Meeting with the medical oncologist

Hi All

As we said earlier, we had the meeting with the medical oncologist this morning.

How did we go? Well, overall the news wasn't good.

The short version is that the doctors cannot cure the cancer, they can only treat it and try to slow down its progress. The long version follows...

The situation
For a breast cancer to metastasize to the liver this quickly is very uncommon. The focus is now on treating the cancer in her liver as the priority. Alison has several masses in her liver and the doctor showed these to us on the CT scan today. The size and location of the masses mean that surgery is not a viable option.

Another problem is that it is unlikely that the liver is the only place with cancer cells. At this stage there have been no signs of cancer elsewhere but it is likely that there are microscopic cells scattered in other parts of her body. It is most likely to show up in bones and lungs, and somewhat less likely in the brain. Ali had a bone scan this afternoon so we should know by some time tomorrow whether there is any cancer in her bones.

We are however, lucky that we've had diligent doctors. As it is so unlikely for breast cancers to metastasize to the liver, many doctors wouldn't notice or be looking there for any signs of further cancer. That we have caught it now rather than later is a small positive factor in our favour.

Next steps
Ali will start her chemotherapy at Calvary Hospital next Monday. For those who don't know where this is, it's only about a five minute drive from our house so, chalk another one up for small positives.

We have an appointment with the treatment centre tomorrow for an induction/learning session where they will tell us more about the treatment and more importantly, how it will affect Ali in the coming months.

What we do know from talking to the doctor this morning:

• treatments are administered intravenously
• they will take several hours for each treatment
• Ali is likely to feel nauseous for a few days afterwards, although this can be managed by the oncologist
• Ali may feel nauseous for longer
• Ali is likely to be tired
• the treatment will cause her hair to fall out (she's been looking at wigs earlier today)
  

Treatments at this stage will occur every three weeks, running for somewhere between two and six cycles. The timing will depend on how the cancer responds to the drugs. The longer they go, the more toxic they are to Ali's body, that's why they stop after six cycles.

After the treatment, the oncologist will consider whether hormone treatment is appropriate and either administer or not at that time. The cancer cells have shown up as positive to oestrogen and progesterone so there is a chance they will respond well to hormone treatment. The reason we cannot do this instead of the chemo, is that hormone treatment would take a couple of months before showing signs of whether it was working or not and the doctor did not want to waste that much time. We need to hit it with something a lot harder.

Throughout the treatment, the doctor will monitor Ali and she will have blood tests done before each cycle (this may time well with Harrison's blood test - the two of them are going for a joint pathology session tomorrow, Harrison said that mum can go first 'cause he thinks she's a bit of a scaredy cat).

At the end of the treatment, they will need to continue monitoring Ali. When the cancer shows signs of spreading/growing, more chemo will be needed.

The BIG question
How long? We don't know.

Excluding the cancer, Ali is strong and healthy. The doctor says she could have years ahead of her. Certainly, we're looking to set some new records here. I think she's one in a billion so that must put the odds in her favour at least a little.

It's all going to depend on how effective the chemo is and how aggressive the cancer is going to be. And we won't know the answer to that for a couple of months yet.

Keep your fingers crossed.