Meet My Army

We have a plan!

OK: in case I have not said this directly, based on imaging, my ovarian cancer is back. The first step is chemo for nine weeks, then possibly surgery, and then more chemo.

While defiance is my favorite cancer strategy, I am pretty exhausted already from the last six months of Lynparza, so we’ve decided I am going to take a leave from work during treatment. I felt like I had to choose between work and all the other things in life, so it ended up being an easy choice. Today was my last day.

Chemo starts on Tuesday. Yes, Valentine’s Day. Which is fine - we are not big fans of Valentine’s Day.

I’m OK with this. I looked at the CT images, and to my untrained eye they are UGLY. Mostly fluid, but the images look like a cloudy mess. So let’s get on this! Plus, I have a trip planned with a friend at the end of March, so if we start Tuesday, I’ll be at my best when we get together. Priorities!

Prayer requests and possibly some inspiration at the bottom, so feel free to skip down if you’re not interested in the drugs we’ll be using to fight this round.

If you’re curious, here’s what I’m getting:

My chemo army is not made of marshmallows. 

Neither are Peeps. This I know from many campfire experiments.

Chemo Drug #1: CARBOPLATIN

This drug is in the platinum category, so I envision him as my knight in shining armor. I believe there is real platinum in the IV bag! It fights cancer by damaging the cells’ DNA so they cannot multiply. I suppose we could say it is a little like birth control for cancer cells. It also effects healthy cells that multiply rapidly, like hair and blood, so I’ll likely loose my hair again and my blood counts will drop.

I had this drug way back during my initial chemo. He is effective but brutal. Last time, this would put me squarely on the couch for three days. I also developed an allergy to it, but in the true maverick nature of cancer science, we don’t really care about that! There are ways around it (allergy-suppressing pre-meds and a slooooooow infusion rate). We are going back to this drug because ovarian cancers in people with BRCA 1 mutations (me) are “exquisitely sensitive” to platinums.

I’ll get an infusion of Carboplatin once every three weeks.

Chemo Drug #2: GEMZAR

This drug is new to me. We’ve always avoided it because it tends to be tough on platelets, which are my most quickly depleted blood cells. Since we call it Gem for short, I imagine this one is shiny and flashy. And maybe a bit dodgy. It prevents cancer cells from making and repairing DNA, so they cannot replicate. Similar to Carbo, but a different action. Also similar to Carbo, Gem hits healthy cells that multiply rapidly, like hair and blood.

I think this drug is fairly tolerable. I’ll get an infusion the first and second week, then have a third week off.

Chemo Drug #3: AVASTIN

This is my pirate drug (as in “AVAST, mateys!”). I’ve had it before. It’s actually a targeted therapy rather than a chemotherapy, so it’s generally very kind as far as side effects go.

This drug is called an - are you ready for a lot of syllables?! - anti-angio-genesis drug! 

If I can get a little geeky for a minute, I think this is SO COOL. Angio = blood vessel. Genesis = beginning or creation. Angiogenesis happens when we need more blood flow. If you’re an athlete, your body will create more blood vessels for your heart and muscles in order to bring more blood to those super active areas. If your heart vessels are mildly clogged with plaque, your heart will create more vessels in order to supply the adequate amount of blood to the heart. Isn’t that cool? Our bodies are incredibly adaptable.

So ANTIangiogenesis means Avastin inhibits the formation of new vessels. Cancers tend to be greedy and build a big blood supply to themselves. When Avastin makes this harder, cancer gets less blood and therefore less fuel, and we essentially create a famine for the cancer.

I’ll get an infusion of Avastin once every three weeks.

Then there are the supportive meds:

Anti-Emetic

Emesis is a fancy way to say vomit. I’m not sure why we can’t just use one word, but that’s medicine. We LOVE this class of drugs because they remove most of chemo-induced nausea and vomiting (thus ANTI-emetic). I’ll get one via IV before starting, and I’ll have a few kinds of pills to see what works if I need anything at home.

I'm also resurrecting this gift from Mike:

Yup, it's a horse's feed bucket, and it's very handy to have, just in case...

Steroid

Probably dexamethasone, because she seems to be the darling of oncology. Steroids get a bad rap, but this darling does a couple things for me that I love. First, it reduces the likelihood of an allergic reaction. Second, it gives me ENERGY for about a day and a half. I’ll be a little jittery, but it’s a beautiful thing to have energy before a few days of feeling awful.

Benadryl

This will also help prevent an allergic reaction. It usually doesn’t make me too sleepy, but Mike says it makes me slur my words. But I sound quite clear to myself and the nurses are professionally neutral, so…

Here's what we want the drugs to do to the cancer:

I've used this image before, but I just love it.

That’s pretty much it. Maybe more, depending on what kind of side effects I have. The first cycle is usually the worst because you figure out what the side effects are going to be. Then you create a plan for the next cycles to better manage the side effects.

Prayer requests

I have a long list today. But there are a lot of you. So choose one or two to focus on - between all of us, I am sure everything will be well-covered.

That these drugs will be effective.

That we’ll be able to get around my allergy to carboplatin.

That my blood counts will be minimally effective and recover well.

That these drugs won’t beat me down too much - for strength and energy.

That side effects will be minimal.

That Mike will have the strength, patience, and peace to walk through this with me.

That our spirits will be encouraged and we will not be discouraged on the tough days.

"It's not the size of the dog in the fight, it's the size of the fight in the dog." Mark Twain

I was praying about this recurrence a few days ago. I’m tired. Tired in general and tired of fighting. I keep choosing to trust God, leaning into Exodus 14:14: “The Lord will fight for you, you need only be still.” While I was praying, I had a new thought. I think this might be what some call God speaking to them. Nothing audible, but an idea that was new to me and in line with biblical truth, so I would attribute it to divine inspiration. 

Anyway, here’s my new idea: In the Bible, King David was at war pretty much his whole life. After him, his son Solomon had peace throughout his reign. So my prayer is that this battle will be effective, and then I will have several years of rest before having to fight again. I am looking forward to a break after this.

Here's to sweet victory over stinky cancer. And over the dark shadows it throws.

Thank you for all of your support, past, present, and future. We need you and we love you.