I saw my oncologist on Wednesday last week and we were finally in a position to decide what my next treatment would be.
I won’t go into the details regarding why it took a while for us to work out what the options were as it’s quite complicated. Suffice to say that on Friday night I started on my third line of treatment for the secondary breast cancer I was diagnosed with in Spring 2019. The other two lines each worked for around a year before the cancer – which has progressed but is still confined to my bones and my bone marrow – found a way of outwitting them. I’d be more than happy to get anything near a year with this treatment I’ve just started. As with any treatment, though, there’s no guarantee it will work at all.
The drugs I’m now on are everolimus (brand name Afinitor) and exemestane (Aromasin). They come in tablet form and I’ve to take one of each, once a day. One has to be taken with or after a meal, so I’ll take both after our evening meal. I will also still have Zometa, the bone-strengthening dug I have monthly via iv infusion.
One of the drugs can cause painful mouth sores so I’ve been given a mouth wash to use to help prevent the sores occurring or to alleviate the discomfort they’ll cause if they do occur.
I’d been off treatment since finishing my final cycle of capecitabine – the oral chemotherapy drug I’d been on – at the end of the first week of April. It’s a relief to be back on medication, even if the drugs I’m now taking come with a horribly long list of common side effects.
I have to admit that not being on any treatment freaked me out, at least initially. “Should I not start another round of capecitabine while we wait?”, I asked the consultant. No, she said, adding that there was little point in taking a drug that has essentially stopped working. “You’d get all the toxicity but none of the benefits.”
As for my new regimen, everolimus is a targeted therapy that blocks cancer growth . Exemestane is an oestrogen blocker. As I’ve explained before, the breast cancer I have is the most common type in that it thrives on oestrogen. Even when when post-menopausal, they still produce a certain amount of oestrogen.
Some of the potential side effects of these two new drugs are very common. Some are specific to everolimus and some to exemestane but I’ll just lump some of them together here: pneumonitis (inflammation of the lungs); mouth sores; taste changes; the usual increased risk of infection; muscle and/or joint pain; fatigue; feeling low; diarrhoea and/or constipation (go figure); liver and kidney dysfunction; sleep disruption; back pain; headaches; hot flushes; and pain, numbness and tingling in hands and fingers. And that’s just the ones classed as very common, which means they affect more than one in ten people taking them.
Of the above, I really wouldn’t notice the sleep disruption as I’m already sleeping badly as a result of the pain I have in my feet, a side effect of capecitabine and also of the chemo I had back in 2015 when I was being treated for primary breast cancer. I’d also been having some joint pain although this has eased off in recent days. To be honest, I also think I’ve been sleeping slightly better too (more on that below).
“I have a feeling that things are going to be tougher from here on in,” I said to the oncologist after I’d signed the consent form for everolimus and listened to her go through the potential side effects. She didn’t disagree but did say she hoped we could get to a place where I was “healthy and happy” on these two new drugs. Let’s hope we can. I honestly would never have thought I’d be so well (as it were) over the two years since my diagnosis. If we can somehow maintain some of that, great.
The next treatment after this one may well involve weekly iv chemo (it’s not quite weekly as you get every fourth week off). This would mean a massive change in terms of quality of life so there’s good reason to hope this latest regime keeps my cancer in check for a good long while.
I’ve seen a lot this past week of St George’s, the hospital in south west London where I’m being treated.
On Tuesday, I went to have blood taken for tests before seeing the consultant on Wednesday. If any of you have wondered what blood tests are done, take a look at what was ordered for me on one occasion recently.
Also on Wednesday, after seeing the consultant, I had a chest x-ray. Given that everolimus can affect your lungs, doing an x-ray now means they will have baseline images to compare with those from the chest x-ray I’ll have after my first 30-day cycle of everolimus and exemestane.
On Thursday, I popped in to pick up some painkillers from the pharmacy, together with some low-dose sleeping tablets. I’m extremely reluctant to take them but not being able to sleep despite taking strong painkillers is no laughing matter. I have so far only felt the need to take them once but I guess it’s good to know they’re there. There’s no point being a martyr about it.
On Friday, I went to pick up the new drugs I’m on; one of them wasn’t in stock when I’d been there earlier in the week. After that I went straight to the Dermatology Department to have two moles on the sole of my right foot and one of my right calf removed. It was done under local anaesthetic. I’m bandaged up nicely and I’d to “take it easy” and have my feet up for the first couple of days after the procedure. I can go on walks but I’ve not to do anything more strenuous than that for at least two weeks, depending on how the healing goes.
The dermatologist who did the procedure reiterated that they were removing the moles for precautionary measures and that they weren’t expecting to find anything nasty when it came to examining the removed tissue.
It’s been a pretty tough few weeks on the health front. On other fronts, though, things have been great. It’s like I’m living two parallel lives.
Work, for example, continues to be challenging and rewarding. Socially, I’ve played tennis and I’ve met up with lots of different sets of friends now that some of the pandemic-related restrictions have been lifted. We’re still not allowed to socialise indoors so we’ve met in pub beer gardens, in roof-top restaurants, in people’s own back gardens, in parks and in the countryside. Lots more gatherings are planned over the next few weeks. The next big thing will be going to visit and stay with friends and/or family around the country that I haven’t seen in ages once that’s allowed.
The weather’s been good.
We’ve done the planned mini revamp of our garden.
It’s Spring. Everything is in bloom and there are lots of baby birds at the pond on Tooting Common at the bottom of our road.
Friday was a beautiful day and I went on a short bike ride before going to the hospital.
I cycled to and around our four local “commons” – Streatham, Balham, Clapham and Wandsworth – to remind myself of how lucky we are to have these beautiful open green spaces so close at hand despite living in the busy capital.
Our boys were home from uni for a couple of weeks and seemed to be on good form – remarkable given the year they’ve had.
Their returning home was well timed as they – the younger one in particular – did the painting that was involved in the garden upgrade.
I’ve also had a haircut, using a voucher our sons gave me as a Christmas present. They bought it days before the latest lockdown that forced all hairdressers to close. They’ve only just re-opened. My hair hadn’t been that long for decades.
My husband continues to be amazing. I could not be more grateful.
Medically, I continue to be closely monitored. I have blood tests and a follow-up with the consultant in two weeks’ time, mid-way through the first cycle. Before then, though, I’m to have an MRI scan of my liver. The consultant wants to see whether anything suspect is happening there that might not have been picked up on the recent PET-CT scan I had.
Let’s see how it all goes. We have no other choice. In the meantime, we’ll get on with enjoying those parts of life over which we have some control.