Oncologist Appointment & My Monthly Faslodex Injections

On Monday, I had my appointment with my oncologist to get an update on how I was doing, run a few blood panels, determine what to do about iBrance, and get my Faslodex injections.

All in all, I have been doing OK over the last month. I didn’t feel better until last week because it took a while for the iBrance to leave my system. I have had ups and downs emotionally because, quite simply, it is hard to deal with having stage 4 cancer. Some days I am upbeat and optimistic, and on other days, I am very depressed and overwhelmed. At this point, I am about 50/50 with those extremes, but I am hoping that I will start to have more good days than bad once my body has adjusted to the medications.

I was very shocked by my blood panel results because of the drastic changes that took place in only one month. My White Blood Cell count went up quite a bit from 2.6 in April to 5.9 on Monday. My ANC was of huge concern in April at .8, but on Monday, it was 3.5. My Red Blood Cell count was still low on Monday, but that was not a surprise because I am fatigued most of the time, no matter how much rest and sleep I get. It amazes me how much the iBrance damaged my body in only one round of medication, 21 days, and how quickly my body repaired itself in the last month while I was off of it.

My oncologist decided to put me back on iBrance but at 100mg, not 125mg. It is clear that the 125mg dose was too much for my body to deal with after seeing the huge changes in my blood in only one month. I should also say here that the first blood panels that were done in March when my treatment started were completely normal for the first time in three years, so this really was a significant change caused by the iBrance 125mg dose. 80% of stage 4 cancer patients are not able to take the 125mg dose, so I am not alone when it comes to having these issues, and I have been assured that studies have found that there is little to no difference in the effectiveness of the medication between 125mg and 100mg. Many of my oncologist patients have been on iBrance and Faslodex for years and have been doing well at stage 4. So on Monday, I started my next round of iBrance for the next 21 days. I have all of the medication I need should I start dealing with side effects again, but as of today, day three, I am doing fine, just dealing with a slight headache.

The longest part of my appointment was getting my Faslodex injections. The process takes a while because they have to order the medicine from the pharmacy, which is right there in my oncologist’s office, and then they warm up the medication to thin it out so it can be injected. I know it sounds terrible, and honestly, it is. I hate getting shots of any kind, but these are worse because they are given in my butt muscle, one on each side. On Monday, I was in quite a bit of pain once I started walking to my car, so once I got in, I sat there for a few moments to gather myself before driving home. I continued to hurt as the evening wore on, so I took a few extra-strength acetaminophen, which thankfully gave me the relief I needed.

My next appointment with my oncologist is scheduled for June 20th. I am fully in my monthly schedule now, so the only change from how my appointment went this month will be when I have my PET scan done. Because I had to take this past month off from iBrance, I will not have my next PET scan until July. I wish it were sooner, but I have to take iBrance for three months before getting the scan so we can see what progress the iBrance has made on shrinking my tumors.

I want to say a huge “thank you” to my family and friends that have been taking the time to contact me and ask me how I am doing. It really helps me, especially on my bad days, to be reminded that more people care about me than I realize. Bless you, and thank you for continuing to support me through this difficult time! 💕

Oncologist Appointment & Third Round of Faslodex Injections

I had an appointment with my oncologist on Monday to run my blood panels, talk about my side effects and get my third round of Faslodex injections. I spoke with the PA first about the medications I had picked up at the pharmacy over the last week for nausea and heartburn. I assured her that both were working great, so I was finally getting some relief.

My oncologist came into the exam room and handed me my blood panel results, and it was not what I expected. I knew that certain levels would be off but for them to be where they are after only three weeks on iBrance was a shock. My white and red blood cell counts are low, not dangerously low, but lower than we would like, and my ANC is low. ANC, Absolute Neutrophil Count, is the “infection-fighting” count. My count is .8, and the low end of normal is 1.25, so I am at high risk for infection. I need to stay away from crowds, busy restaurants, and people who have a cold or the flu because I could end up in the hospital with an infection and become severely ill.

After taking in the initial shock of this news, my doctor said he was very concerned, so he told me to stop taking iBrance for the next month. The break in taking the medication should give my system a chance to get back to normal levels. I had already received this next round of drugs from Pfizer because I was scheduled to start back on it after a week off a few days ago on Monday. We did discuss dropping my dose from 125mg to 100mg, but we will only do that if my bloodwork doesn’t improve. So, for now, he told me to hold on to the meds, so I will have them to take again starting on May 23rd.

Once I was done discussing everything with my doctor, I went back to the infusion room to get my Faslodex injections. Have I said how much I hate injections? I absolutely hate injections, but that is the only way this particular drug is administered, so I don’t have a choice. It seems that each time I have the injections, I have different side effects from them. Generally, I deal with headaches, bone pain in my hips, and, as with this last time, pain from the medicine itself. I have a small area on the left side near the injection site that is causing me some pain, but it has improved each day. Some good news is that I am done with the initial three doses, so now I will have the injections monthly instead of every two weeks.

During my next appointment on May 23rd, I will see my oncologist, have my blood panels run, and get my Faslodex injections. This will be my regular schedule moving forward every month for an indefinite period of time.

**WARNING** Graphic details about side effects: Days Thirteen thru Twenty-one on iBrance and Starting My Week Off

A quick disclaimer, please remember that the subject matter in this blog post is specific to my experience while taking iBrance for Stage 4 Metastatic Breast Cancer. If you are about to start or take the same medication, your experience may differ from mine, so please keep that in mind.

On days thirteen thru eighteen, I continued to have issues with nausea; it was not as severe or as frequent but still annoying. I called the nurse’s line at my oncologist’s office, and my doctor prescribed an anti-nausea medicine for me since the one I have is three years old and has expired. It is comforting to know that I have a current drug that I can take should I need it.

On days nineteen through twenty-one, the nausea, for the most part, had stopped, but my heartburn was getting worse. Every night after dinner, I would get heartburn from mild to severe, and it didn’t seem to matter what I ate. I had the same scenario as I did with the medicine for nausea; my heartburn medicine was expired. I rarely ever have heartburn, so I know that just like the nausea, it is a side effect of the iBrance.

Today is day three of my seven days off of iBrance, and I feel much better. I still have slight nausea, but it has stopped for the most part. My heartburn continued, so I called the nurse’s line yesterday, and my doctor prescribed a new med that I will be taking every day. I took it last night before dinner, and I was very pleased to finally not have that dreaded pain in my chest after eating.

On Monday next week, I am starting back on iBrance, and I have an appointment to see my oncologist, have my bloodwork done, and get my Faslodex injections. I am curious to see where my white blood cell count is now that I have completed my first twenty-one days on iBrance. I know it could be potentially low, but I hope it won’t be too low because it puts me at risk of having issues with a weakened immune system.

I will update again after my appointment next week. Thank you for being here! 🙂

Oncology Appointment & First Injections

I went to see my oncologist today. First, some good news, my blood panel was completely normal today, with no low or high levels on anything! Today was the first time I have had my blood look this healthy in 3 years. Of course, now, that will change somewhat with the meds that I started today. We discussed both meds that I started today, and I asked him a few questions that we thought of after my last visit. So, this is what we discussed and the questions he answered.

The Faslodex is given in two injections because it is a lot of medicine, 500 mg. The drug is very thick, so they must warm it before injecting it. It is administered intramuscularly into the buttocks (gluteal area) slowly (1 -2 minutes per injection) as two 5 mL injections, one in each buttock, on Days 1, 15, 29, and once monthly. Today was day one, so my next three appointments are on April 11th, April 25th, and May 23rd.

My dose of iBrance is a 125 mg capsule taken orally once daily for 21 consecutive days, followed by 7 days off treatment to comprise a complete cycle of 28 days. It is highly important that my doctor keeps an eye on my white blood cell count because this medication can drop my levels to too low, just like infusion chemo did. If my white blood cell count drops too much, he will lower my dose to 100 mg or 75 mg if necessary. 

I will have a PET scan every three months to check the progress of the meds on my tumors. If the meds shrink the tumors, we will keep my meds the same. If the tumors are growing, we will change my meds and try something else. The goal is for the tumors to disappear or shrink and then stay that way; at that point, my cancer will be controlled, and I will be in remission.

My questions: How long will I be on these meds? I will be on both meds as long as they are working, indefinitely.

Do I need to do anything special while on these meds? I need to drink 2 to 3 quarts of water every day, get plenty of rest, stay away from large crowds or people with colds because I will be at risk of infection, wash my hands often, and something new this time; I can’t eat grapefruit or drink grapefruit juice.

There are, of course, side effects, as with any medication. So far, I have had a headache tonight, but nothing that Tylenol couldn’t knock out. I had some discomfort from the injections for a few hours after getting them, but that has stopped.

I will let you know how I am doing as I go through my next few appointments.

Oncologist Appointment & 2nd Biopsy Results

My husband and I went to see my oncologist on Tuesday to get the biopsy results on my rib. He told us that the results were positive, that there are several cells of cancer located on my rib, and that the mass as a whole is 2.9cm and is located about 1 inch from my spine. I do not have bone cancer; the cancer is not inside my rib. I had absolutely no idea that it was there until a “spot” showed up both on the nuclear bone scan and the PET scan, hence getting the biopsy last week. The cancer cells are similar to the cancer I had before, so it is the same type, breast cancer, so I am diagnosed with Stage 4 Metastatic Breast Cancer. It is metastatic breast cancer because my originating cancer was breast cancer, and it has now spread from the breast to another part of my body.

Once the biopsy results were in, my oncologist and my radiation oncologist spoke and determined that putting me through radiation would not only be challenging to treat but also a waste of time. It is difficult to treat me because I have cancer in two very different areas of my body, my neck, and back. They decided it would be a waste of time because they are convinced that I most likely have cancer elsewhere in my body that is too small to show up in scans. So they decided that we should treat my entire body instead of just the areas where we know I have cancer. Surgery is not an option because there is no point in opening me up when I most likely have cancer elsewhere. Plus, surgery in both areas is quite risky due to major blood vessels, arteries, and the spot on my rib being so close to my spine. So with all of those facts in place, I will be starting medication on Monday.

Stage 4 cancer has no cure. As odd as it sounds, I am lucky that we are dealing with breast cancer because there are many drug choices for treatment, and the medical world is always coming out with new and improved drugs. Why is that? Because breast cancer is the leading cancer in the US, with over 2.26 million cases per year, followed very closely by lung cancer at 2.21 million cases per year. Stage 4 breast cancer ads constantly barrage us on TV, and that is why. Not all stage 4 metastatic breast cancer meds are chemotherapy drugs, but I will be on a chemotherapy drug called iBrance. No, I will not lose my hair while on iBrance, even though it is chemotherapy which I am very thankful for. What is sad about iBrance is that it is $18,000 a month; no one can afford that, so thankfully, there is an aid to apply for to get it free for a year. I will also have a new inhibitor in an injection called Faslodex. These two medications are often paired together with favorable results in killing cancer, keeping it from coming back, and extending life.

It is hoped that iBrance being chemotherapy will kill the cancer in my body, and Faslodex with replace the current inhibitor that I am taking, which is Anastrozole because it didn’t work. The Anastrozole might have kept my cancer from spreading and growing more, but it did not keep cancer from coming back by lowering the estrogen in my system, which is its primary job. I have estrogen-driven breast cancer, so I have to take an inhibitor. I took Anastrozole for two years out of 10 before my cancer returned. My treatment plan is as follows…I will be taking iBrance for 21 days, and then I will stop taking it for seven days, then that cycle will repeat. On Monday, I will start my Faslodex injections, with the first three injections being one injection every two weeks and then once a month after that. In about three months, I will have a PET scan to see if there is any change in the size of my tumors. If the medications are working, my tumors should be smaller; if there is no change, my medication will most likely be changed. If my tumors are persistent, I may have to undergo infusion chemotherapy again, but we will try to avoid that. I don’t have any details about how long I will be on the medications, but I suspect it will be at the very least until having a clear PET scan; but I will find out for sure when I see my oncologist on Monday.

I will post again when I have more information about the length of my treatment and how my first injection appointment went. Take care, everyone!

CT Guided Biopsy

A few days ago, I had a CT Guided Biopsy of my 8th rib on the left side, on my back. Everything went well; I am in a little bit of pain, but nothing that Tylenol can’t help. The doctor instructed me to rest for the rest of the day on Thursday, remove my bandage on Friday, and resume my normal activities.

After finishing my paperwork in the hospital registration office, I went to the lab to have my blood drawn for a few panels; among a few other things, they had to check my kidney function before doing the CT, and after that, I went to radiology to wait to be taken to the pre-op area.

Once my nurse was done prepping me for my procedure, my anesthesiologist came to get me and take me to the CT room. He explained that he would only give me enough medication to make me relaxed and a little sleepy but not entirely out. He said that if I did get sleepy not fight it and let myself fall asleep. I did fall asleep for some of the procedure, but I don’t think it was for very long because the process only took about 30 minutes.

When I walked into the CT room, they had me lay on my stomach on the CT table. I was shocked to find out that the lesion is actually on my 8th rib on the left side of my back, not in the front, and it is very close to my spine, so that has me a bit concerned. The rib that I fractured some 18 years ago, that I was thinking was what was showing up in my scans, was a few ribs down from where the lesion is located, so it has nothing to do with the lesion at all. So with that said, I don’t know what to expect when I meet with my oncologist next Tuesday to get my biopsy results.

I have had many people ask me what I think of all of this, how I am feeling, and what my gut is telling me. I can’t help but see the similarities to the first time I went through cancer three years ago. With every appointment, things get worse and worse, more scans, more biopsies, etc. As before, I want to know what type of cancer I have to fight against, and I want to get started on whatever treatment plan my doctors and I agree on as soon as possible so I can get this over with and move on.

I am feeling OK so far. Even if the lesion on my rib is positive for cancer, it appears to be localized like the tumors in my neck, so it is not as aggressive as it was in 2019, and because of that, I have been feeling much better physically this time around so far. Mentally I am up and down; the stress is unreal because this is the moment as a cancer survivor that I have been fearful of, having to deal with recurrence.

Lastly, what is my gut telling me? I will be shocked if the lesion on my rib is negative for cancer. After reading the PET scan report and looking up a few medical terms that I had not seen before, I immediately thought that it would be a bad result once the biopsy results came in. I, of course, hope that I am wrong, and in a few days, I will know for sure.

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