Next up: Taxol

I hoped I wouldn’t have a new treatment line to write about for a long time, but the time has come to change again. I am now on my 4th treatment line in the MBC setting — 1) Verzenio (with Keytruda for a while) + Anastrozole (4 years); 2) Xeloda (2.5 months); 3) Enhertu (5 months); 4) Taxol (current). 

Earlier this week, I had scans: MRIs of my hips and liver and PET/CT of my chest, abdomen, and pelvis. On Enhertu, I was being scanned every six weeks, and if you remember, the last two scan results showed some growth and some shrinkage, but we called that “stable” even though things were mixed. Going into the scans this week, I had a feeling that I wouldn’t have mixed results again. Something inside me just knew things weren’t moving in the right direction. 

Results showed that my bones likely have stable-ish disease, so that’s pretty good. But my liver lesions have grown. Not a lot, but enough that I cannot stay on Enhertu any longer. The cancer has become resistant to this medication. I got about 5 months on this treatment line. Not great. My liver enzymes continue to rise slowly, and my tumor markers are also rising again. 

After discussing the scans, my oncologist and the fellow presented some treatment options to me, and I asked a bunch of questions about the pros and cons of these options; the leading choice was Taxol, though. I was hesitant to do this chemotherapy again. I was on Taxol in 2016 for cancer 1.0. It’s usually pretty well tolerated with manageable side effects, but I did something called dose-dense Taxol previously, which can be much harder on folks as it was for me. This time though, I will be doing regular taxol infusions. The schedule sucks, to say the least — weekly infusions for three weeks and then one week off. This is one cycle. I will have two cycles and then have scans again. Because my doses are more spread out compared to my dose-dense regimen before, I should tolerate the infusions better. Fingers crossed, my friends! 

That’s the gist of it for now. 

If you want to hear about my insane day on Thursday, then keep reading. More details to follow.

A full day

Yesterday my FIL picked me up at 10am. I usually drive us down to Boston, and he drives us back, but today I needed him to drive so that I could take a call from 11-12pm while we were driving. I started a virtual Memory + Attention workshop through the Dempsey Center, which will be very cool to be a part of since I have been struggling HARD with this since beginning IV chemo. 

When we arrived at Dana Farber, we checked in, and I headed over to BWH to visit my friend that is in hospice over there. I am so grateful that my friend’s family allowed me to have time with her. I hope to see her again, possibly next week, but only time will tell. Seeing a friend in this state is tough, especially when they are dying from the same disease I have. But it’s also incredibly powerful and meaningful to be in the presence of someone you love in their final days. I came out of that visit with renewed strength to keep living fully as long as I am able. I was also amazed that she was still being a friend to me in these moments. She and her husband bothered to check in with me. Seriously incredible and selfless. 

After compartmentalizing that visit as best as I could, I made my way over to DF again to meet with my FIL for some lunch. I scarfed a slice of pizza and battled with the elevator traffic to make my way to my psychiatry appointment. I started a medication called Zyprexa three weeks prior. It was to help with sleep, nausea, focus, attention, and mild anxiety. The good news is that the very low dose has been working wonders, and I have felt much better. So I will continue with this medication for a bit longer. Hopefully, it works well with Taxol too. 

I headed back downstairs and got my blood work at lab services and then back upstairs to meet my FIL in the atrium. If you’re ever at DF, the atrium is a lovely quiet, tranquil indoor garden in a sea of chaos. 

Next up, we headed upstairs again for my oncology appointment. My appointment with my oncologist was a little crazy, to say the least. Unfortunately, appointments were running behind, so I didn’t get in to see my oncologist until 4pm. We discussed the scans and new treatment options (two standard-of-care options and three clinical trials). At 4:15pm, mid-discussion, Dr. Tolaney got a call from infusion saying that if I wanted to start Taxol that day, I needed to be in an infusion chair by 4:30pm because of how long it all takes to infuse with cold capping. 

So with that, I put on my decision-making hat: if Taxol was the best option for right now, then why put off starting it until next week? Yes, let’s begin today. I signed the paperwork, and we worked out a rough schedule. Three weeks of infusions, one week break, repeat. Scans in eight weeks.

Want to know a little about Taxol? Below is the information sheet I was given. Of course, we also talked more in-depth about it, but these are the basics. 

Folks on Taxol that choose to cold cap have had pretty decent success. I will continue with my cold capping but will probably encounter even more thinning than before. I hope it won’t be too bad. I’ll keep ya posted. 

The oncology visit was brief and felt rushed, which is not my typical experience, but I made it into the infusion chair by 4:30pm. Before I left the oncology appointment, I asked for a new liver biopsy and another liquid (blood) biopsy. The information gathered from these biopsies won’t change the choice to start Taxol, but it will help with knowing what treatment should come next. I should probably get the tissue biopsy in the next week or two. And the liquid biopsy was done yesterday in infusion; those results should be back in two-ish weeks. 

Once I was in the infusion chair, we started with the premeds and scalp cooling. Premeds are different for Taxol than for Enhertu. I have to have steroids, Pepcid, and Benadryl. Taxol can cause allergic reactions, so they premed with Pepcid and Benadryl to help offset any reaction. The steroids help with nausea. Plus, I am on a low dose of Zyprexa (medication from a psychiatrist), which also helps with nausea. I remember that the steroids will hype me up for a few days, and then I’ll crash, but hopefully, the nausea will be minimal. These premeds were all administered through my port, and the Benadryl made me feel crazy! But that wore off, and I was just sleepy for a bit. 

I walked out of the infusion suite with my FIL at 8:30pm. We made it home by 9:45pm. It was a long day. 

I woke up this morning feeling good physically and mentally. Hoping to get out for a walk soon. I want to enjoy this sunny day! 

The meal train has been updated with a few more dates since my schedule is changing. If you feel so inclined to feed my family on treatment days, we very much appreciate it! Love to you all. XO