July 1, 2016: Health Overview and Update

My Cancer:

Non-small cell lung cancer (NSCLC)

Adenocarcinoma, Stage IV

w/ EGFR Mutation https://www.mycancergenome.org/content/disease/lung-cancer/egfr/4/

My Doctor Team at OU Medicine/Stephenson Cancer Center, OKC:

Aljumaily, Raid MD (Lung Specialist- Lead Doctor)

Hatoum, Hassan MD (Liver Specialist)

Herman, Terence S MD (Radiation, Chairman)

Gunter, Tyler C MD (Radiation)

 

I have completed 16 total days of radiation targeting 50 identified “critical spots.”

I started my systemic treatment “chemo” pill on June 14, 2016.

Follow up Scans scheduled for July 15, 2016 to compare to baselines. Original follow up scans were scheduled for 8 weeks post-radiation/beginning of Tarceva but because of new symptoms/side effects the doctors agreed we can do them at 4 week mile marker. 

Updates:

Cancerous Areas 6/14/16 Scans & Report 5/18/16 Scans & Report
Lung

Origination of cancer

-Lower lobe mass lesion measured 4.4 x 3.1 cm

-There is mild dependent atelectasis in both lower lobes

-There is a trace right pleural effusion (collapse of lung tissue)

-New onset prominent hepatic steatosis (rare but can be caused after pregnancy)

-Lower lobe mass lesion measured 3.7 x 2.6 cm
Liver

Cancer has spread to this organ and is the place they have used for biopsies because of its accessibility

-Right liver mass measured 5.8 x 5.1cm

-A 3.1 cm lesion is again demonstrated in the dome of the liver

-Sensitivity is decreased by lack of intravenous contrast and degree of hepatic steatosis.

-Right liver mass measured 4.4 x 4.3cm

-A 2 cm lesion is again demonstrated in the dome of the liver

Brain No scans in June -18 brain mets

-Some mets hemorrhaging (bleeding)

-Severe swelling

Hip Bones/Ribs/Spinal Cord No scans in June -Large mass on right hip, throughout ribs and up spinal cord.
Lymph/Bone Marrow System No scans in June -Cancer present throughout lymph and bone marrow system

 

Other Health Concerns Details
Thrombocytopenia

Deficiency of platelets in the blood. This causes bleeding into the tissues, bruising, and slow blood clotting.

Blood work was done 6/29/16 and showed more progress but hasn’t been uploaded into my portal yet.

Cause of counts to drop so suddenly is said to be response to the 16 rounds of radiation I went through and we should continue to see these rise.

Deep vein thrombosis (DVT) in bilateral lower limbs Serious condition of blood clots in veins, which can break loose, travel through bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).

Normally someone with DVT could take blood thinners but because of my blood conditions and bleeding brain mets, an IVC filter was placed inside of me on 6/10/16 so if any blood clots dislodge from my legs and travel, they will be caught before reaching the heart and lungs.

Screen Shot 2016-07-01 at 9.39.09 PM.pngScreen Shot 2016-07-01 at 9.39.21 PM.png

Current Symptoms & Side Effects Cause Resolution
Insomnia Combo of my treatment induced menopause and emotions Medicine as needed
Shakes/facial twitches Cause unknown
Sore throat  (adam’s apple area)/chest/lung

Dry coughing

Cause unknown: either side effect from upper rib radiation or spread of cancer in lung Upcoming scans on 7/15/16 will be able to confirm if cancer on lung has grown, which would explain increasing symptom. If it has shrunk, then the pain and cough is just from radiation side effect and will get better
Hair loss From full brain radiation Regrowing already!
Swollen legs and ankles Blood clots in lower legs IVC filter put in on 6/10/16 below heart and lungs to prevent pulmonary embolism. IVC filter can come out one day, but not until blood counts are strong over a long period of time and my brain mets are confirmed to not be bleeding.  
Headaches Brain tumors swelling Steroids help control the swelling which controls the pain, but steroids cause swelling of face and neck
Swollen face, upper back, belly Radiated spots and steroid meds Should go down over time
Right leg skin numbness/ internal bone pain “Deferred pain” from cancer on spinal cord / nerve fluctuations Will either hve permanent nerve damage or the numbness/pain could go away as cancer shrinks off of nerves being pressed on
Nausea/tiredness Side effect Tarceva & radiation Take Zofran as needed/eat something
Rash Side effect Tarceva

-said to be a good sign that targeted therapy is working

 

Current Medications Dosage Purpose
Tarceva (150MG) 1 x Day Targeted therapy/systemic treatment/“chemo”
Dexamethasone (4MG) 2x Day Steroid/anti inflammatory for brain mets
Keppra (500MG) 2x Day Anti seizure
Memantine (10MG) 1 x Day Protection of cognitive function from whole brain radiation (potential for short term memory loss)
Zolpidem As needed Insomnia
Percocet (allergic to morphine) As needed Pain
Zofran As needed Nausea
Holistic Medicines:

Boswellia, Curcumin, CBD Oil

Daily Daily

It can all be a little overwhelming, especially now while I am not in doctor care everyday and just waiting on the next scans. We will be praying for time to go by slow (to enjoy each day) but fast (to get more answers and see tangible results of healing).

Until then, #jenistrong!

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