Family and friends,

     Since the last update in March, Natalie has continued on the Trodelvy treatment plan. In addition, she has discovered that the cancer that has presented itself on the skin of her chest seems to be less inflamed when she follows a keto diet, which has been a praise. All in all, since the start of this treatment, she has had mild side effects and has been able to work and do all the typical mom things that come with having two teens and a preteen.
     This past Tuesday, she had a PET scan to determine whether there was any residual disease and assess the effectiveness of the Trodelvy. The results of the scan contained much to be thankful for but, at the same time, indicated a new concern. I'll start with the praises:

• The biggest praise is that there was no evidence of metastatic disease in the liver, where she had a tumor removed in January. 
• There was no cancer found in the lymph nodes, lungs, or other organs.
• There were no tumors that showed up in the breast tissue, despite the visible cancerous nodules Natalie has on her chest.

     The unfavorable part of the scan is that it showed  the cancer has spread into bones all over Natalie's body.  Despite this news, the oncology PA indicated she was not alarmed because the levels are currently mild.  However, to combat the cancer in her bones, the oncology team believes that it is time to pivot to the next treatment that Dr. N (the  research doctor in California) recommended. Natalie will start this treatment next Friday and will continue the two-weeks-on, one-week-off treatment cycle. 

      Although this isn't yet the cancer-free scenario we all hoped for, Natalie feels at peace and remains hopeful. We would appreciate prayers for the following as she begins this new treatment course:

• That the new chemo pairing would eliminate the cancer from Natalie's bones, keep it out of her organs, and clear up the small cancer nodules on her chest.
• That Natalie would have minimal side effects and could learn how to manage them well.
• That the keto diet would continue to assist her body and the treatment in reducing the cancer and that she would have the time and energy to prepare the food that is required.
• That this treatment would put her cancer into remission so that she could move to lower doses of chemo in order to gain back some of her basic quality of life. 

     Once again, we all remain grateful for all of you who continue to follow Natalie's journey and are an encouragement to us all. I'm always amazed at how many people continually ask about how Natalie is doing and faithfully pray for her. We couldn't continue this journey without the love and support surrounding us. We all feel it and are thankful for this blessing of the community of support both near and far!

Stephanie Wasson