More cancer

On June 9th, we learned that Laura’s breast cancer has moved into her brain.  I will try to tell you what we currently know:

First a little back story.  Laura has had a hard time and even stopped doing flip turns swimming a month or so ago because she felt odd and could not do them.  Laura has complained to me that when she turns her head quickly she feels like her eyes do not track like they used to.  She even forgot someone’s name this week which is unheard of.  Every three months she gets CT scans of her body to see if there is any change in the cancer.  She asked Dr. Raish if he would authorize a brain MRI since it has been a year since her last one and he agreed.  Luckily, the CT scans show no evidence of cancer in her lungs, liver and lymph nodes.  Unfortunately, there is cancer in her brain.  Dr. Raish said that around 20-30% of people with metastatic HER2+ breast cancer get brain METS.

She has 17 tumors in her brain.  Eleven or twelve are in the cerebellum and the rest are “above” the cerebellum.  Some are up to 1 cm in size and the rest are smaller but I do not know the resolution or the smallest size that a brain MRI can detect.  We will go to Portland next Monday, June 15th to see a radiologist to see if Laura is a candidate for the Gamma knife which is very targeted radiation on her specific spots of tumors in her brain.  In Gamma Knife radiosurgery, specialized equipment focuses close to 200 tiny beams of radiation on a tumor or other target. Although each beam has very little effect on the brain tissue it passes through, a strong dose of radiation is delivered to the site where all the beams meet. 

She will start a new form of drugs that get into the central nervous system and brain.  All will be pills.  She will have a chemo pill, anti estrogen pill and a breast cancer specific biological pill.   Capecitabine (brand name Xeloda) is the chemo pill she will be taking daily.  Two weeks on one week off.  General chemo side effects along with more hand and foot cracking, peeling and issues.  Lapatinib is the biologic drug that attacks breast cancer cells.  While the two biologic drugs she has been on (herceptin and perjeta) works by binding itself to the outside of the cancer cells and disrupting them, this new biologic drug goes inside the breast cancer cells to disrupt them so its the same outcome but a different process.  Letrozole lowers the amount of estrogen made by the body. This may stop the growth of cancer cells that need estrogen to grow which Laura’s tumors do. Letrozole is a type of aromatase inhibitor. It is also called Femara.  

Hopefully all the insurance authorizations will go through so Laura can start taking all these new pill on Friday or Monday.  As we learn more, I will update this blog.