No chemo for me

At 6:45 last night, when my 3:30 doctor's appointment finally ended, my doc broke the news I couldn't have chemo today. We were all set to go, excited to start a new treatment plan when he took a second look at my blood work to discover my platelets are way too low at 64 to proceed. (According to Wikipedia - in very mathematical language - it looks as though normal is between 150 and 450.)

While I will still get paracentesis today to drain my round belly, my first chemo treatment on the new regime won't happen until next Friday.

As an FYI, the ascities drained will be sent to the Translational Ovarian Cancer Research Group for study. I will be providing raw materials for the very researchers we raise money for with The Run for Ovarian Cancer. How cool is that?

The plan
Dr. W was open to switching my treatment. He said, since my CA-125 hasn't decreased (it's still at 223) and the ascities continues to build, it's reasonable to change our plan of attack at this point. We discussed the different options and decided to go with paclitaxol alone weekly for three weeks in a row, with the fourth week off for recovery.

When I asked about going the carboplatin and paclitaxol combo route, because it's worked in the past, he said, while that was a good point, he isn't confident adding carbo to the taxol will create any better results because I'm receiving carbo with my treatment now and it isn't creating the response we want. He also mentioned he'd like to try something different than what I've received before.

 

Part of me is okay with that reasoning, but another part of me is drawn to the tried-and-true carbo/taxol treatment I know worked in the past. We tried something new with the cisplatin/gemcitabine route and it only stabilized the cancer. Now, if we didn't use that treatment, the cancer could be out of control and spreading throughout my body right now, so it may be working in its own way. But I do want something stronger, harder, faster, better. So that's why I want taxol. It's how and with what it's administered that's up for debate. In the end, I'm confident enough in my doc's recommendation to try the weekly taxol treatments. 

 

He said the study data surrounding the weekly taxol treatments indicates the lower dose more frequently can also work better than a big dose every three weeks. On the bright side, the side effects should be less intense with a lower dose, as well. But on the downside, there will be fewer days with no side effects because I'll be receiving the treatment more often. So I'll only have a couple of days of feeling good before I have to be hooked up again to the IV bags of toxic chemicals again.

 

But I have no idea at this point how I'll respond and I guess, like anything on this journey, I'll have to take it one day at a time.

He also said taxol has greater antiangiogenic activity than the chemo I'm currently receiving. An angiogensis inhibitor is a substance that inhibits the growth of new blood vessels. As a result, it should help with the symptoms like ascities, which has been the bane of my existence. It should also work against the new cancer cell growth.

So we're going to try the taxol alone for a four-week cycle and then reassess how I'm responding to the treatment. I like that Dr. W is open to options, and that we're working toward the same goal of making me feel better and doing more than simply stabilizing the cancer. If needed, we can also talk about going to the carbo/taxol route, if we aren't seeing any results from the taxol alone.

 

I also asked about clinical trials and whether I qualified for anything, but there's nothing appropriate for me right now. But he said he's always keeping his eyes open. That's good.

The results of the appointment made me happy because I feel like I'm moving forward again with a treatment plan to beat back the cancer, but it also made me feel sad because I can't see the end of the road I'm travelling down. I was supposed to be heading into my sixth and final round of chemo today (although without the results I want and need), but now I have no idea how long I'll be on treatment.

 

When I asked Dr. W if I was on treatment indefinitely, he said yes. So I have no end in sight, which makes me feel a bit depressed. But as the nurse said, I can take a treatment vacation for a few weeks at any time if I want to do something like a vacation. I may consider that when I'm feeling better and feel up for a jaunt somewhere warm or exotic.

 

I need to remind myself of my old mantra - one day at a time. Today, I get paracentesis to give my poor squished belly some room to accept and process food. Then I enjoy my weekend; we're headed to the spa to celebrate some birthdays and with less fluid, I'll be able to eat and drink more easily. Then next week, I'll enjoy the first four days of March Break with my kids before I head to the chemo suite on Friday to start tackling this disease another way. One day at a time.

 

Tina