Chemo Six and the MRI

This week really began last Friday, May 22, with the taking of two MRI tests, one on the cervical spine and one on the thoracic. I may have mentioned my oncologist is a stickler for detail, and when my left arm pain did not subside, he wanted to see what was going on.

The MRI gave us perhaps more than we bargained for, but I’d still rather know what was happening than not.

On the weekly bloodwork , he ordered the tumor markers be run, to see if there was change. There was, to the good.

The good news after this first six weeks of chemo:

Leane’s most recent blood work (Friday) shows her tumor markers
decreasing. One of them is down from 736 to 690.9 (CA 15-3), and another is down from 1006 to 865.5 (CA 27.29). For a great article on the value of CA 15-3 in the cases of metastatic lobular breast cancer past Stage II please read this.  This marker will track disease regression in cases like mine, so I was pleased it’s value went down.  My lab reports the norms for this value should be0.0 to 31.3 U.ML so there is a way to go!! The CA27.29 Marker, especially when used in conjuntion with CA15.3 and others,

The CA 27.29 test is used to monitor your:

  • Response to treatment
  • Status of your cancer
  • Possibility of early recurrence.

This marker dropped131 points. I was delighted. The oncologist says he’s seen it higher in others, and isn’t scared of the value. That gives me a great deal of confidence, especially in light of the newly found involvement with bone. I have faith in the zometra bone med and calcium to help control this. In fact, I would be satisfied in a few months with “stable disease”. It is very hard with this cancer to assume you know where in the body it all is — so it’s best to assume it is everywhere. By careful monitoring, we hope to get the very best out of the chemo treatments, and I’d like to avoid local treatments and stick to systemic as long as possible in my case.

The bad news — well, not really because we have better knowledge now — came from the MRI where it appears more spine is involved than first thought.

Here’s the report that came back from Leane’s MRI last week, which they
did because she was complaining about pain and loss of muscle mass in her
*left* arm (opposite the cancer side) (thanks to my husband Mark for this part of the report):

Report
15 mL Magnevist

FINDINGS:
There is abnormal signal and enhancement at C5, C6 and C7. While this may
be due to degenerative disease, metastatic disease is not excluded. There
is no pathologic compression fracture. There is C5-6 and C6-7 central
canal stenosis due to disk bulging and posterior osteophytes.
There is no abnormal cord signal, mass or enhancement.
There is a known large right neck base and right apical soft tissue tumor
mass.

IMPRESSION:
C5, C6 and C7 metastases without pathologic compression fracture.
Mild C5-6 and C6-7 central canal stenosis due to degenerative disk disease.

We also ran the thoracic spine — the PET scan had indicated bone cancer in the upper thoracic area. The MRI verified this and specified exactly where.

MR Spine Thoracic w + wo contrast

15mL Magnevist

FINDINGS:

There is abnormal marrow signal/edema and abnormal enhancement at T1, T2, and T3 consisten with metastatic disease. T3 is most severely involved.
No pathologic vertebral compression fracture is seen.
While there is no frank cord compression there is sufficient spinal stenosis at T2 and T3 and to lesser extent T1 and T4 due to right dorsal dural/epidural soft tissue thickening. This measures up to 6.6 mm and may represent dural metastatic disease or extra osseous soft tissue tumor.

(NB: Dural metastatic disease is very rare.  Read about it here. Again, this is a systemic phenomenon. )
There are numerous dorsal subcutaneous nodules and masses consistent with metastases. The largest is at the T12 level measuring the 3.3 x 2.2 x 2.0 cm.
There is a large right pleural effusion.

IMPRESSION:

T1, T2 and T3 metastases. No pathologic compression fracture.

And, although the “large plural effusion” is back, it is not what it was. We are holding on another thorentecitis session for a few more weeks. The right lung is working better and I am not subject to shortness of breath like I was. I suspect natural draining is occuring.

Regular bloodwork shows the wbc to be on the low side but increasing, as are rbc and platlets.  I am adding additonal calcium to compensate for the bone medicine, and will be adding more vitamins.

Chemo Six, which was today, ran very smoothly — just like last week save for the bone meds which are run monthly. I do not have to go back until June 15th, so this will be a good rest, and give my wbc, rbc, and platelets a chance to recoup. They are all slightly down on the low side — the wbc count jumped to 2.5 from 1.06 (normal 3.7 to 11.0) so all the rest and good food has paid off this week.

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One Response to “Chemo Six and the MRI”

  1. lpmccort Says:

    I have been impressed by the way you have dealt with all this. Hopefully the gap in your blogs is of no real import. L.P.McCort

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