Category: Diagnosis - The Funny Thing About Cancer
 
The next thing that everyone should understand about cancer treatment is that it changes ALL THE TIME.

You know Susan Komen foundation and the 3 Day walks and all those other fund raisers?  Well they help fund research.  And there is a TON of research going on that is exciting and changing the face of cancer treatment every single year.

So after my last blog, we all know that standard treatment = surgery + chemo + radiation (if necessary) + other drugs depending on the type of cancer you have.

These treatments alone have translated to an average 75% survival rate for breast cancer patients, which is amazing. 

But to get to that elusive "cure", we move onto the exciting world of possibilities.  The world of experimental drugs and drug trials.

Wow, that sounds bad huh?  Mom, I swear the experimental drugs I'm talking about are ALL legal ;)

Anywho, as a cancer patient, these new drugs and trials are VERY exciting.  The direction these drugs seem to be going is towards blocking/destroying the building blocks of cancer cells.  Drugs to this point have focused on killing cancer, but none of these drugs have succeeded 100%.  Doctors feel as though even after chemo, radiation, and surgery, the body continues to house tiny traces of cancer that can eventually lodge somewhere and cause a recurrance.  The new drugs focus on stopping cancer growth and stopping recurrance by not giving cancer the fuels it needs to grow/survive.

Exciting right?  I just wish these drugs were tested and trialed and proven!  I wish these things were part of every treatment and that there was a true cure.

But we're not there yet.  Many of these drugs are super new.  SO new, in fact, that they are only being tested with stage 3 and 4 cancer patients (people with wide spread cancer). 

I, luckily, am NOT in that group.

There is only one drug that is currently in the trial phase that I'm eligible for.  This drug is called Avastin.  The idea behind how it works is that it stops the body from creating new blood vessels.  If the tumor can't create new blood flow, it can't grow.  At least that's the theory.

This drug is already in use for certain types of cancer. 

However, with stage 3 and 4 breast cancer patients, it hasn't met the barriers necessary to get FDA approval.  It does extend the life of these later stage patients, but only by a few months.  That being said, within that group, people with MY type of cancer (triple negative) had stronger results.  It still didn't extend their lives drastically, but it was more effective than with the hormone receptive group.

Which leads to the current trial.  They want to test to see if this drug has any benefit for the stage 1 and 2 cancer group as far as stopping recurrance.

I've been asked to take part in this trial and I'm struggling a bit with the decision.  In my cancer group (triple negative), I don't have any long term treatment.  There are no drugs to keep my cancer at bay.  Recurrance rates are higher.  Survival rates are lower. 

If this drug can possibly keep my cancer from coming back, then I'm ALL ABOUT IT!

That being said, I can't get surgery while on this drug.  Due to my pregnancy at the time of diagnosis, I only got a lumpectomy for my first surgery.  The plan was to get a full bilateral mastectomy and reconstruction after the baby was born and chemo was complete. 

I personally feel that a bilateral mastectomy is still very key to keep recurrance at bay.  In my family history, everyone that has had breast cancer has had recurrance in the other breast.  This surgery is very important to me.

So those things being said, here are my perceived options:

Option 1:  Get bilateral mastectomy before I start chemo.  This means chemo is delayed for at least another 6 weeks.  The thought of little cancer cells floating around in my body trying to spread freaks me out.  It makes me want to start chemo yesterday.  But surgery first means I can probably have the best of both worlds, surgery AND being a part of this trial.

Option 2:  Start chemo and be a part of the trial and wait for surgery.  This study has 3 groups, one that has plecebo, one that gets 8 rounds of Avastin (all during chemo treatment) and the 3rd that takes Avastin all throughout chemo (8 rounds) and another 10 rounds after treatment is over... totalling about a year of treatment.  If I get group 1 or 2, then I could still get surgery when I originally thought I would, which is after chemo.  If I get the 3rd group, then surgery would be delayed a year.  The mastectomy, recovery and reconstruction is another long process and I couldn't even begin to embark upon that until 2012.  And would my insurance even cover it a year later?  Just so many questions.

Option 3: Don't take part in the study and just go with my original treatment plan.  Chemo, then surgery.  My fear with this is that the cancer comes back in a year or two and I always wonder "what if I had done the trial?"

And this is my current struggle.  I need to have some conversations with my doctor, talk to my insurance company and get some questions answered.  The more information I have, the better the decision I can make.  Hopefully I will be able to come to a decision in the upcoming week as I learn more about each of my options.

Note: I wrote this blog on Sunday.  I spoke with my oncologist yesterday and some things about my diagnosis have changed that change EVERYTHING.  Aside from the obvious "MORE CHANGES?!?!?" reaction, this is actually a really good thing.  I'm 100% comfortable with my diagnosis and my treatment plan.  More to come on this :)