Today we saw Seattle's best oncologist and got the results of my recent ultrasound and bone scan.
The ultrasound indicated five liver lesions. This is a good baseline number for testing the chemo's effectiveness in the future. The CT scan I had in July indicated seven liver lesions. Since these two types of scans show different information, it's not possible to say for certain that two of the seven liver lesions are gone.
The bone scan revealed increased activity on my many sites of bone metastases, as compared with the last bone scan taken at this facility in 2005. There are mets in my skull, cervical spine, scapulae, humeri, forearm, thoracic spine, ribs, lumbar spine, sacrum, pelvis and femurs. (Apparently I light up like a Christmas tree.) However, there don't appear to be any new spots of disease, and Dr G would not recommend radiation at this time. He doe not think I am in danger of a fracture.
My tumor markers have consistently decreased since starting chemo in May, so something has been working.
The current plan is to start me on Adriamycin (doxirubicin) once a week for four weeks beginning next Monday, and then re-evaluate. On this low dose regimen I am likely to experience more mucositis (mouth sores). Dr G will try to prevent that side effect with some other meds such as L-glutamine powder (also prescribed by my naturopath), calcium phosphate rinse, Neulasta, chlorhexidine gluconate rinse, vitamin E, Gelclair and "Magic Mouthwash" (xylocaine viscous solution, Zovirax® (alcohol-free), and Maalox® or Mylanta®). Dr G told me I should suck on ice chips while receiving treatment.
I'll also be at risk for infection due to low red and white blood cell counts and will probably experience more hair loss. Hopefully I won't have more issues with hand-foot syndrome.
Rik and I have already decided on a plan of action if the mucositis prevents me from eating. He will feed me milkshakes, smoothies, even Ensure "lattes" -- anything to get calories into me. I dropped five pounds the last time this happened and although Dr G praised me for keeping stable weight, I don't really want to lose much more.