April
My sister Sarah came for a visit with her youngest, Audrey. The boys and I had never met Audrey, so we were eager to spend time with them.
Next, my mom's lifelong friend, Margie, came for a visit with her daughter, Monique. It was their first trip to visit my parents since they moved to Texas.
Mom was feeling and looking great, making it harder to believe that just a few weeks earlier, she was as ill and weak as she was. Or that she is ill at all.
May
Mom had another CT scan the first week of May, which prompted a colonoscopy the following week. The boys and I spent Mothers Day weekend with my parents, and we were all worried that maybe the CT scan had shown something, but the colonoscopy came out normal, meaning they found nothing abnormal in the colon.
I wonder if my parents think they've told me stuff. Mom called yesterday afternoon and in her chatty discourse on random topics, she started talking about her new chemo drugs, and whether she'll tolerate them, and how her oncologist told her this treatment he'd started her on was the last on the list, so to speak.
What!?!
The last I'd heard, she was going back on Xeloda. It appears I am not up to date. So, I ask her which drugs she's on.
"I don't know," she drawled. "Your father writes it all down and keeps track of everything I'm taking. You'll have to ask him."
So she puts dad on the phone, who gives me the download, though I'm not sure of the chronology of it all. So, in no particular order...
A lymph node that had enlarged at some point in the past, then reduced, had enlarged again. I didn't think to ask why they don't just remove the renegade lymph node...I only thought about it after I hung up the phone.
New Direction
Mom's oncologist had originally thought that putting mom back on Xeloda was the way to go, but he changed his mind and instead decided to try a combination of chemo drugs: Irinotecan, also known as CPT-11, as well as Erbetux® Both are drugs designed specifically for metastatic colon cancer, or colon cancer that has spread to other parts of the body, or cancers that have not responded to other treatments. Each is delivered via a separate IV infusion, though she receives them both at the same time.
The list of side effects for Erbetux is pretty lengthy, but here are a few:
- Fatigue
- Skin irritation
- Diarrhea
- Nausea
- Electrolyte depletion
- Decreased white cell count
- Kidney failure
- Lung disease
- Blood clots
- Constipation
- Shortness of breath
- Insomnia
- Cough
- Headache
- Dehydration
- Chills
- Skin rash
- Mouth sores
- Heartburn
- Swelling of feet and ankles
"The oncologist said we could try going to MD Anderson," mom said. "He said if these two drugs don't work out, he's out of options for me."
She's referring to the MD Anderson Cancer Center in Houston. One of the largest cancer research and treatment centers in the world, there are opportunities for new and experimental treatments or to become part of clinical trials that a clinic of its scope is afforded.
She balks at the idea of transiting between Georgetown and Houston -- about a four-hour drive each way. I suggest that she get her doctor's opinion of the Cancer Therapy & Research Center (CTRC) in San Antonio. Both are connected to a university hopsital system, meaning that they are teaching and research centers. She would have similar opportunities at CTRC -- maybe even better chances of getting selected to participate in clinical trials, if her options have narrowed to that point. And, she could stay with me and the boys, instead of an impersonal patient suite.
The idea that there may not be many choices left makes mom wonder what she will choose. She's seen her share of friends either suffer endless treatments and their side effects right to the end, or friends who have made peace with Fate and choose quality of life over the poison of chemo and radiation for the time they have left.
"It's your decision, mom," I tell her. "We can all have an opinion, and you can look to the experiences of people you know who decided to go one way or the other, but you need to remember that everyone's experience is different. What happened to someone else may not happen to you. It's your decision."
"I suppose you're right," she replied thoughtfully.
"You're feeling great. There's no reason for you to think that it's time to stop fighting this now," I said. "Let's just see how you do with these new drugs. You might tolerate this pretty well, and you may see some improvement."
"I am feeling great," she replied, her voice brighter, and a little higher.
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