Liver Woes - 12/22/11

The two week hold to get into my next clinical trial turned into four weeks. For various reasons, the start date kept getting pushed forward. Finally, on Tuesday, December 13, I started with the trial drug LY2523355. I went into the treatment center on Tuesday, Wednesday and Thursday for an hour infusion each day. On Friday, as expected, the white blood cells were dropping, so I was given an injection of Neulastra. I was already getting mouth sores with a slight sore throat. By the weekend, I was ill, spending the entire weekend in bed. The sore throat was the worst that I've ever had. The mouth sores were painful, and my fever was increasing. I had been in this position several times before and knew that I would eventually start to feel better. I just had to hang on until the blood cell counts went back up.

On Monday, I was back at the treatment center. I was given IV infusions of fluids and antibiotics. On Tuesday, I was not feeling any better, and again at the treatment center, I was given fluids and antibiotics. My weight had dropped, and the fever was way too high. I was given a mask to protect me from others. My oncologist came into the treatment room and informed me that I had practically no white blood cells, which would open me up to all kinds of infections. In addition, my liver numbers were indicating the beginning of liver failure. She would have to hospitalize me and get things under control.

After my infusions of fluids and antibiotics, the oncology nurse wheeled me to my room on the isolation floor of the hospital. Everyone that came into my room had to wear a mask and gloves. My immune system was compromised, and no chances were to be taken. I was given infusions of fluids and antibiotics all day and night from Tuesday to Thursday. Slowly, my fever started decreasing, the mouth sores were healing, and that awful sore throat was gone. On Thursday, my oncologist told me that my white blood cells were up to 5,000. That's not great, not even normal, but it was high enough for me to leave the hospital. Before I left, I was given pills for my low potassium, a shot of Procrit in my thigh to boost the red blood cells, and a 7-day prescription for more antibiotics. I felt like a new woman when I left the hospital.

On Tuesday, while I was in the hospital, I was given a chest x-ray and a CT Scan. My cough and shortness of breath are worsening, and the scan showed more progression in the lungs. The biggest problem is the liver, however. The tumors there are extensive and diffuse, and the liver had started failing. My oncologist decided that this was the time to have "the talk". Without a fully functioning liver, in six months or less, it could all be over. I needed to decide how I wanted to die. Would I like the doctors to attempt to resuscitate me if I stopped breathing? Would I like for them to shock my heart if it decided to stop beating? A social worker came to talk to me about my decisions and gave me papers to fill out. I also called my sister, and we have a plan of action, just in case things take a turn for the worst.

There are several things that can be going on with my liver. It could be a tumor flare. It could be that the liver tumors have become resistant to treatment because I've been on so many different treatment protocols. The poor liver function could be preventing the chemotherapy drugs from metabolizing. The dramatic drop in white blood cells could also keep the liver from functioning properly. At this point, we just don't know what happened.

So the plan is to get the blood cell counts up so that I can have a Cycle 2 of this treatment protocol. It's hard to say that after the first treatment cycle that it is not working, so we're going to continue as planned. Hopefully, I won't have to be hospitalized after this next cycle. Cycle 2 starts on Tuesday, January 3. January also marks my four year metastatic breast cancer anniversary. No matter what happens, I've been blessed.