So much for the pituitary plan ...

I got a call yesterday from the endocrinologist's fellow. They took some blood while I was there last Wednesday to run their own hormone level tests and got the results this week. My prolactin levels were normal as were all other hormone levels. This was before I started taking the Dostinex (drug to lower prolactin levels if this were a prolactinoma). So that pretty much rules out the possibility of a prolactinoma, and they think it is most likely a breast cancer met. It could still be a non-secreting benign adenoma, but there is no way to know without having the surgery. I think they are leaning towards met because it seems to be shrinking and growing, possibly due to chemo (though chemo is not thought to cross the blood/brain barrier??). The endocrinologist doesn't think I need to have the surgery right away since I'm not having any symptoms (blurry vision, severe headaches or wacky hormone levels). He wants to see me in 6 months. The neurosurgeon wants to see me next week and wants me to meet with a radiation oncologist. I suspect he will recommend having the surgery now that a prolactinoma has been ruled out. I'm not sure why he wants me to see the radiation oncologist, but I guess I'll find out next Wednesday. I'm waiting for a call back from my medical oncologist to get his opinion, but I know that he does not think this is a breast cancer met. So he'll probably recommend against having the surgery. I don't know what to think, but I will wait to get all the opinions before making a decision.

In other news, I had treatment #2 on Monday. This round has been a bit easier with the fatigue and less grogginess, but the nausea is back, though not too badly. Steroids kept me up most of Sunday night, but I've managed to make up for most of that sleep over the past two nights. I lost huge hunks of hair in the shower on Saturday, so I'm back to the bald look:



It's not so much fun being bald in the middle of winter in Chicago. Temps today started at 2F with a wind chill of -19F! Currently it's up to 11F with a wind chill of -4F. So I have to wear a hat at all times, even while sleeping, but I do save time in the shower and after with no hair to wash/condition/dry/style :)

For now, we are going to sit tight and wait for all the opinions to come in on the pituitary tumor. It seems that the surgery is inevitable, but I don't want to rush into it and compromise the systemic treatment for the liver tumor, which I feel is a bigger threat to my health at this point. The surgery is "minimally invasive", but it's still brain surgery! We'll post another update once I get through all the doctor's appointments next week. Thank you all so much for all the support ... it really helps to know so many people are thinking of me and praying for me!

24 Jan - The Pituitary Plan

Yesterday I went with Sarah to see a neurosurgeon and an endocrinologist down at the University of Chicago Cancer Center and both agreed that Sarah's pituitary adenoma was not an immediate threat and that we have the time to try a drug treatment. She started on Dostinex today (twice a week pill with few side effects) and she'll go on with that for six weeks (in parallel with her chemo) and then do another brain MRI to see how the pituitary growth has changed. At that point we should know if Sarah will ultimately need to have the growth surgically removed.
Sam and Ben are doing fine. Ben's still playing cello and I actually will be swapping his instrument out for one in the next size up since he's grown a bit since last October. He's playing Twinkle Twinkle pretty well. :)

22 Jan - Overdue Update

Here's a quick update since it has been a while since the last post - Sarah came through the first Taxol-Carboplatin treatment fairly well. No significant nausea after this first one, but definitely fatigue which usually set in hardest near the end of the day. Sarah also felt "groggy" for a week. She's feeling fine now as we wait for the next treatment.
Sarah also saw a neuro-oncologist last week and we'll be seeing a Neuro-surgeon this Wednesday to discuss what the treatment options are for her pituitary macroadenoma. Because her prolactin levels were not super-high (although above normal) and the other hormone levels were normal, the adenoma is either a typical benign "non-secreting" pituitary growth or it's a breast cancer met (which is much less likely). Options will probably range from no treatment and periodic MRI checks to biopsy and/or removal through neurosurgery. We'll know more over the following weeks...
On a much less dramatic note, I had Lasik eye surgery last Friday and it went great. I could see 20-20 the next day and my eyes are healing up nicely - great to be free of glasses and contacts after all these years.
I'll post an update after we've talked to the neurosurgeon.

Starting a New Treatment and More Health News

The new treatment is starting today, and it is a long one! I will have to be "in the chair" for nearly 7 hours! So I thought I'd try my hand at some blogging and give an update on the latest news from cancerland. I had been having mild headaches for a few weeks ... didn't think much of them at first, but I started to notice that they were always on the left side of my head, moving from above my eye to the top of my head. I mentioned them to my doctor last week, and because the cancer had progressed in my liver, there was a chance it could have progressed elsewhere (like my brain). So he sent me for an MRI of my brain and pituitary last Thursday.

When I got a message that my doctor had called me at home this morning right before I was to come in for treatment, I knew they had found something. Fortunately, there are no new spots on my brain .... whew! But the tumor on my pituitary has grown considerably since the last scan (three months ago). It is laying on my optic nerve, and although I am not currently having any vision problems, it could cause problems in the future, so I am going to go see a neurosurgeon to discuss medical and surgical options. Although the radiologist's report says that "the marked interval enlargement since 9/2007 is highly suggestive of pituitary metastasis", my doctor assures me that it is "extremely, extremely, extremely unlikely" that it is, due to the fact that it is a solitary tumor and it's been there for at least 9 months with no new brain tumors or lesions developing. I have contacted a neurosurgeon at the University of Chicago (one of the top 10 cancer centers in the US), who specializes in neuro-oncology and pituitary tumors. Seems like I'd be in good hands there ... I am waiting for a call back, but I'm going to have my oncologist call them and see if he can get them to put a rush on it.

I've got about one more hour to kill (good thing they have wifi here!) and then we'll see how hard this treatment is on me. As Alan said before, I will lose my hair again (maybe the third time is the charm?) and fatigue is a given. Muscle aches and possibly neuropathy in my hands and feet. But I'm willing to do whatever it takes. Although the news on the brain MRI wasn't what I was hoping for, it could have been much worse, so I'm counting my blessings. And with the every three weeks schedule, I don't have to come back to the onc's office until next Thursday for blood work. That will be the longest I've gone between visits to the onc since I started back in May ... gotta count the small victories where I can find them, I figure :)

White New Years and Time for New Treatment

The snow is really coming down - we didn't have a White Christmas but we'll have a White New Years Eve! We're also glad to have Elizabeth here visiting and celebrating with us.

Sarah and I went to get the results of her MRI earlier today and it was about what we expected after seeing those tumor marker results: her cancer has advanced and we need to start a new treatment. On the positive side the smaller liver lesions have not gotten bigger, but on the not-good side the largest one has tripled in size in the last three months and is now 4.4cm wide. So, Gemzar is out and Sarah will start something new. We're going to firm up the treatment plan with the doc on Thursday but it looks like a heavy dose of Taxol + Carboplatin every three weeks will be the next step. Back to hair loss, nausea and possibly neuropathy in extremities. Also, Sarah will begin taking Zolodex again to ensure that her estrogen levels are low (estrogen makes her cancer grow faster) and she'll continue taking Herceptin and Zometa.

Since we were expecting something like this, it seems to have softened the blow of this bad news a bit. But, we also know that the relatively "quiet" and stable period over the past 6 months will come to an end when Sarah begins this more intense chemo treatment next Monday. Sarah is determined to do whatever it takes to fight her cancer and we will continue to be focused on living today while staying hopeful for the future.

Christmas and New News

Here's Ben giving Santa a big hug when he came to visit before Christmas as he was passing through the neighborhood. Next we see the boys making cookies for Santa. Then there's Sam in his chef's costume as he tests out his new toy kitchen. Overall, the Christmas chaos ended well and we all had fun! The kids made out like bandits on the present front and the grown-ups didn't do too badly either.

On a more sober note, Sarah finally got tumor marker results at the doc's office on Christmas Eve and her numbers had gone up. CEA went from 3 up to 42 and CA27-29 went from 15 up to 70. This likely indicates that Gemzar is losing its effectiveness for her. Sarah's going to get a new MRI asap to see what's going on in her liver - scan Friday, results Monday. If the mets are growing again then she'll likely start on a new chemo right away. Sarah has been on Gemzar for approx. 6 months and her oncologist says that second-line chemo often only maintains efficacy for around 4.5 months on average. That doesn't sound good at all, but he says we still have a list of other chemo drugs to try and it's likely time to move on to the next one. In the back of our minds is the knowledge that several chemo drugs have not worked at all for Sarah so far... so it looks like we're back on the cancer roller coaster and anxious about the Monday doc appt.

Xmas Tree

We went to a local christmas tree farm (called "Ben's Xmas Tree Farm!") - here are a few pics that show what that experience was like. We all loved riding the horse-drawn carriage and then picking out the tree and cutting it down. There was also hot chocolate in the cashier's hut which was a big hit with the kids! With all the snow, this was really a just-about perfect xmas tree experience.
We're all doing fine and preparing for the holidays. What a busy time! Sarah just got chemo again today (12/18) and is doing ok. We expect to get a set of tumor markers next week from her blood work-up today.
Here are two links to a funny Lopez family snowball-fight and elf dance. :)
http://www.jibjab.com/sendables/view/Qlai5caLCcEdaVahFLponROx

http://www.elfyourself.com/?id=1464871654

Snow!

We finally got a bit of snow this year! School was canceled and the kids got to play out in the back yard, which they loved.
The Christmas season is really going very quickly - seems like a head-long rush towards 25 December and we're barely keeping up.

New Orleans Trip

Here we are eating Beignets at Cafe Du Monde in downtown New Orleans. We went down to be at Thomas and Kerry's wedding reception, which was a great event! Also got a great pic of Thomas and Sarah in Jackson Square. Chemo week for Sarah but she felt pretty good because we were there at the end of the week.

Leaves!

We got a chance again this year to make a big leaf pile and jump in to it. Ben and Sam also like it when I throw them on top of the pile. Fun!

We had Ben's birthday party at a place that has many huge inflatable play structures - everyone loved it... even the grown-ups got in on the action!

15 Nov

A shot from Homecoming at Rice University.

Here's a mini Lopez family reunion in Houston.

The kids are thinking of getting their MBA at Rice!

It's been a busy few weeks. We had a great trip back to Houston for my Rice U 15yr reunion during homecoming. We saw many friends and family, too!
Sarah's feeling ok as she continues to get weekly Gemzar chemo. The only recent thing that has changed is that we had a radiologist take another look at her last MRI in order to compare it to her last one (it had been compared to an earlier one from December 06 due to where we had it done). The new comparison seems to indicate that there has been no change in her liver mets since starting Gemzar. Or course, we would have liked to hear that there was clear shrinkage after treatment with this drug... but we are thankful that Gemzar is clearly protecting Sarah from progression. And this together with the very low tumor markers + satisfactory liver function + less side effects is still a pretty good place for now. So, we'll continue with Gemzar while monitoring tumor markers and looking for another MRI in January to get a better read on how her mets are responding to this chemo drug.

Halloween Pics

Sam was a very cute dragon with a tail & wings, and Ben went as Harry Potter - which I think looked pretty good! Trick or Treating went great and they got loads of candy. Sam really got in to it this year and had a ball.

29 October

Ben and I went to our Fall Campout with the Indian Guides Program and we had a great time! Tiring weekend, but worth it. Ben even got to wear his Halloween costume (Harry Potter) which was a big hit with everyone when we did camp trick-or-treating.
Sarah got another Gemzar treatement today and is working her way through the beginning-of-the-week yuckies. We're preparing to head back to Rice for our homecoming soon which is our next larger trip.

17 Oct Update

We had a very eventful Columbus Day weekend - Sarah went to visit Leslie and Ken in Lake Tahoe and I took the boys to see Grandpa and Oma in San Antonio. We also made a quick trip down to Padre Island where Ben and Sam had a great time.
Sarah ended up getting another treatment this past Monday although we expected this to be an "off" week. Although we're grateful for every week we can fight back with the Gemzar, she is not looking forward to having it feel like a 3rd week of treatment. She's had some nausea and fatigue so far - manageable but definitely not fun. Other than that, we are all doing ok and preparing for Halloween! Ben will be Harry Potter and we're still working on Sam's costume.

1 Oct - Good MRI Results

First here's a pic of Ben after a Cajun lunch we did at church last weekend. He really digs those beads... We've been helping a church in New Orleans by sending money to rebuild - and this weekend they come up to cook us some authentic Cajun food and invited our parish to lunch!
Sarah and I went to go get the MRI results - there was good news all around. Her pituitary adenoma shrank significantly and her pituitary is now considered "normal" size. No change in her spine (that's good) and all other organs except the liver are clear. The liver mets are smaller and fewer in size overall (yes!). So, she'll stick to this chemo drug weekly unless something changes. The doc will continue to monitor tumor markers in her blood and also liver enzymes monthly to verify that the treatment continues to work. Assuming all goes well, the next set of MRIs would be six months from now.
It is a great feeling to know that we've finally found something that has halted the relentless advance of Sarah's breast cancer. There are no guarantees for how long this will work, but we are just celebrating "today" and hoping it will be a long time! Gotta take it one step at a time and focus on life.

29 Sept Update

Quick update since it's been a while since I posted. Sarah didn't get chemo this week but did get her MRIs done of her brain, abdomen and spine. We'll be going in together next Monday to get the results. Keeping our fingers very crossed and hoping for confirmation that her mets are shrinking due to the Gemzar chemo treatments. Ben and Sam are both doing well in school. Ben is still playing his weekly soccer games and I think we'll let him start playing cello, which he saw at a school demo and showed quite an interest in. More to follow after Monday...

14 Sept Update

Quick update today - here's a pic of Ben and Sam looking forward to a school day. Sarah got her treatment on Tuesday this week and is doing ok. She's transitioning to Monday treatments so that it fits better with Sam's pre-school schedule. It got cold this week in Chicago as a reminder that the summer really is coming to an end - tonight it's in the high 40's outside.

6 Sept - Vacation Pics

We had an fun and relaxing time in Minocqua for our vacation last week. In these pics, we're at an Indian village, fishing, at a wildlife park, and touring the lakes on a small motor boat. Everyone had a great time and we really enjoyed our get-away.
Sarah got another set of tumor marker results and the numbers were promising - another decline in levels which took one number (CA27-29) down to normal levels and the other (CEA) almost to normal levels. This should indicate that the liver mets are stabilized and maybe even shrinking. We'll know for sure when the next set of MRIs are done at the end of the month, but we are celebrating this trend for now and enjoying a break from the constant anxiety we felt earlier this year. Sarah got another Gemzar dose when we got back from vacation last week but didn't feel too bad from it (and she felt pretty good during our vacation as well despite it being a chemo week!). Ironically, she feels worse now during her off-week because she got a white and red blood cell booster shot instead... sigh. Overall, it seems that Sarah is tolerating the Gemzar treatments much better, although I think some part of it is that she's gotten more used to the ebb and flow of fatigue and sort-of nausea under this drug. Chemo side effects seem to be almost as unpredictable as cancer itself - different from week to week.
On a final note, this is Ben's first week of school (first grade) and he loves it so far. During kindergarten he informed me that he would not be attending first grade, but he seems very happy with his "decision" to go afterall. :) Sam is also excited about starting pre-school which kicks off next week.

21 Aug Update

Here's a long overdue post and some recent pictures. You can see Sam and Ben goofing around, a pic of Sarah with her hair growing back and also a rare picture of me during our annual trip to see Thomas the Tank Engine at the Illinois Railway Museum. The boys both had a great time despite the rain. Thank God they were selling ponchos there!
Sarah is feeling ok these days. Gemzar chemo is hitting a rythm of one week on, one week off. She still gets Herceptin ever week and the 2wks schedule allows her body to keep up with the blood cell production with some booster shot help here & there. I think we've also got the right formula for her nausea under Gemzar - two of the anti-nausea drugs seem to have proven more effective with this treatment so that's a huge relief for Sarah. She still gets some nausea, but it doesn't freeze her in her tracks like at first... and it usually lasts for one or two days.
The plan will likely be to have Sarah get another MRI shortly after we get back from our vacation. We should also have some fresh tumor marker results waiting next week which will hopefully validate that the Gemzar continues to work.
Ben and Sam are getting excited about going to school. Ben will experience First Grade, which he sees as a big deal, and Sam will get to go to Pre-school like a "big boy." :)

3 Aug

A few T-ball pics - Ben playing shortstop and then right after a good hit. Sam didn't want to be left out of the picture-taking, so we got some shots of him too! (you can see the remains of a Harry Potter lightning bolt tattoo on Sam's forehead - those were a BIG hit).
We're doing ok this week. Sarah didn't get chemo this week due to a low white blood cell count. Although we want to get her as many treatments as possible, she can't help but be a little bit relieved to get a week off due to the nausea that sometimes goes with it. Her hair is slowly starting to grow back now since Gemzar chemo doesn't affect hair - and the nerve damage from the Abraxane is completely gone as well.
Ben's last day of summer camp was today and now we've got a few weeks where the boys will be home all day until school starts. We better come up with some things to keep them busy or they'll be driving us crazy... :)

26 July - Update

High time for another update! Sarah got another Gemzar treatment today. Unfortunately, she got very nauseated after the last one despite trying all available anti-nausea drugs and this time it is happening again. She's pretty miserable and is probably going to ask to go back to Abraxane - we'll see how this week goes.
But, there is some good news: Sarah got her tumor marker results today and they are way down & within normal levels! So, the Gemzar is likely helping. We won't know for sure until the next MRI which is not yet scheduled, but this was a big relief (except for the nausea part).
It's good that we do have a young nanny (Grace) coming twice a week to help out. She can watch the kids while Sarah gets treatment and when I work from home on Fridays I can keep an ear out so Sarah can rest and get through the worst of it.
Ben and Sam are doing well. Summer classes are starting to taper out & we're headed in to the lull before school starts again. We're going to try and plan a family get-away. Jury is still out on where we'll go.

4th of July

In the first pic - Sam says, "I'm ready for the parade!" The boys both loved the parade (and the candy, as you can see Ben eating in the last one). We've had an eventful week with Elizabeth B. visiting us from New Orleans and the extra holiday excitement.
Sarah's feeling ok after another Gemzar treatement. The nerves in her finger tips and feet are starting to recover, but fatigue and mild nausea seem to be a bit more pronounced after her treatments. We're still excited about the progress made with her liver mets. Hopefully we'll see a lower CEA number in a few weeks as well.

28 June - Good News from MRI

Well, we certainly were not expecting this - but we got some good news today! Despite the rise in tumor markers (CEA and CA27-29), Sarah's liver mets are around 50% smaller in size... so Abraxane did work afterall. There's still the question of why the markers were up, but we are celebrating that we've finally found something that helps fight the battle in her liver.
Since Sarah has already started the new drug Gemzar, we'll keep doing that for four treatments and check markers again. If it is also effective then she'll stick with that since Gemzar should not have the nerve-damage side effects that Abraxane and Taxotere did.
What a relief after walking around for a week thinking, "ok, how bad did it get?" Cancer is so unpredictable - we should know better by now that what you think will happen rarely does!

21 June - Starting New Chemo

Well, unfortunately now there is something new to report. Sarah went for treatment today and found out that her tumor markers went up, so it is almost certain that she's got at best a partial response to Abraxane. She's going in right away tomorrow for an MRI of her liver and already switched chemo drugs today. Now she is taking the next one on the list which is Gemzar. We're worried because the number of drugs that aren't able to control Sarah's BC is growing - Adriamycin, Cytoxin, Taxotere, Navelbine, Abraxane...
There are a few more to try and there's also Tykerb+Xeloda which is a recently approved advancement in BC treatment - of course we were hoping that it would be years before we'd cycle through all these drugs. However, we are trying to stay focused on hope. Any one drug can have just that right formula for an individual tumor and drive it back in to remission - that can still be out there for Sarah. The big question on our mind now is, "how bad will the MRI be?" This will be another nail-biter week of difficult waiting.

20 June

Not too much new to report. Sarah continues to tolerate the Abraxane treatments well except for the numbness in her feet and finger tips (which seems to have steadied out). She goes in for her treatment again tomorrow, but will likely not get Abraxane since her onc. wants to sprinkle in some off-weeks in order to give her body add'l time to recover. He's checking her blood counts and liver enzymes to ensure that we're not pushing past a tolerance threshold. Sarah's such a trooper - these days Sam constantly is asking, "Can you play with me?" and she manages to answer "yes!" despite chemo fatigue fairly often. :)
Father's Day weekend was fun. We didn't get ambitious with the activities, but got to spend lots of good family quality time together.

10 June Update

Wow, where to start - much has happened since my last update. First was Sam finally deciding he was ready to stop using diapers. You can see him proudly dropping trou' to display his new "big boy underwear!" Then came Ben's first communion at church last Sunday which went well. In the picture above, Ben is checking himself out in the mirror with a new elephant towel. :)
On the next day we got some sad news - Scott Davis, who we know from church, passed away after an all-too-brief struggle with brain cancer over the past five months. As we felt deep sympathy for Scott's family, we also experienced a sharp reminder of the uncertainty in our situation.
This past weekend, Sarah's long-time friends Nicole and Shelby flew in from out-of-town so the three of them could do a girl's weekend. They stayed in downtown Chicago to take in the sights together and really enjoyed themselves. I think I managed ok at home with the kids, too. :)
Sarah continues to feel ok. Just waiting for the next scan to determine how well the Abraxane is working on her liver mets.