Tomorrow is going to be a long day -- I start at 7:30 at the hospital with blood draws and other paperwork things, and start chemo at 9:00. It'll take six hours -- although the actual infusion only takes one hour, there are apparently a bunch of breaks while they observe me to see how I'm reacting to the drugs? That part was a little unclear to me, but tomorrow will clarify everything.
The really great news, if I'm understanding it right, is that I'm not getting the older form of chemo drug, taxol (brand name Paclitaxel). That's the one that people not on the clinical trial typically get, and it's the drug that kills all rapidly-dividing cells (if I'm understanding this right, take everything I'm saying right now with a grain of salt, because it's a lot of information for a non-science-person to absorb).
It's that rapid-division thing that makes your white blood cell counts dive (making you susceptible to infection / fever risk), etc. And I'm not getting that drug, at least not in the next six months! (All of which means that I think I don't have to take excessive precautions to keep from catching colds, etc., which is particularly nice to hear tonight because Anand isn't feeling well and didn't want his dinner -- I think he's catching the bug that's going around the school. Will confirm this with doctor and nurse tomorrow before I let him sneeze all over me, though.)
Instead, I'm getting new drugs that are specifically targeted to malignant cells, to characteristics that are amplified in cancer cells. They still have side effects, but they're notably milder. Hooray! The plan is to see if the new drugs work to shrink the tumor effectively (and I'll have frequent biopsies and MRIs to check on that, as part of the clinical trial). If they do get it tiny, then the surgeon can go in and try to do a lumpectomy, and if they can get it with clean margins, then they just follow-up with some radiation to seal the deal, and we're done.
If the trial drugs don't work, if the tumor isn't shrinking with the new drugs they can add Paclitaxel later. But let's cross our fingers and hope the new drugs work, eh?
It's good to get some good news.
Okay, I'm feeling a little overwhelmed and oddly exhausted. Tension, release, tension again, flood of information, processing. I have made myself a really good curry and eaten it, and now I think I'm going to take a cup of hot, sweet, milky decaf tea and go tuck myself in bed with Agents of Shield. Tomorrow's going to be a big day.
Info that follows for the medical types who are curious about the drug specifics:
I've been randomized to the treatment group that receives T-DM1 and Pertuzumab.
T-DM1 (Trastuzumab-emtansine) is an investigational drug, meaning that is has not yet been approved by the FDA. Trastuzumab, also known as Herceptin, is a specific type of antibody that binds to HER2 proteins on cells. Antibodies are a type of protein made by cells to attack a foreign substance that the cell thinks is harmful. T-DM1 has the same antibody as Trastuzumab but coupled to a cytotoxic compound, emtansine. By interacting with HER2 proteins, T-DM1 may make the cancer cells grow more slowly or kill them directly.
Pertuzumab is a type of antibody that binds to HER2 proteins in breast cancer. However, Pertuzumab binds to a different part of the HER2 molecule than Trastuzumab and consequently the combination of the two antibodies has been shown to have an increased activity in controlling cancer cell growth. Pertuzumab has been tested in large numbers of women with breast and other types of cancer and has recently been FDA approved.