Medical update No. 3

On Wednesday 11/2/09 we saw Jen's oncologist again before chemo. She's pleased with the scan results from January, and is keen to continue with this chemo. She says she hasn't had anyone go past 8 cycles of this chemo, and that would take us to late May. Next scans are scheduled for March 3rd at the end of cycle 4. At an abstract level, we are also keen to keep going in the hope that the tumours will shrink more, but at the everyday level it's daunting to think we might only be half-way through - a price Jen is paying in the present for the sake of the future.

Apart from the pain, fatigue, nausea and general dread, one of the difficult side-effects of this chemo (gemcitabine and paclitaxel) is peripheral neuropathy - loss of sensation in hands and feet. It will most likely worsen as the number of cycles increases. There's a risk that the damage could be permanent, and would affect walking and manual dexterity (e.g. doing up buttons). So far the symptoms have come and gone a bit, which is a good sign. The worrying stage (apparently) is when you start to lose sensation progressively further up your limbs.

We had a partial answer on surgical options after chemo. Jen will probably see a breast surgeon after cycle 5 (late March) to discuss this. The focus at the moment is on surgery on the primary to deal with local issues. The obvious one is the lymph glands, which were causing pain in Jen's left arm at the time of diagnosis. It would be better to try and deal with this when the tumours have been reduced as much as possible. Some researchers think that removing the primary tumour can affect the secondaries and improve overall survival. In some cancers (e.g. involving the kidneys) it has been shown that there is some "communication" between the primary and secondaries, but this is controversial for breast cancer. We'll have to do some reading on recent findings in this area.