Friday, July 15, 2005

Cancer Chronology

This is a chronology of my diagnoses, tests, surgeries, etc., in reverse chronological order.

Jan. 2, 2009
X-ray chest: Increase in fluid in lining, especially on right side, but not enough to require draining.

Dec. 27, 2008
Ultrasound liver: Increase in both number and size of tumors. Largest measures 4.3 cm compared to 3.8 in previous scan of Nov. 3, 2008.

Dec. 10, 2008
MRI brain: "Marked improvement in the size of the lesions" compared to August 2008 scan.

Nov. 26, 2008
Chemo: Ixempra + Avastin, fourth dose. All three tumor markers (CEA, CA15.3, CA125) have gone up slightly since three weeks ago.

Nov. 5, 2008
Chemo: Ixempra + Avastin, third dose.

Nov. 3, 2008
X-ray chest: No significant change from previous X-ray.
Ultrasound liver: Multiple lesions in liver, as in previous scan. Largest tumor was in right lobe, measuring 3.8 x 3.7 x 3 cm. Last scan on Aug. 8 showed largest measuring 3.6 cm.

Oct. 15, 2008
Chemo: Ixempra + Avastin, second dose.

Oct. 14, 2008
X-ray chest: Some improvement with less opacity in lungs, but still some pleural effusion; more in right than left.
Tumor markers - two went down but one went up slightly.

Sept. 24, 2008
New chemo regimen: Ixempra (Ixabepilone) + Avastin (Bevacizumab). Tenth new regimen this year.

Sept. 22, 2008
X-ray chest: Progression of disease. Fluid in both lungs; more in right than left.
Tumor markers - mixed results since starting new chemo:
Sept. 5, CEA was 19.3 and on Sept. 22, it went up to 21.2
Sept. 5, CA 15.3 was 43.4 and on Sept. 22, it went up to 44.3
Sept. 5, CA 125 was 496.9, and on Sept. 22, it went down to 362.6

Sept. 5, 2008
New chemo regimen: Ixempra (Ixabepilone). Ninth new regimen this year.

Sept. 4, 2008
Whole-brain radiation #10 of 10

Aug. 22, 2008
Whole-brain radiation #1 of 10

Aug. 20, 2008
Custom-fitted for head radiation mask.

Aug. 19, 2008
MRI brain: Five tumors total, up from three in February 2008 - four on left side and one on right. Largest is 2.12 cm, compared to 0.81 cm for largest one in February.

Aug. 17, 2008
Seizures caused by swelling caused by tumors in brain - hospitalized for two nights.

Aug. 11, 2008
Tykerb - Round Two, Last Day (started daily on April 26, 2008)

Aug. 9, 2008
Xeloda - End of Cycle 3, Day 15

Aug. 8, 2008
X-ray chest: "No obvious pulmonary nodules to suggest metastases. No pleural effusion. Increased curvilinear opacities in both lungs, especially in the right lower zone. This could be due to infection." Comparison with June 28, 2008 x-ray shows "no significant change".
Ultrasound liver: At least eight tumors, largest measuring 3.6 cm. Compared to June 28, 2008 scan, increase in both size and number of lesions, progression of metastases.

Aug. 7, 2008
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 57%

July 26, 2008
Xeloda - Cycle 3, Day 1 (daily)

July 21, 2008
Last Herceptin - started April 4, 2008 (once every three weeks)

July 18, 2008
Xeloda - End of Cycle 2, Day 15

July 4, 2008
Xeloda - Cycle 2, Day 1 (daily)

June 28, 2008
X-ray chest: No significant change from June 9, 2008 X-ray.
Ultrasound liver: At least seven tumors, ranging in size from 1.36 cm to 3.7 cm.

June 27, 2008
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 56%

June 25, 2008
Xeloda - End of Cycle 1, Day 15

June 11, 2008
New chemo regimen: Xeloda - Cycle 1, Day 1 (daily)

June 9, 2008
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 54%
X-ray chest: Interstitial lung markings in both lower zones, slightly more in right lung. No large area of consolidation or pleural effusion.
Ultrasound liver: Five solid nodules in right lobe, largest measuring 3.3 cm, with a "slightly hypoechoic rim and centre, forming a target appearance, showing central necrosis, which may be a response to therapy. Smaller lesions range from 1.5 to 2.9 cm.

June 3, 2008
PAP, HPV DNA (Digene) test, ultrasound ovaries: PAP - normal. HPV - "is not detected". Ultrasound - normal.

May 20, 2008
Liposomal Adriamycin + Herceptin - Last day

May 16, 2008
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 60%
X-ray chest: Shadowing in mid to lower zones in both lungs. Nodular densities in left mid to lower zone.
Ultrasound liver: At least three tumors seen, largest measuring 3 cm - fewer than seen in Apr. 24, 2008 ultrasound. Larger nodules in current ultrasound are same size as in previous scan.

Apr. 26, 2008
Tykerb - Round Two, Day 1 (daily)

Apr. 24, 2008
X-ray chest: "Large hazy irregular nodular opacity" mainly in the middle and lower lobe of the right lung. "No discrete lung nodules or masses otherwise."
Ultrasound liver: "Multiple masses in both lobes of the liver; largest is 3.5 cm." No significant change in number or size of nodules in liver from Mar. 17, 2008 ultrasound.

Apr. 4, 2008
New chemo regimen: Liposomal Adriamycin + Herceptin (Herceptin once every three weeks until July 21, 2008)

Apr. 3, 2008
X-ray chest:

Mar. 18, 2008
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 65%
New chemo regimen: Liposomal Adriamycin

Mar. 17, 2008
X-ray chest: "No active lung lesions."
Ultrasound liver: Seven tumors, ranging from 1.7 cm to 3.4 cm.
Tykerb - Last day (daily since Jan. 13, 2008)

Mar. 3, 2008
X-ray chest:
Gemcitabine + Cisplatin - Last day after just two weekly doses due to low blood counts.

Feb. 26, 2008
New chemo regimen: Gemcitabine + Cisplatin (weekly).

Feb. 25, 2008
Ultrasound liver: Five tumors, ranging from 1.58 cm to 3.06 cm.
MRI brain: Three lesions in brain, largest is in left back region and measures 6.7 x 6.7 x 8.1 mm. Other two are in left upper back and right front regions. Intracranial metastases likely to be of "recent onset".

Feb. 22, 2008
Transbronchial Lung Biopsy (Bronchoalveolar Lavage): "Adenocarcinoma with lymph/vascular embolization", i.e., cancer in lungs.
Lung biopsy supplementary report: ER negative. PR positive - Change from negative on Dec. 8, 2005 core biopsy sample from breast lump. HER2 positive (3+) - Change from negative on Mar. 13, 2006 post-mastectomy histology report and positive (2+) on Dec. 8, 2005 core biopsy sample. P53 positive.

Feb. 21-22, 2008
Breathing test with respiratory specialist: Below normal.
Examination and breathing test with second respiratory specialist: "Peaked expiratory flow rate was 270 L/min (normal 440 L/min." Low white blood count.

Feb. 21, 2008
X-ray chest:

Feb. 12, 2008
X-ray chest:

Feb. 5, 2008
Taxol - Last day after just three weekly doses due to low blood counts.

Jan. 28, 2008
X-ray chest: Shadowing in "right mid zone" and "left upper lobe".

Jan. 27, 2008
Last period since resumption on March 6, 2007.

Jan. 24, 2008
PAP, HPV DNA (Digene) test, ultrasound ovaries: PAP - normal. HPV - "is not detected". Ultrasound - normal.

Jan. 21, 2008
New chemo regimen: Taxol - weekly.

Jan. 17, 2008
X-ray chest:

Jan. 13, 2008
Tykerb - Day 1 (daily)

Jan. 12, 2008
X-ray chest:

Jan. 10, 2008
CT, X-ray of chest: Shadows in both lungs - "could be related to opportunistic infection". Multiple lesions in liver, suggesting metastatic disease.
Intravenous antibiotics for suspected infection in lungs.

Dec. 26, 2007
Navelbine + Herceptin - Last of 15 doses.

Dec. 12, 2007
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 56%

Nov. 6, 2007
PET-CT: Nodes in right armpit, collarbone, lungs "have resolved". Nodes between lungs show signs of "resolving nodal disease". "Most of bilateral pulmonary metastases have resolved." Lesions on sternum and right first rib "consistent with residual bone metastasis". No sign of liver metastasis.

Oct. 18, 2007
PAP, HPV DNA (Digene) test, ultrasound ovaries: PAP - normal. HPV - "Negative for high risk types". Ultrasound - normal.

Sept. 11, 2007
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 65%

Aug. 20, 2007
New chemo regimen: Navelbine + Herceptin - 1st of 15 doses, once a week for three weeks, then one week off.

Aug. 14, 2007
PET/CT: Evidence of cancer recurrence throughout chest area, including lymph nodes, soft tissue, sternum, collarbone, lungs, "coeliac node" (abdominal).

Aug. 10, 2007
MRI full-body: In right chest, an "irregular soft tissue mass" measuring 2.7 x 1.2 cm - may be abnormal cell growth or infection and should be further evaluated. Bilateral pleural effusion, more in right lung. Left labial cyst measuring 1.0 cm, "likely to be incidental". No evidence of disease in brain, spine, liver.

May 16, 2007
PAP, HPV DNA (Digene) Tests: PAP - negative for malignancy, but "mildly atypical squamous cells present". HPV - "not detected".

Mar. 6, 2007
Periods resume.

Feb. 13, 2007
PAP, HPV DNA (Digene) Tests: PAP - normal. HPV - "not detected". Menopausal (due to chemo).

Dec. 28, 2006
Intravenous antibiotics for suspected infection in lungs - for three days.
Last period due to chemo-induced menopause.

Dec. 23, 2006
Ultrasound chest: Fluid between skin and implant on right side.
CT chest: No evidence of lung metastasis - no lesions, no pleural effusion. Scarring in right lung, "presumably related to previous radiotherapy".

Dec. 20, 2006
Intravenous antibiotics for suspected infection in lungs.

Nov. 9, 2006
Ultrasound ovaries, HPV test: Normal.

Nov. 3, 2006
Herceptin - last day.

Oct. 3, 2006
Reconstruction surgery: Silicone implants on both sides, without nipple reconstruction.

Oct. 1, 2006
Periods return post-chemo.

Sept. 5, 2006
Chest X-ray and liver ultrasound: No evidence of disease in lungs or liver.

July 20, 2006
Radiation - Last day.

July 4, 2006
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 55%

June 13, 2006
Radiation - Day 1 of 28. 3D Conformal Radiation Therapy to the right chest, armpit, collarbone.

June 6, 2006
Radiation simulation post-surgery.

May 28, 2006
Surgery to remove fluid, distressed tissue (?) in left and right chest.

May 26, 2006
Cytopathology Report of seroma (fluid) in right chest wall: no malignant cells.

May 22, 2006
Radiation simulation with second radiation oncologist.

May 2, 2006
Herceptin only, once every three weeks, from today until Nov. 3, 2006

Apr. 28, 2006
Radiation simulation.

Apr. 11, 2006
Cycle 12 of chemo (Taxol + Carboplatin + Herceptin). Last of this chemo combo.

Mar. 28, 2006
Resume chemo (Taxol + Carboplatin + Herceptin) - Cycle 10

Mar. 13, 2006
Surgery: Bilateral mastectomy with right axillary clearance.
Histology Report (post-surgery): "Multifocal ductal carcinoma in situ (DCIS)" and "residual invasive ductal carcinoma, measuring 0.15 cm. Grade III. Out of 17 lymph nodes removed, 2 nodes contain micrometastasis, measuring less than 0.1 cm. ER/PR negative. HER2 negative (for both invasive carcinoma and DCIS). P53 positive.

Mar. 9, 2006
PAP, HPV DNA (Digene) Tests: PAP - normal. HPV - "Positive for High Risk Types".

Mar. 7, 2006
PET/CT scan: No evidence of disease.

Feb. 24, 2006
Cycle 9 of chemo (Taxol + Carboplatin + Herceptin)

Feb. 15, 2006
Subclavian central venous catheter removed and Port-a-Cath implanted.

Feb. 9, 2006
Ultrasound ovaries: No cyst, just "shadows".

Jan. 27, 2006
MRI brain: No evidence of disease.
Subclavian central venous catheter implanted.

Jan. 20, 2006
Echocardiogram: LVEF (Left Ventricular Ejection Fraction) - 55%

Jan. 16, 2006
FISH test: HER2 positive.

Jan. 6, 2006
First chemo: Taxol + Carboplatin + Herceptin.

Jan. 4, 2006
ER/PR, HER2 (IHC) Tests from Dec. 8, 2005 biopsy sample: ER/PR negative. HER2 positive. P53 positive.
PET/CT scan: Mass in right breast measuring 3.3 x 1.4 x 2.8 cm, plus multiple axillary (armpit) nodes and one parasternal (near breastbone) node on right side affected. One node above right collarbone affected. Nothing on left side. Possible cyst in right ovary - need ultrasound. No evidence of disease elsewhere.

Jan. 3, 2006
Fine Needle Aspiration Cytology (FNAC) of right cervical lymph node (small lump above collarbone): "Carcinoma cells present."
Fine Needle Aspiration Cytology (FNAC) of red lump on skin of right breast : "Features consistent with metastatic carcinoma of breast."

Dec. 9, 2005
Bone scan - whole body: No evidence of bone metastases.
X-ray chest, ultrasound liver: No evidence of disease in lungs or liver.

Dec. 8, 2005
Core biopsy of lump on right breast: "infiltrating mammary carcinoma".
Mammogram with ultrasound: "irregular mass" in right breast measuring 3.43 x 1.54 x 2.94 cm. Several enlarged lymph nodes in armpit, largest measuring 2.85 cm. "Highly suspicious for breast malignancy."

Dec. 7, 2005
Reported lump in right breast remains despite continued massage. OB/GYN says it's a clogged milk duct and sends me to surgeon to have clog drained.
Fine Needle Aspiration Cytology (FNAC) of lump on right breast: "Atypical cells, suspicious for malignancy."

?? Oct. 2005
Reported lump in right breast remains despite months of massage. OB/GYN says it's a clogged milk duct.

July 14, 2005
Discovered and reported lump in right breast to OB/GYN within an hour of baby's delivery. Dr. says it's a clogged milk duct.