Loose Strife

Sorry for taking so long to post about Laura’s MRI scan results. The originally scheduled MRI last Thursday had to be rescheduled to this past Tuesday and we just got the results today. The MRI confirms the PET/CT scans indicating that cancer is stable. Recall that there were three concerns with her back that prompted a full neck to pelvis MRI scan: possible encroachment to the spinal cord at the neck, a compression fracture at the middle back, and large tumor deposits in the lower back. It turns out there were no significant changes between her last scan at the end of January and now. The neck issue is not threatening any nerve damage. And the other bone changes are stable, so there’s no cause for alarm. On the contrary, relatively speaking, this is very good news.
In addition, Laura’s neurological state seems to also still be stable — another 2 weeks with no ill effects. Truth be told, that’s not completely accurate. Laura has minor hand tremors that we think have gotten a little worse. But certainly no headaches or serious nervous system effects.
I asked the doctor how she reconciled Laura’s very good state with the statistics that most people with leptomeningeal mets decline rapidly. The reply was that WBR could have had an impact, but the other suspicion is that Laura’s cancer is very hormone responsive and remaining stable due to the ovary suppression drug she’s on.
Maybe it is hormone responsive or maybe it isn’t. Laura was taken off hormone therapy early in her initial treatment last fall because her condition was rapidly worsening. But she wasn’t on hormone treatment long enough to definitively say it wasn’t working. Instead, she was put on chemotherapy, which as a side effect, also puts one into menopause. So, maybe the chemo “success” was at least partially due to the hormonal effect.
Whatever the case, Laura has somewhat remarkably remained stable. And as for treatment, she’s just going to continue with the minimal drugs that she’s currently on: ovary suppression, bone strengthening, and as needed pain control.
Laura’s actually feeling conflicted right now about treatment. She’s frustrated that she’s not feeling great — her broken leg still bothers her, some back pain, achiness, fatigue. Her leg was xray’d again and it looks fine. Physical therapy is planned, but another 2 weeks out, so her oncologist is trying to pull some strings to have her seen sooner. But although she’s not feeling great, relative to the way she felt before surgery, she can’t complain and wonders whether her current condition is acceptable: the new normal.
On the one hand, she wants to do something about her aches and pains. On the other hand, she’s very resistant to new drug treatments — surprisingly so and more than I am. I think she recalls her experiences from last fall and really dreads being on more pills. It’s something that she’ll continue to be considering in the coming weeks. Her oncologist heard Laura rattle off her various issues and started to push for chemo again, but Laura flat out refused.
I definitely understand. Who wants to mess with a good thing — even if it’s not perfect? Today was another gorgeous spring day and Laura relaxed on the porch most of the day while Naomi played. The two strolled around the yard picking daffodils while I was yanking brambles along a fence line. Life is good right now… except for the aches and pains. Laura has a strong hope that physical therapy will be the help she needs.
Last night there was a PBS program about metastatic cancers. It’s excellent. If you missed it, it may show or be rebroadcast at a different time in your region. Or the whole program can be viewed online. I thought it was outstanding, touching on a lot of the life and death issues faced by people with advanced cancer, their families and doctors. When is enough; how the research clinician wants to push experimental drugs; the odd guilt that you’re letting down your friends and family by not fighting “hard enough”; the sad truth about the low success rates for advanced cancers; the emotional impact of diagnosis and treatment decisions; etc. Even the follow up interview piece, although not nearly as poignant, was good because it touched on two key points about cancer: the importance of living in the moment instead of suffering in the past or the future and the idea that hope is not just about a cure, but also about the confidence that treatment will be expertly administered, that pain will be comfortably controlled, that family, friends and doctors can be trusted and so on. I recommend the whole two hours.
Let’s see… before I finish, a couple more newsy bits. There’s only a few spots of stubborn snow in Ashfield now. The seasonal springs and resulting mud are quickly drying up. We’ve got some early veggie starts already in the ground. We spotted a river otter in the pond. We took a day trip to Boston for Lily’s birthday and last weekend she had a fun tropical birthday party, inspired by our recent Hawaiian getaway. Naomi will be three next week. And Laura also had her 38th birthday last week. The tulips that friends came to plant last fall are starting to bloom. At one point it seemed like she wasn’t going to enjoy all these gifts, but now things are so different.