After a long run of bad news, we finally have some better news. The last scans on Monday 19th January show that the current chemotherapy is working, and that the tumours have reduced in size.
In more detail, the four tumours on Jen's liver are still there, but
have shrunk quite significantly. At the previous scan in early December, the largest of these tumours was 2.6cm x 1.4 cm, whereas now all the tumours are less than 1.0 cm diameter (by comparison, in the scans in September there was one tumour visible of about 1.8 cm diameter). The lymph nodes under Jen's left arm are also reduced: in December the largest was 5cm x 3cm x 2cm, whereas now it is 3cm x 2 cm. For a few weeks now Jen has noticed that the primary tumour in the left breast has felt a lot smaller, and our oncologist was quite pleased with this two weeks ago. In the scans this is harder to define because of other fibrous tissue that complicates the ultrasound interpretation, but the conclusion is that the tumour is smaller and "more ill-defined".
It's good to know the current chemotherapy is working, as the side effects have been more unpleasant in the last cycle. Early on it was vomiting and diarrhoea, joint pain and fatigue. Later in the cycle it was a constant tingling in the feet and hands, and pain in the hands. In the current cycle (which started Wednesday 21st Jan), Jen had intravenous anti-nausea drugs before the chemo drugs, and this has so far stopped the nausea and vomiting. However it's still hard to get the balance of the drugs, since they all have their side effects e.g. the steroids cause Jen to eat more and put on weight.
Looking ahead a short distance, the most likely scenario is to have 6-8 cycles of the current chemotherapy (gemcitabine and paclitaxel), with repeat scans to assess the tumours.That will take us to April or May. In 5-10% of cases the tumours can shrink almost entirely, but it's more likely that the shrinkage will stop at some point. When the chemotherapy is over we'll consider the possible surgical options. After some period of time the tumours will most likely start to grow again, and at that point we'll start on another chemotherapy regime. That period, the "time to progression" is quite uncertain. The median time is about 7-9 months, but that's only half the story. For about 20% of people it could be less than 5 months, while at the other end, for 20% of people it could be more than 18 months (this doesn't take account of the fact that the tumour cells are "triple negative", which unfortunately reduce these times). In summary, don't get too fixated on one number.
In more detail, the four tumours on Jen's liver are still there, but
have shrunk quite significantly. At the previous scan in early December, the largest of these tumours was 2.6cm x 1.4 cm, whereas now all the tumours are less than 1.0 cm diameter (by comparison, in the scans in September there was one tumour visible of about 1.8 cm diameter). The lymph nodes under Jen's left arm are also reduced: in December the largest was 5cm x 3cm x 2cm, whereas now it is 3cm x 2 cm. For a few weeks now Jen has noticed that the primary tumour in the left breast has felt a lot smaller, and our oncologist was quite pleased with this two weeks ago. In the scans this is harder to define because of other fibrous tissue that complicates the ultrasound interpretation, but the conclusion is that the tumour is smaller and "more ill-defined".
It's good to know the current chemotherapy is working, as the side effects have been more unpleasant in the last cycle. Early on it was vomiting and diarrhoea, joint pain and fatigue. Later in the cycle it was a constant tingling in the feet and hands, and pain in the hands. In the current cycle (which started Wednesday 21st Jan), Jen had intravenous anti-nausea drugs before the chemo drugs, and this has so far stopped the nausea and vomiting. However it's still hard to get the balance of the drugs, since they all have their side effects e.g. the steroids cause Jen to eat more and put on weight.
Looking ahead a short distance, the most likely scenario is to have 6-8 cycles of the current chemotherapy (gemcitabine and paclitaxel), with repeat scans to assess the tumours.That will take us to April or May. In 5-10% of cases the tumours can shrink almost entirely, but it's more likely that the shrinkage will stop at some point. When the chemotherapy is over we'll consider the possible surgical options. After some period of time the tumours will most likely start to grow again, and at that point we'll start on another chemotherapy regime. That period, the "time to progression" is quite uncertain. The median time is about 7-9 months, but that's only half the story. For about 20% of people it could be less than 5 months, while at the other end, for 20% of people it could be more than 18 months (this doesn't take account of the fact that the tumour cells are "triple negative", which unfortunately reduce these times). In summary, don't get too fixated on one number.
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