot in R temporal lobe. No symptoms, THANK GOD! 1/25/12 – Start WBR x 15 rounds 2/10/12 – Oral Cytoxan WORKING! Melted supraclav node & undetectable by US! 2/14/12 – FINISH 15 rounds WBR;) 6/12/12- Continuing on oral Methotrexate BID & Cytoxan qpm, but on chemo break for 3rd week due to low counts. 6/15/12 – Yay! Resume chemoJ 6/25/12 – Chemo break again due to low counts L 6/28/12 – PET Scan & Brain MRI this week… NED IS BACK!!! NED in the HEAD, NED in the BODY! 10/26/12 – Still NED in the HEAD, but single troublesome node in chest, precariously close to superior vena cava/heart. Not a perfect scan, but pretty darn good. Maintain current treatment and Echocardiogram on 11/1 to keep an eye on node.11/1/12 –echo shows normal cardiac function J & node non-threating, but experiencing symptoms of Superior Vena Cava Syndrome (obstruction/compression) 12/3 - hold cytoxan & methotrexate bc counts too low. 12/13-moved up PET scan due to increased SVC symptoms 12/14 –No more NEDL node progression causing increased SVC symptoms 12/17 – repeat echo & new chest mri for closer look… Radiation to chest node recommended, change of systemic treatment pending 12/20-started 15 rounds of rads to chest for SVCS |
Re: Started Rads to chest for SVCS
As I read your wonderful post - I was thinking -she experienced what our pastor means when he says "may you have the peace that passes all understanding". And how interesting it came to you with the word "No". It sounds like you will have a wonderful Christmas even while going through the treatments. You are amazingly strong and your faith is a blessing to us all.
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Re: Started Rads to chest for SVCS
o.k., you have a good plan now, good docs, know what to do and are doing it........and you have super cool family members who know how to go with the flow. I am relieved for it all. Although it may not be the Christmas you had planned it sounds like you will still get to be surrounded by loved ones/cherished ones..........and know that you are taking care of yourself medically. So, here is to a great (but different than expected) Christmas. You are amazing and so is your family!!! Merry Christmas and here is to a better and more peaceful New Year !
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Re: Started Rads to chest for SVCS
So happy that the uncertainty and stress of last week has moved on Jessica. And really pleased that you have found a way to be part of the Christmas madness as well - I'm sure that made you feel alive! I hope that your wish comes true and that you have a wonderful Christmas with your family, who obviously love you very much.
Best wishes, Marie |
Re: Started Rads to chest for SVCS
You have been, and continue to be an amazing beacon of hope and joy, my friend!
So happy you'll be able to get the treatment you need and still surround yourself with the love and care of those who cherish you most. God Bless you Jessica! Merry Christmas, and Happy New Year! Denise |
Re: Started Rads to chest for SVCS
What a wonderful family you have. They just turned their plans around to make sure you stay included! That is a great outcome and, from what you have said of your mom, she is a great helper. This is a gift you two can only give each other.
I like Bonnie's hubby's words of wisdom about the situation being smarter than we are at times. |
Re: Started Rads to chest for SVCS
Jessica,
What a wonderful story. Thanks for sharing! May you and your family have a wonderful Christmas! |
Re: Started Rads to chest for SVCS
My dear Jessica, I am glad there is a plan now of what treatment you need to follow, greater is that you will have your family around with you during this time of the year. God always put things in place. May you have a good holiday and enjoy your family visit.
Love always, Paty |
Re: Started Rads to chest for SVCS
That's great things are coming together for you and you've got a good plan and medical team. Have a wonderful time with your family!
Paula |
Re: Started Rads to chest for SVCS
Happy holidays to you and all your family - being together is really the only important thing at this time of year - Ii hope your 3 days off treatment and fun filled, joyous and restorative to carry on kicking butt!!
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Re: Started Rads to chest for SVCS
The peace and understanding that comes only from surrounding to God's will - what a great thing. Sounds like He's got other plans for Christmas for you. I bet you'll have a great time. Keep us posted. Still praying...
- Penny |
Re: Started Rads to chest for SVCS
Dear Jessica,
Only two more days till Christmas. I know you will have a wonderful one, filled with family and love. Very close countdown now.................! |
Re: Started Rads to chest for SVCS
Hey, Jessica, can you post your photo with Santa? I'd love to see that! In the meantime, please know that while I am sorry your trip had to be foregone, I am overjoyed to hear Christmas will happen for you. Nice to know you are so loved that your family is dropping all to head your way. Please let us know when you begin to feel a lessening of symptoms since you stated the rads have a tendency to produce quick results in your condition. Hoping you will feel less shortness of breath and pressure by year's end! You are one tough, brave cookie! I admire your pluck and determination.
A very Merry Christmas to you, Jessica, and warm wishes for a wonderful birthday! |
Re: Started Rads to chest for SVCS
Dear Jessica,
I am so happy that your family will be with you. Enjoy the holiday and have a wonderful birthday. I am proud that you asserted yourself with the new radiologist. Peace be with you. Take good care, Jackie |
Re: Started Rads to chest for SVCS
All the best to you for a successful outcome.
What a wonderful family to come and be with you for Christmas. You are blessed. Peace, hope and health in 2013. |
Re: Started Rads to chest for SVCS
Jessica,
I had awesome Christmas plans and was going to spend time in the Sierras with my family. My hubby had a dental emergency and boom - we couldn't go. He's neutropenic, and it scared the heck out of me. But he's tough like you Jessica and is healing up nicely. My sister went up without us, and my nephew and brother-in-law are having a blast with all the crazy amount of snow that is being dumped right now. We've been sending pics back and forth, and texts. It is the first Christmas we've been apart in many decades. I've got the 3 foot tree from Home Depot, the stocking up by the fireplace and the Christmas music playing non stop. So its not so bad. Ah . . . so I can totally relate to being disappointed about not being able to go. So glad you are not out here, the weather out here is crazy with the rain and snow. I love hearing your family is coming out to see you - so very cool! Ahhhh . . . shucks. I wish you were free of cancer too. And why can't you be? Let's all gang up on God and pray for it. Merry Christmas Jessica. May it be more than normal, may it be a magical, beautiful holiday. |
Re: Started Rads to chest for SVCS
don't know if this applies ie if you had a port and which side it was on vs where your problem is
I deduced they think your problem is from the bothersome node---just one more thing perhaps to think about if response to Rads is not what what they expect(Hopfully, it is!): http://www.dirjournal.org/pdf/DIREPUB_5781_online.pdf |
Re: Started Rads to chest for SVCS
Thank you again everyone. My mom and sister are here and we've had a nice cozy Christmas thus far. While they're here we're going to shop, eat my mom's cooking and I surprised them with tickets with the latest Cirque du Soleil that's in town. And I sprung for the seats 'close enough to see their faces' as I know my mom prefers.
And yes, the SVCS is the result of a once described 'troublesome node', now referred to as a 'significant mass' in my chest, compressing the superior vena cava & likely in contact with the right atrium of my heart. I do believe the symptoms are mildly improved, but I'm careful not to bend over as to lower my head below my heart, crouch or squat & sleep propped up. I now this treatment will work. I just know it. Just need a systemic therapy option as I'm not eligible for Pertuzumab & can't wait for TDM1. Hope everyone's enjoying a Happy Christmas~ Keep the faith! Jessica |
Re: Started Rads to chest for SVCS
Jessica,
I posted a reply ( or thought I had) a couple days ago but obviously forgot something! Too bad, I worked very hard on it and felt I was very eloquent in expressing my feelings about how YOU must be feeling. Lost in cyberspace... Anyway, what I wanted to say was I felt such relief for you when I read your post that I cried. It was like having an unshoulderable burden lifted from you. It is so hard to fight with so many options, so many"experts" and so much at stake. You are so very strong and full of life. When I get caught up in trying to over manage complicated treatment choices, I usually end up completely paralyzed by the over analysis and the feeling that there are actually no, or many, "right" answers. If I'm lucky, I remember I just need to surrender it, and my prayer is for wisdom for my caregiving team. You have a great team, who seem to be smart, on your side, and fully on board with you in this fight. You also have a great family who loves you and it sounds like you are having a special Christmas, if not the one you had planned. Much love to you my friend, Chris |
Re: Started Rads to chest for SVCS
Hi Jessica,
How are you doing? Give us an update if you have time. K |
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