Medical update No. 5

We had a meeting today (Tuesday 24th March) with Jen's oncologist, a breast surgeon and a radiation oncologist. The one clear outcome is that Jen's chemotherapy is over for the time being. In this last treatment cycle, the peripheral neuropathy in Jen's feet has become more painful, and persisted right to the end of the three week cycle. She has been walking slowly and with difficulty. Our oncologist took that as a clear sign that Jen should stop now, since the neuropathy would only get worse with another chemo cycle, and increase the risk of permanent damage.

Not having chemo therapy tomorrow (Wednesday) feels a bit like having an exam cancelled just before you're about to sit it (if you don't like exams, that is). In another way we were hoping to continue with the chemotherapy and so perhaps shrink the tumours further, but there's no consensus about the additional benefit of another cycle when the response has already been good.

The discussion about surgical options hasn't reached any definite conclusion as yet. More scans (PET and MRI) are being scheduled to get a better picture of the current state of the tumours, especially the lymph nodes. The breast surgeon was concerned about whether the lymph nodes could be removed cleanly without affecting the veins,and suggested that radiation might be a better option. In a separate consultation, the radiation oncologist suggested that surgery might be a better option, or even doing nothing. The main focus in any case is about "local control" i.e. controlling the damage that the tumours might do locally at a later stage. There is controversy in the medical literature about whether a mastectomy at this stage improves overall survival, but it seems not to apply in cases like Jen's (liver metastases and triple negative). We meet the specialists again on the Tuesday after Easter for further discussions. It would be reassuring if they could agree on a course of action.

Our hope at present is that surgery or radiotherapy would take place in April-May. Our rough plan at the moment is to have an extended holiday sometime in July-September. and we need Jen to be recovered fully from treatment before that can happen.