This is a quick update with more to follow later this weekend. I just finished chemo and I am resting. The PET/CT scan shows the disease is progressing. The disease now involves the lymphatic system and the bone & liver cancer continue to grow. We are changing chemo protocols.

A friend asked me “wouldn’t the cancer ’seeds’ have been in your lymph system already, for it to have spread to your liver and spine.” It is a great question. What I have learned today is cancer spreads through either the lymphatic and/or vascular system. Due to node negative state of the original tumor and all nodes have been clean & clear throughout the prior studies; it is believed my cancer was proliferating via the vascular system until now.

Please know we are never alone. Today at chemo after getting the news I was feeling sorry for myself. One of the patients came to me . It seems her young niece and friends wanted to do something for other patients. They made bookmarks with encouraging verses. I looked at her and said thank you - God had a message for me today. She asked me to read through them and pick one I liked. I told her God knew which one I needed. I said a prayer, closed my eyes and picked. Here it is:

Trust in the LORD with all your heart: do not depend on your own understanding. Seek his will in all you do, and he will direct your paths. Proverbs 3:5-6

Grace & Peace my warriors - Steph

Helena, my nurse practitioner at The Center, reviewed the lab results with me. They are not what we are wanting to see and could indicate possible progression of current disease (liver & bone) or a new location. It will be tricky scheduling with the holidays but we will attempt to get these scheduled and approved by insurance so we can have these completed next week. If you remember from a couple of weeks ago we anticipate the liver tumors are smaller and improved. From a physical exam, my liver is much smaller and the blood work for my liver is back within the normal range. Below I have a chart with my tumor markers and then a lesson:  ”Tumor Markers - What do they mean?”

UPDATE: The CT/PET scan is scheduled for Wednesday morning at 7am. We should have results by Friday; it is our regularly scheduled chemo Friday. I don’t even have to ask you to pray for us because I know you already are. I promise to post an update Friday even if it is no news, good news, or bad news. Grace & Peace - Stephanie

Tumor Markers: What do they mean? 

Tumor markers are measurable biochemicals that are associated with a malignancy. They are either produced by tumor cells (tumor-derived) or by the body in response to tumor cells (tumor-associated). They are typically substances that are released into the circulation and thus measured in the blood. Once cancer is diagnosed, tumor marker levels sometimes help to determine the extent of cancer. Higher levels can indicate more advanced cancer and a worse prognosis in some cases. The patient and their physician may use this information to choose between more or less aggressive treatments.

Monitoring cancer treatment is the most common use of tumor markers. As cancer is reduced, levels often decrease. Stable or increasing levels often indicate that the cancer is not responding to treatment. The choice of tumor marker to use for monitoring is important. Only a marker elevated before treatment should be used to monitor a person during or after treatment. Timing of the tests is also important. Each tumor marker has a unique life span in the blood. To monitor a treatment’s success, enough time must have passed for the initial marker to be cleared from the blood. Tests done too soon may be falsely elevated because the marker produced by the untreated cancer is still present.

Watching for cancer recurrence after treatment is another reason for tumor marker testing. Periodic testing can sometimes detect a recurrence often months earlier than could an ultrasound, x ray, or physical examination. Conclusions based on tumor marker tests are seldom based on one test result but on a series of test results, called serial measurements. A series of increasing or decreasing values is more significant than a single value.

Tumor marker testing is currently the object of much research and attention. Their use is directed by approval from the Food and Drug Administration (FDA) and guidelines established by organizations such as the American Society of Clinical Oncology and the American Cancer Society. Not all tumor receptor marker tests are widely available nor are they widely accepted

CA 15-3 is produced by cells in the breast and increased levels can be associated with breast cancer. Rarely increased in women with early breast cancer, it may be used to detect recurrence of cancer in women following treatment or mastectomy and to monitor treatment for women with advanced breast cancer. However, adenocarcinomas of the ovary, lung, colon, and pancreas also express elevated CA 15-3 levels. Non-cancerous conditions sometimes associated with elevated CA 15-3 include benign breast or ovarian disease, endometriosis, pelvic inflammatory disease, and hepatitis. Pregnancy and lactation are also related to high CA 15-3 levels.

CA 27-29, also called breast carcinoma-associated antigen, is used as a marker for breast cancer. Eighty percent of women with breast cancer have an increased CA 27-29 level. This marker may be used with other procedures and tumor marker levels such as CA 15-3 to check for recurrences of cancer in previously treated women. Serial measurements monitor treatment response and identify recurrence. Levels of CA 27-29 may also be increased in cancers of the colon, stomach, kidney, lung, ovary, pancreas, uterus, and liver. Noncancerous conditions associated with elevated CA 27-29 include first trimester pregnancy, endometriosis, ovarian cysts, non-cancerous breast disease, kidney disease, and liver disease.

I hope you have find the lesson in tumor markers informative. As we have learned they are just a piece of the puzzle and a guide. They not an absolute. All these advances are here today as a result of research and a combination of monies and time invested to find a cure for Breast Cancer. Raising money and creating an increased awareness has become a mission for us. We appreciate the financial support for the Komen 3-Day. We look forward to the day we can share the national Komen commercial with you. One day we will have a cure.

Apologies for the delay in posting. We had another successful Friday, we completed a round of chemo… I think this makes 12. My platelets, white count and red count were within “chemo range” (see prayer works)! We reviewed our lab work and our tumor markers while remaining quite high did drop 76 points (prayer working again). We will repeat this today and see where we are next week to determine if we need to schedule scans. My extreme fatigue continues. Some say if I would slow down it would help. Helena, NP says we are beating this cancer with a very aggressive protocol and the fatigue is expected.  They had mentioned before that some trials had been conducted with low dose Ritalin with varied success; some saw a mild increase in energy while others did not. I told her I was willing to give it a try.

I have lost count of courses and rounds and I thought we would validate these. A little review of the calendar should be fairly easy and/or maybe a bit confusing but let’s give it a try.:

1. The 1st protocol started the end of June and we completed two courses by the end of August. We had to delay treatment several times due to low counts. The 1st protocol, “A”: one course consisted of 3 rounds, once weekly then a week off.  So the total for Protocol A, 2 courses times 3 = 6 rounds.
2.  The next and current protocol, “B”: one course consists of 2 rounds, once every other week with a week off. This protocol started Sept 7th and we have not missed any rounds. Today we completed three courses. The current total for Protocol B, 3 courses times 2 equals 6 rounds plus Protocol A: 6 rounds makes today Round 12 or Protocol B Course 3:2.

Our tasks at hand are pray for a continued drop in my tumor markers, increased energy and continued health with our chemo regime. As we prepare for Thanksgiving pray for safe travel for all our friends and family that travel and that we might all stop and reflect on all our blessing we have received or witnessed this past year.

Grace & Peace my cherished friends and family.

I did not have chemo this past week, it was my scheduled off week. Friday I had my weekly lab drawn. My white count was beautiful. The red count was low and I received a shot of Epogen. My platelet count was low (80) and unfortunately there’s nothing I can do for platelets. I will need my platelets be  at least 100 to receive chemo this coming the 16th. Rest, prayers and hopefully they will be high enough. I have been resting plenty as I am quite exhausted from our trip.
 
We reviewed my latest tumor marker (CA 15-3) and the good news is it dropped 75 points. and is now under 600. Normal is less than 30. We will repeat it every 2 weeks to make sure it continues to drop. They still have concerns the cancer has spread to a 3rd site but we will monitor. We are trying to stretch out my exposure to radiation from the scans since it is quite possible we might use radiation with the bone cancer at some point. The plan is to repeat all the scans after Thanksgiving.

Trudy and I had lunch Friday, we ate at Pappadeaux. We split a greek salad. I got to play with her new HCT touch phone (Sprint). I setup her connection to the Exchange server at work. John, David and I went to dinner with my folks and some of their long time friends tonight, Sunday. Several of them were benefactors for David on the 3-Day walk. The company was grand and the food was pretty good too. We had tortilla soup, king ranch casserole, tamales, seven layer dip and a cake that was to die for. They also had a homemade cherry pie but after the cake I didn’t have any room. They are all active readers of the blog.

Wow, we are home from an astonishing whirlwind trip to LA where we made a commercial for the 2008 Komen 3-Day. I am glad David and I traveled despite the fact I had chemo on Thursday. My mom asked if I had a chance for a ‘do over’ would we still go; my answer was ABSOLUTELY! All the people we met were awesome and inspiring. Each of you has an amazing story. They all include as a core: love, devotion, commitment, beauty and inner strength. I can’t believe we all just met on Friday. This weekend was truly a “God trip”. I believe, much like I heard Amy and others express, he placed all of us together with divine purpose. When I used the words “all of us” I mean everybody involved in making the PSA: Jason, Jerry and the entire Sticks & Stones crew, Liza, Rex and all the Radarworks agency team and of course the “Talent”.

I am continuing to add photos from the 3-Day to the Gallery. I only have a few loaded which means I have lots of work to do this week. I was so tired, I hardly pulled out my camera this weekend. The Sunday morning session was the only time. After looking at the photos I had, I wish I had gone to support the Saturday group and taking pictures of their experience. Of course I say that now after coming home and napping from 7 pm until 10 pm tonight. I can’t wait to see everyone’s pictures from the weekend.

Since March, when I was diagnosed with recurrent stage 4 breast cancer and given 18 months, I have received so many blessings. God is constantly opening doors and putting me in unique opportunities to meet remarkable people. It has been a never ending supply of renewed strength, spiritual growth and encouragement. I cherish these moments and find myself surrounded by special people when I need them most. I am never alone. The poem Footprints has become a blueprint or reflection of his presence in my life. It sounds weird to say but breast cancer has become a blessing in my life. It is also a horrid disease that is likely to steal milestones from mine and my family’s life. The picture of Mary and her Mom at her wedding was so beautiful. I pray I have the opportunity to be there in person and share a wedding with both Jennifer & David. We must find a cure to eradicate this wicked disease! If not in my lifetime, please can we do in Jennifer’s?

I cherish my autographed t-shirt & group photo and the very special gift of FAITH. This weekend is just the beginning of our relationship. I promise to keep in touch. I love you all!

Steph & David

We awoke at 9:30 (11:30 CST). I feel almost human. We went down to breakfast, most of the group was already there. It seems half the group is working today and half tomorrow. We have decided to rent a car and slit it with a group that is working tomorrow. David and I will have it to see the town Sunday. They returned from the rental car place with a Mercedes. Yea… nothing but the best for the “Talent” they said. David and I headed back to the room to rest, I am planning on taking a nap and he is playing video games.

I have uploaded some of the pictures from the 3-Day in the Gallery. Enjoy, there are tons more but I won’t get to those until after we get back. Time to nap so we can go be “Talent”.