As many of you know, just a few weeks ago–June 19, 2018 to be exact–I was reveling in having wrapped up my last chemo treatment. Six cycles of atezolizumab + paclitaxel + carboplatin + bevacizumab or a placebo + paclitaxel + carboplatin + bevacizumab, and I was done. I’d had surgery in March after which I was determined to be virtually cancer free, so the plan after this final chemo treatment was to move to maintenance therapy with atezolizumab and bevecazumab.
Unfortunately, there’s been a development that’s thrown that plan out the window, at least for now.
When I was told I was virtually cancer free in March, I was informed that the term “virtually” is used because there is always the chance that there is some remaining cancer that cannot yet be detected. In my situation, that turns out to have been the case. The CT scan I had on June 22, 2018 showed my para aortic lymph node(s), which lie in front of the lumbar vertebrae near the aorta and receive drainage from the gastrointestinal tract and the abdominal organs, were double their normal size due to a tumor that had previously been undetectable. The good news, and it’s important to look for good news, is that this is not a recurrence of my cancer. Rather it is a progression of the same cancer I was diagnosed with in November 2017. Unlike my other tumors, however, for some as yet to be determined, this tumor hasn’t responded to standard of care treatment of paclitaxel + carboplatin + bevacizumab. This means it is classified as platinum-resistant, and so will need to be treated with a different chemo cocktail.
So in a week or two, I will begin a new treatment plan which will entail treatment every 2 weeks and alternate between bevacizumab, a.k.a. Avastin and doxorubicin liposomal, a.k.a. Doxil for a total of 3 cycles each. I will also receive all the anti-nausea and blood supportive drugs I’ve been receiving and Neulasta, and for the first treatment I’ll also get dexamethasone, a steroid to ensure I don’t have an allergic reaction to the doxorubicin liposomal.
From everything I learned in my chemo class today and have read since, this treatment will not be as nearly as hard on my body as has been my last. The most common side effects of chemo: vomiting, nausea, constipation, diarrhea and compromised immune system will be less severe, and I won’t experience any additional hair loss.
My doctor was very clear that this is a set back and not a death sentence, and that she is still optimistic that I can achieve remission. She says she has lots of options available to her if this particular treatment doesn’t work and will be doing a biopsy of this tumor to determine what targeted therapies might address its particular make up. Additional clinical trials may also be options.
Of course I am angry, disappointed, and sad. I was so happy to have reached the end of the first stage of treatment and looking forward to moving to maintenance therapy, but I am determined to get through this just as I did the first line treatment.
Let the new battle begin.