Sunday, August 20, 2017

Onward!



I. Am. Cancer. Free. 

Like the sound of those words. As of my surgery on July 24th, I no longer have cancer.

Although, it could return (and if you have been following along closely I apologize for being repetitive) as I have triple negative breast cancer (TNBC). The most aggressive all breast cancers. According to Contemporary Oncology, about 34 percent of women with triple negative breast cancer experience a distant recurrence with the average time of relapse being 2.6 years. According to BreastCancer.org, the five year survival rate for TNBC is around 77 percent versus 93 percent for other breast cancer types.
 

But enough of the scary news. Right now I'm now cancer free. And from a medical "standard of care" definition, I have completed my cancer treatment. I'm done.

But.... I'm not. 

You see from the very beginning of this fight, I told Liz I would go beyond my treatment (regardless of the outcome) and enroll in a clinical trial. Whether or not the trial helped me, I wanted to play a part of helping women who will come behind me in this fight. To do that, you can become a participant in a clinical trial. You volunteer to join the medical professionals who are giving their careers to finding a cure for you and others like you. Clinical trials are specific- meaning the participants selected for any trial must meet rigorous characteristics and protocols. 

Post-surgery, my oncologist was excited about a clinical trial currently being run out of the National Institutes of Health (by the way, people who work there are super heroes and literally life savers). The results of my surgery discovered my tumor had shrunk 90%. And my entire medical team was thrilled about those results. Me, being of type-A over achiever ilk, was looking for 100% (referred to in the medical world as "complete pathological response" or "pCR"). According to the most recent research, complete pathologic response rate of approximately 15%-18% is seen among patients with all breast cancers, and the pathologic response rate in patients with triple-negative disease is quite a bit higher, maybe as high as 30-35%. This is in part because triple negative breast cancer reacts well to chemotherapy. But I got a 90 percent response and I will take every percentage . 

To qualify for this specific clinical trial, one had to have a certain percentage of "residue disease" or cancer left after chemotherapy but before surgery. My oncologist called a few days post surgery to give me "good news and bad news". The good news being obviously a 90 percentage shrinkage is terrific, but the bad news was to qualify for this trial, one needed a higher percentage of residue disease before surgery. That's ok. I didn't want to "qualify" for that trial, anyhow! So at the moment, there are no trials out there that I meet the criteria for. 

However, a clinical trial presented at the 2015 San Antonio Breast Cancer Symposium on December 2015, known as CREATE-X, was actually stopped early, in 2015 when it became clear that the drug, Xeloda had benefits for women with triple negative cancer with residue disease post surgery. 

While this drug has yet to become part of the "standard of care" for cancer patients like myself, my oncologist, Liz, and I agreed that given what we know about my disease and my willingness to continue care, I would start yet another round of chemotherapy - this time using Xeloda - to give me the best chance known of survival. I suspect I will begin this next round in the coming week. We are looking at 18-24 weeks on this drug, if I can tolerate the side effects. It is a pill that I will take at home, twice a day for two weeks and have one week off for 6-8 rounds. I will be closely monitored by my medical team while I am on the chemo as before. I look at it as my "maintenance drug". Women who have other forms of breast cancer take medication 5, 10, and 15 years post original diagnosis to keep cancer from reoccurring. My type of cancer has no known medication so I will throw another chemo drug at it, continue to look for clinic trials that I qualify for, and remain positive and to lean on my wife, and our village of family and friends to get us through. So keep rooting for me.  Keep Liz in your thoughts (and occasional email).
 
And so I move onward. Cancer free and determined to stay that way. Oh and boob-less. 
Cheers!!!

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