Anna's Book of Days

Treatment was easy once again today - and now we're done with neoadjuvant chemo!!! Prior to the infusion, we saw Maddie for my checkup. She was very pleased with how my tumor is feeling, very soft with no discernible margins. I asked her if she thought it was still even a tumor or just scar tissue, and she said, "Dead tumor." The only good tumor is a dead tumor! Of course, we won't know for sure that mine is really dead until the pathology report from my surgery is completed, but now both Patients #1 and #2 are confirmed to have "pathologically complete responses" - no cancer. We also saw Dr. Hurvitz and questioned her about MARIANNE. She said that no one knows anything yet because the underlying data wasn't released, only the top line results. Roche had to release the top line results due to an SEC requirement that they disclose information that could affect stock value (which these did) - but the detail wont be announced until a future medi...

Over the past three months, I've met with three reconstructive surgeons for consultations about my breast reconstruction following mastectomy. All three talked with me about the two reconstruction options: synthetic implants and natural tissue flaps (where your own tissue from the belly, gluts, or back is used to recreate breasts). I decided early on that I wanted implants; flap reconstruction is a better option for women who are overweight, it has a much longer recovery time, and it leaves significant scars at the donor site (plus, to be honest, it kind of gives me the willies just thinking about it). Reconstruction using implants can either be done at the time of the mastectomy, or temporary implants called tissue expanders can be placed at the time of the mastectomy. The expander has a valve that allows it to be gradually filled with saline over a period of two to three months, allowing the surrounding skin to adjust, then, when the desired size is reached, the permanent impla...

Clinical Trial MARIANNE has been in the news since pharmaceutical maker Roche announced the preliminary results on December 18.  In MARIANNE, a Phase III study, researchers randomized 1095 women with metastatic HER2-positive breast cancer into three arms: T-DM1 with Perjeta (the same treatment that I'm getting), T-DM1 alone, and Herceptin plus standard chemotherapy drugs (either docetaxel or paclitaxel), which is the current standard of care. The primary endpoints of the study were progession-free survival (PFS) and the incidence of adverse events, while secondary endpoints included overall survival, response rates, and duration of response.  In what came as a surprise to both the medical oncology community and Roche's investors, no significant difference in PFS was found between the three arms. This was counter to both laboratory models and the results of the Phase II trial that preceded MARIANNE, in which TDM-1 had shown more than 50% improvement in PFS over the standard of ...

Five down, one to go!

As long as I can remember, I have taken pleasure in my body's abilities, my strength and vigor and health. All of my happiest experiences have had some physical component - walking for miles through the streets of New York and San Francisco and Paris, hiking in Point Reyes National Seashore, climbing a glacier in Patagonia, combing the beaches of California and Hawaii and Vancouver, swimming in oceans all over the world. Though no great athlete and certainly no extreme sportsperson, I have always been able to count on my body to help me do the things I wanted to do. Because of this, one of the more difficult things for me about having cancer is the feeling that my body has failed physically - after so long as my ally, my body is now an impediment. And yet, I have begun to question if my perception of my own physical infallibility was always fundamentally flawed. Prior to having a baby, I would have said that we are born perfect. But anyone who has witnessed birth knows that a ...

Yesterday I forgot for a while that I have cancer. We are far from home in Vancouver, and the day was busy with the small tasks and pleasures of baby care (diapers, bottles, songs, naps, burps, toys), as well as a drive through the beautiful city and a visit to the aquarium. It wasn't until dinner that my cancer was mentioned in passing, and for a minute I didn't recognize what it meant. For a minute that word, cancer , floated in the air before my eyes as something completely unrelated to myself. Then it shifted into focus and became my reality once again. The ability to forget is a luxury for someone in cancer treatment - I am extremely lucky that my body is allowing me that luxury. But it also made me think - someday, maybe a year from now, or two or three, there will come a day when I spend more of my day not thinking about cancer than thinking about it. And someday after that, perhaps I will forget for days or weeks or months at a time, and all this will be just a dista...