Where is my mind?

Bad news and stress always seems to leave me forgetful.  It's like my brain can only take so much before it's out of room.

When my grandfather died, I locked my keys in the car.  When I was first diagnosed with cancer, I drove all the way from the surgeon's office to work before I realized I'd left my purse on the chair at Dunkin Donuts.  So far with this most recent bad news I haven't done anything that dramatic, but I'm definitely finding myself realizing that I am not, at the moment, at the top of my game.

But still, without any real alternatives, the thing to do seems to be soldier on. And I'm sure my brain will catch up eventually.  It always has before, right (ok, maybe don't answer that)?

I don't feel bad physically.  Which makes sense, it's not like I'm any sicker than I was before Wednesday, it's just that I have some scary news.

So I go through moments of normalness and moments of terror and moments of worry and then back again.  I remember how this goes and I know it will get better.  And, God willing, Ibrance and Letrazole will do a good job and I'll get some good scans under my belt again.  That would go a long way toward helping me relax.

But for now I try fairly unsuccessfully to stop borrowing trouble.  And stop googling advanced liver failure.  And stop imagining I'll have every unpleasant side effect in my little Ibrance pamphlet.  Kate's helpful cancer hint: excessive "worst case" research is rarely helpful (see, now you know!).

And, besides, I'm not a rookie at this anymore.  The progression, drug regime failure, and liver mets are new, but I'm practically an old timer at having cancer now.  So I know if I can just ride out this "just found out" phase, I will get mentally better.

And you (yes, you), please be patient with me while I get through to that.

And maybe also let me know if you see my purse or keys in all the wrong places?

Moving on

Edward Hopper - Compartment C Car

I got some results from the bone scan I had last week and the CT and MRI earlier this week.  My brain still looks good, but my liver and bones are starting to show signs that the cancer is evolving its way around the Faslodex.  There are some new spots on my spine and some smallish areas on my previously unaffected liver.  It's not terrible, but it's not that great, either.

I also have more kidney stones.  Because today is my day, it seems.

So, at the recommendation of my oncologist, I'm moving on to a new drug combo and last month's Faslodex was my last Faslodex.

It was expected that this day would come, and I think I still did better than average, but I was hoping I'd get a longer run of it.

But, starting tonight, I'm on to Letrozole, an aromatase inhibitor.  I'll be combining that with Ibrance, the  new drug from Pfizer that was just approved by the FDA 2 months ago.  Timing is everything.

The Ibrance will take a few weeks to get (it has to come through the mail from a speciality pharmacy) and my oncologist wants me to wait until after I get back from the first away vacation I've taken in years later this month--it should be fine, but it seems a little ironic that I had 12 mostly uneventful months on Faslodex and the one week in 3 years that I plan to get on a plane for fun, and this happens.  As I said, timing is everything.

Letrozole's side effects should be similar to Faslodex.  Ibrance brings fatigue and low blood cell counts (red and white), so that may be a little more of a challenge.  Or maybe not.

The good news is, in the clinical trials, the Ibrance/Letrozole combo had a median progression free survival of 20 months, which compares to 10 months with Letrozole alone.  Those were women who had not already failed a different hormone drug like I did on Faslodex, so it may not be as good for me, but obviously median PFS is a guideline not a promise, anyway.

I guess I'm getting better at cancer these days.  I'm sad, but for now I'm feeling like it's ok.  It's time to roll up my sleeves again and move on to this next treatment.  And fortunately I'm not out of treatments yet.

And so I move on.  And hope this next new thing will be the next new thing.  And so it goes.