are nearest:
breath in your body,
light in your eyes,
flowers at your feet,
the right path before you.
~ Robert Louis Stevenson
It is amazing what a difference a few weeks makes. It has been tough and stressful. The PET/CT scan I had on Febuary 1 was really bad news. 5 more new tumours and the tumour in vertebra T9 was now taking up most of the vertebral body and T11 now also had a tumour. I panicked. My great fear was that the structural integrity of the vertebra T9 was compromised and could fracture or collapse at any moment. Worse case scenario was paraplegia. Yikes. Had an MRI on the 3rd, saw the oncologist on the 8th and had a more detailed CT of the spine on 10th. All to be assessed by a radiolgy intervention specialist to see if vertebroplasty (pumping of 'cement' into the bone to give it support) was an option. Also saw a surgeon that day to assess possible stabilisation of the spine with steel rods if cementing was not possible or not enough. It was a really scary week. I felt I was walking on eggshells and worried that any sudden movement or jarring could mean collapse of the vertebra and paraplegia. It was pretty hard to stay positive.
The good news was that the tumour in the vertebra was a mixed lytic and sclerotic tumour. The sclerosis means that there is strong bone within the tumour and in this case enough of it that imminent collapse was very unlikely. It also meant that vertebroplasty was not an option. No horse riding or bunjy jumping, but otherwise ok. Phew!! Surgeon said there was more chance of becoming paraplegic with the surgery than from the tumour at this stage. In other words very low risk. Back pain was increasing and radiating around the ribs to the front of the chest and I am sure the stress didn't help with that. The rapid progression of the cancer was still scary but I didn't feel as panicked.
So, I still needed to deal fairly quickly with the spinal issues and also with the cancer progressing so quickly generally. The Aromasin obviously wasn't working. More visits to oncologists. Included this time was a radiation oncologist as well as my chemo oncologist. Now the plan is that I have radiation treatment on the spine from vertebra T8 to T11 starting today. I will get 10 treatments, one a day, except weekends. As breast cancer metastases are relatively sensitive to radiation a fairly low dose of 30 Gy is used so there should be minimal damage to surrounding tissue - main concern is the spinal chord of course which lies right next to the vertebral body where the tumour is. Fortunately, these days, the radiation is beamed from different angles and only where the beams converge do you get the full dose. This also helps protect surrounding tissue although I may get some effects to intestine and liver. May also get some burns on the skin. Hopefully no lasting damage to spinal chord which apparently copes well with that level of radiation. I will start a new hormonal drug, Farestin, as soon as I finish the radiation. This is again an estrogen suppressor but works on a different pathway to the 3 previous hormonal drugs I have been on which were all aromatase inhibitors. This is a pure anti estrogen.Treatment progress will be monitored. I will also have a blood test for the cancer marker, CA15.3, three weeks post radiation and revisit the chemo oncologist then. The last CA15.3 was increased again to 78. Some people have the marker well into the thousands but it is a relative and individual thing. The highest level I have had was when I was first diagnosed at 80. I have had it as low as 29. It is going up at more that 10 a month. The results in 5 weeks will determine what other treatment I may need. Chemotherapy will be an option then. The reluctance with that is that I am feeling physically pretty good. Chemo would be longer term (average is 4 months) and will make me sick. If the new hormone treatment can hold the cancer and stop progression it may be better to just leave it and keep the chemotherapy for later problems if they occur. There is also a limit as to how much chemotherapy the body can tolerate over time. Unfortunately no brakes on the cancer spread while having the radiation to deal with the spine.
So, I am trying to enjoy my physical well being such as it is. The radiation should resolve the back and chest pain issues. Now that I have a treatment plan I feel like I can get back to a more normal life. I am very lucky that the radiation can be done at a new hospital 5 minutes away so that should have minimal impact on my daily activities. I have not returned to Tai Chi. A combination of the back pain and being too busy with appointments and research to get there. Dog walking also suffered and I am just getting back into that the last couple of days. I did spend a lovely couple of days visiting my mother at Tea Gardens in between appointments. Also bought a portable zero gravity chair to help take the weight off my spine. Very comfortable.Surviving and thriving
