Liza Yore's Journal
Written Dec 29, 2012 12:44pm by Liam YoreLiam here -- brief updateNot a lot to report, really. We have had a nice christmas with family in town. Very busy and very loud. Liza's been on the oral meds for a little while now. She is doing quite well with them, it seems, at least as well as you can expect on chemo. The main thing is that she has been very tired, which may be as much from the anti-nausea meds as anything else. She has had some GI side effects (diarrhea being the most prominent) but no vomiting and that at least is welcome. We are hoping that we can stop the nausea meds, because they are sedating enough that Liza is pretty wides out and sleeping much of the day, and maybe that will reduce the fatigue factor.Beyond that, it's been a happy holiday for us, the kids got tons of legos (boys) and ponies (girls) and now are getting a little stir crazy so we are wracking our brains trying to get them out of the house. Hope your holidays were good too.
Written Dec 21, 2012 10:39pm by liza yoreLiza here-Today was day one of chemo for me. I have one of the two drugs in hand and took my first dose of Xeloda today. My daily routine will now be to get up, take a Zofran, eat breakfast, and then take 4 Xeloda pills. I will take another 3 Xeloda pills with dinner. When I get my second chemo drug, I will take those pills before lunch on an empty stomach. I think that is 5 pills. I believe I am up to something like 18 pills a day when I add in my other meds.I also received news about my latest echo today. My EF is at 45-50%, which is subjectively better according to my medical oncologist. What is means is that it isn't better or isn't worse. I will take that as a win. It does put me right on the boarder for being eligible for some drug trials should I need them. I am hoping that I won't need them.So much going on in my head. I will write more about my thoughts over the past month at a later time. I am just beginning to see some light in my world and want to take a little more time before I start writing again. Its hard to put into words everything that has gone through my head lately. For now, I continue to live in the moment.I appreciate your support and wish you all the best this holiday season.
Written Dec 15, 2012 1:46pm by Liam YoreWe met with the oncologist yesterday evening. It was a long talk - about 90 minutes. In short, we will be going on Xeloda and Lapatanib. These are both oral chemo (pills - no port or infusions needed) which is nice. Lapatanib is a molecule that specifically blocks the HER-2 signal on the inside of the cell, and is pretty well tolerated with few side effects. Xeloda is a DNA synthesis inhibitor, which helps kill rapidly dividing cells. It has moderate side effects, mostly some nausea, vomiting and diarrhea and something called "Hand-foot" syndrome, in which the palms & soles can get inflamed and painful. Her hair may thin but will not fall out. It can be rough sometimes, but not nearly as bad as the IV stuff we had the first go-round. She will take the Lapatanib every day (with food) and the Xeloda two weeks of every three (without food). We will continue this regimen indefinitely, either until there is evidence of treatment failure or if the side effects are too severe to bear. Our oncologist said she has seen people take these meds for "years" and do well on them.If or when we have to stop this regimen, there are still other options. There is a new antibody-based drug called Perjeta which is quite efective (though less so for brain mets, whereas the Lapatanib hits the brain mets well) and there is another med called TDM-1 which is in Phase III trials. It's basically Herceptin, an anti-HER-2 antibody, with a chemo agent linked to it: sort of a "magic bullet" approach to therapy. We might be able to get it on a trial, on compassionate-use basis, or it may even be FDA approved shortly.So we have a lot of options. We will get started this week, as soon as the pharmacy gets us the meds. I asked the oncologist to re-present our case to the docs downtown at the Seattle Cancer Care Alliance, to see if they have other recommendations, but I doubt they will. The treatment we are going on, based on my reading of the current literature and conversations with some oncology friends, seems to be very much the mainstream for our situation. The trials that are ongoing are either not quite appropriate for our situation or not exceptionally promising; we may pursue that approach later, if needed. I wish we were more excited about getting on the treatment, but it feels like deja vu all over again, getting back on that treadmill that we never wanted to be on in the first place, and this time we know we will never get off of it.Lest this sound like too much of a downer, I offer this important bit of perspective, written by one of my favorite science authors, Stephen Jay Gould, when he was diagnosed with an "incurable" cancer: The median isn't the message. It's well worth the read. He lived another 20 years and died from an unrelated illness. That's the goal we are aiming for, and Liza is very determined to get there.Thanks again for reading.