It's week 13 since diagnosis and Kathy's will receive the 7th cycle of chemotherapy tomorrow. (3rd cycle of Taxol)
Kathy's hematocrit continues to trend downward (from 42 at diagnosis to 29 last week), her nails have turned black/brittle, and her eyelashes have disappeared, but the worst is over. She's feeling fine, the tumor is undetectable, and she's tolerating Taxol very well.
Taxol typically does not cause a drop in hematocrit, so why the gradual downward trend over the past few weeks?
Kathy received Neulasta as part of her 4 cycles of Adriamycin/Cytoxan. Neulasta is a colony-stimulating factor that encourages hemopoietic stem cells to produce white blood cells, avoiding the neutropenia and susceptibility to infection that was previously a serious problem with chemotherapy. One issue with Neulasta is that it may encourage so many stem cells to differentiate into white blood cells that fewer red blood cells are produced, leading to a mild anemia. Over the next few weeks, her bone marrow should return to normal and her hematocrit should rise. The only consequence of a low hematocrit for Kathy has waning energy mid-day that necessitates a 15 minute nap. Otherwise, her activities of daily living (including packing the house for our upcoming move) remain unchanged.
Her hair is beginning to grow back. She wears head wraps for warmth around the house and while sleeping. When we go out to dinner, she wears a wig (interestedly termed a "hair protheses" for reimbursement purposes) that is so attractive, her friends and family have grown accustomed to the style. When her hair grows back, she'll likely get the same cut.
One unexpected consequence of having breast cancer is that Kathy has stopped eating Tofu and soy products that are estrogenic, given that her tumor is Estrogen Receptor positive and is "fueled" by estrogen. Minimizing estrogenic foods seems reasonable. She continues to get her protein from vegetable sources, but has also added eggs - remaining vegetarian but not vegan. Given that we'll soon have a coop of chickens on our new farm property, having at least one person in the family who eats eggs makes sense.
Thus, her trajectory is positive, her clinicians are optimistic, and we're pressing forward with life, balancing the needs of our personal lives, family lives, and work lives. We're in control, not the cancer.
Thursday, March 15, 2012
Our Cancer Journey Week 13
Posted by John Halamka at 3:00 AM
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Hi Dr. Halamka.
Nice to hear that Kathy is keeping a positive attitude during this battle.
Kathy and you are stronger than cancer, and the amazing perspective that both of you have is powerful and magical.
I just admire you both.
Thanks for sharing Kathy's cancer journey. I look forward to each installment and I am relieved to hear that the treatment seems to be working.
I look forward to hearing you speak in vancouver in May and perhaps even getting to meet you.
I have been away for a few weeks, and nervously checked in this AM to see how you guys are doing (we've never met, but I am a reader of the blog). Really great way to start my day knowing the worst is behind you and you're in control of the demon. I admire your bravery and openness- I imagine your ordeal will be immensely helpful and inspirational to others who need to mount a similar battle. Cheers. Dave S.
Anne and I have been closely following your blog and are so pleased with Kathy's progress. Our prayers are with you daily.
Our prayers are with your family, John. My wife is also a breast cancer surviver. Ten years out now and no regression. Life is normal, though she also avoids certain estrogen creating foods like soy.
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