Feb 15, 2012 - 3:23 pm
I met with my gyn-onc yesterday and had long discussion reviewing all possible scenarios for addressing disease progression. My situation is a little more unique in that I have had 2 primary cancers that could be involved, singly or a combo. The only way to know for sure would be to biopsy everything. Not really practical. It’s 2 years since I stopped taking Femara to control breast ca. The breast ca at the time ('99) of my recurrence, disease was extensive, not optimally resected, treated with radiation and tamoxifen then changed to Femara after I developed significant uterine polyps and bleeding. In 2010, while dealing with UPSC recurrence with chemotherapy, I opted to discontinue Femara – and have been thrilled to lose all that awful weight gain I had with it and have been enjoying being ‘normal’ size again! So there is the dilemma as to which cancer has surfaced in lungs and liver, or is it a mixed bag?
We discussed UPSC recurrence primarily as it had already been confirmed by lymph node biopsy last June. I asked questions I probably didn’t want answers to – got them anyway. Actually just confirmed my own analysis of incurable nature of recurrent disease. Before we reviewed issues, he noted he was sure my first response was to address this quickly and aggressively. At this time, he considers me healthy, all lab work shows all organs systems functioning normally, and therefore, wants to conserve my quality of life as long as possible. Despite my initial panic, I have opted to try the conservative approach. I am starting tamoxifen treatment to see if it will control disease with minimal side effects or impact on my daily life. In case any issues are breast cancer, it will work for both cancers. Unless symptoms develop or any other issues arise (total panic!) will repeat PET/CT in 3 months and review again. This plan allows me to try conservative and yet be able to switch to aggressive anytime. If I go the more aggressive chemo, radiation treatments, etc. first, QOL will suffer and be at a lower level if I then want to switch. I have been fighting cancer for nearly 19 years and this is the scariest it has been.
I groused some about lack of trials for UPSC recurrence and that it’s treated like ovarian but we are not eligible for the trials. He did note it might be possible to get into a Phase 1 trial just not a 2 or3. Worse, he noted that ovarian is more responsive to treatment than UPSC. Despite all the mutating that the cells do they still retain some of their original nature, enough to make UPSC cells more aggressive based on the way they originally functioned. And I always thought it was the opposite.
I still have appt scheduled with another gyn-onc and will pose same questions to him for his POV. Sorry for such a long post, but I will be eager to read treatment plans, experience, etc. from others.
Healing thoughts to all.