June 2017 updates

IN SUMMARY

I have been feeling more tired, and my lungs and cough are worse. My scans show that the cancer has spread further in the lungs and the lymph nodes, but I may not have any metastasis in the liver.  This means that the current treatment (Herceptin / Pertuzameb) is not working 😦  I had some hopes of going on a new chemotherapy / immunotherapy combined  trial. Unfortunately, I am not eligible as the tumour(s) don’t pass the size test.  So the next step is to start a new targeted and chemotherapy drug combination called Kadcyla.
IN DETAIL

Step 1: CT scan

Went for my scheduled CT scan to measure the effectiveness of my current treatment.

In preparation for the scan, a contrasting agent is injected into the veins. I always dread this part, as it is impossible to find a usable vein on my arm.  I do have a portacath, but it is not suitable for this procedure. So this time around I ended up going to Cardiology, where the catheter was inserted into my neck.  Ouch… painful.

The results of the scan showed further spread of the cancer and worsening lymphangitis.  So, the current treatment is not working.

Slightly good news is that I now have a tumour measuring more than 1cm, which makes me eligible for a trial of a new immunotherapy drug called atezolizumab… IF the cancer has not spread to my brain!

Ref. What is a CT scan?

Ref. What is a portacath?

Step 2:  MRI scan for the brain and liver

I have been experiencing headaches (pressure in the head) and tiredness in the last few weeks. Could this be caused by the spread of the cancer to the brain?

The way to find out is to have and MRI scan of the head.  At the same time, my liver will also be looked at , as the CT scan image is not clear for that area.

The results of the scan showed that the cancer has not spread to the brain.

It also showed that there is no cancer in the liver. There is an area (3.5 x 1.7 cm) that was identified by the CT scan, which in the Radiologist opinion is ‘Focal fat infiltration’.  Something quite harmless.

The good news of course is that the cancer is not spread to further organs. The bad news is I am no longer eligible for trial, as the tumour in the liver – that qualified me for the trial – is not a tumour after all.

At this point I am beginning to question how reliable CT scans are. Is it that I never had any metastatic disease in the liver in the first place? I also physically feel several tumours in my neck.  However, the CT scan doesn’t list them as cancerous because they don’t pass the size and formation criteria.

Ref. What is an MRI  scan?

Step 3: Treatment

The next step is to start on a new treatment regime, a drug called Trastuzumab emtansine (Kadcyla). A combination of an antibody (targeted therapy drug, Trastuzumab) and chemotherapy drug (Emtansine) administered every 3 weeks intravenously.

The literature says that the drug is not widely available on the NHS, I think it is quite costly.

Fingers crossed it will be an effective one and that the side effects won’t be too severe.

• Chemotherapy
• Diagnosis
• Scans
• Treatment