A stark reminder that you can never relax

The results from the PET-CT scan I had at the beginning of this month could have been a lot worse but they did not bring the across-the-board good news we were hoping for.

Everything had been pointing to a positive overall response to the treatment I started in May for secondary breast cancer. However, the scan results showed that there has been some growth in the cancer that’s in my spine.

The level of growth is not enough to necessitate an immediate change in core treatment but I’m aware this could now happen sooner rather than later.

The results from the MRI scan I had yesterday will provide additional information that will help inform near-future treatment decisions. We’ll also be looking very closely at next month’s blood test results and I’m to have a repeat PET-CT scan in two months’ time.

I wasn’t surprised by the results; nothing surprises me with this, good or bad. I’m not freaking out but I am hugely disappointed.

We had hoped that the drugs were keeping everything under control. Rather, it turns out I’m having a varied response to treatment. Some aspects of the cancer are responding differently from others. While this is not usual, it’s also not hugely unusual.

I’d been having blood tests every month since starting treatment for the breast cancer that had spread or metastasised to my bones (the main focus is certain vertebrae in my spine) and bone marrow. We knew from the results that the drugs were working really well on the bone marrow front. We’d even postponed the PET-CT scan – my first since I was diagnosed – by a couple of months because things were looking so good. There had been some twitches here and there in my back in recent weeks but nothing approaching what I’d describe as pain.

The good news is that there’s no sign the cancer has spread anywhere else and my bone marrow function continues to improve. And so I continue on my current treatment.

Of potential significance is the fact that the latest blood test results showed that a tumour marker specific to secondary breast cancer is very slightly up. It’s fallen every month since I started treatment. While the rise is within acceptable limits, if it contines to rise – and depending on scan results – we’ll potentially be looking at calling it a day on the drugs I’m on and moving to the next line of treatment.

More positively, other tumour markers are continuing to fall.

There has been one change to treatment. “Bone mets” weakens your bones and puts you at risk of “skeletal related events” such as fracture, radiotherapy or surgery, or spinal cord compression. 

I was on a bone strengthening drug called zoledronic acid or Zometa that was aimed at preventing these SREs.  I’ve come off Zometa and have moved to a different drug – denosumab (Xgeva) – that is designed to do the same thing but in a different way. The two core drugs – fulvestrant (Faslodex) and abemaciclib (Verzenios) – haven’t changed. Treatment is on a monthly cycle; I went ahead with round #7 last week.

In other news, I’m still running, edging closer by the week to my 100th Parkrun, the free, volunteer-led 5k running event that takes place in parks up and down the country every Saturday morning. Just last weekend, visiting my family in Glasgow, I ticked off number 94. I ran with two of my brothers and a niece and nephew.

It’s taking some time to get my head round this latest development. Things had been going so well that I’d allowed myself to start looking further ahead than just one or two months. After this turn of events, it’s very much back to one month at a time.

So, a stark reminder that no matter how well you think things are going, with this disease you cannot take anything for granted. As I’ve said before, we can but take things as they come.

In the meantime, on we go. For now,  that involves a ten-day holiday in Israel and Jordan for my other half and me. It was have to been 14 days but we changed our outward flight to accommodate the MRI appointment and are leaving a few days later than planned. We fly out later today. An adventure awaits.