Meeting with the oncologist, Sept 13, 2012

I was so nervous last night that I couldn’t sleep. I had itchiness all over the past few days and was worried maybe the billirubin had risen.

This morning we had an appointment with the oncologist dr. van den Berg. He is a very empathic, amiable and knowledgeable oncologist with a good reputation. Dr. van den Berg greeted us kindly and invited us into his office. He asked me how I was feeling. I said I was feeling much better now that I had the antibiotic for the infection and no longer have fevers. Of course I have some minor side effects which cause minor discomfort, but on the whole I feel fine, and don’t have problems such as nausea or vomiting, what many patients experience.

Dr. van den Berg told us the billirubin had stabilized at 22, which was good because normal values should be between 17 and 19. He said the liver had stabilized enough, so the chemo had worked and the liver was functioning as it should.

The CT scan showed that the liver has not yet decreased in size. Also the tumors have not decreased in size or number. But the color of the tumors had changed; they are now a dull, vague color, whereas they were very clear before. This means that they have stopped growing and are no longer expanding. The tumor marker he is tracking is CA 15.3 (CA stands for cancer), which is measured in the blood. The tumor marker has decreased, meaning the tumor is no longer growing. Also, there are no new metastases outside the liver.

Dr. van den Berg said he was moderately optimistic. He said this has increased our chances and has bought me time. He explained that he wants to increase the dosage of the Doxorubicine (Adriamycine) which is the chemo that targets the breastcancer. This is the chemo that was given to me in a very low dosage over 3 weeks, because of the possibility that the liver couldn’t manage it. Now that the liver is functioning normally, he feels it is safe to increase the dosage to more than 3 times what I was getting up until now, which will help to reduce the cancer cells in my body, specifically the liver, but also the breast. We will change to a cure of three weeks, which means one week chemo and two weeks recovery time.

I will start with the new cure (both Adriamycin/Doxorubicin and Cyclofosfamide) next Wednesday (19-9), and will come back to see him in four weeks time (15/10). For now, we’ve got the second cure planned on 10th of October, with a visit to dr. van den Berg on Oct 30th. A new CT scan will be planned just before, unless the blood values are enough to see the progress. Once the cancer is diminished in the liver and the liver is back to its normal size, he will see what we can do about the tumors in the breast and lymph node. For now, the focus is on removing the cancers from the liver as much as possible. Dr. van den Berg believes the higher dosage will have the impact that is needed. So, the new round of chemo will have to do the job! I’m am happy that this round of chemo will be much stronger and – I’m assuming – more effective. I’m sure it will impact me much more than the previous round, but I won’t have as many needles stuck into me which will help because my veins need a bit of a rest. I don’t know how many rounds I will receive, but that will depend on the initial results.

On a lighter now, I just wanted to share with you a line from a movie which we borrowed from Marita, our neighbor. The movie is the Best Exotic Marigold Hotel: for the elderly and beautiful which is a wonderful film about several British people who – for very different reasons – decide to relocate to a hotel in India. Of course, the hotel is nothing like the brochure (“It is a vision, ma’am”, explains Sonny, the young hotel manager, “of how it could be.”). But each guest (and Sonny too) copes in his or her own way, and discovers something important to them. What Sonny tells his guests (and himself) is a life lesson in and of itself: he says “It will all be all right in the end. And if it is not all right, it is not the end.” And that’s how I see it too!

So the next weeks I will probably have little news, but I will keep you posted of how I feel. Thanks for all your lovely comments. I cannot reply to each of you individually, but I am moved by your positive thoughts. Take care!