Thinking out loud …
I will be starting Kadcyla on Thursday. This is my first major change of drug in 3 years. I’ve had different drugs added, then dropped, but Herceptin has been my major maintenance drug since chemotherapy with Taxol ended in January 2013. Kadcyla is a cancer medicine that combines Herceptin with chemotherapy in a single treatment. This type of treatment is called an ‘antibody-drug conjugate’.
I have HER2+++ disease, which means that my breast cancer cells have too many little HER2 tags on them. +++ means that I have a lot of those tags.
Herceptin has worked for me because it targets those HER2+++ cells and tells my immune system that they are not good. This is “targeted therapy”. Then my immune system gets rid of them. It has worked well for me. My scans from neck down look “clean”. The lesions that were rampant in my bones in 2012 appear to have healed.
However Herceptin does not cross the Blood Brain Barrier, so my brain has been vulnerable. Lesions – little growths of HER2 cells – have been intermittently showing up in my brain, 8 last October. There aren’t any good drugs yet for treating or preventing these brain lesions, only radiation.
My doctor has been letting me take the lead and make the decisions regarding how I am treated. We both know that my disease cannot be cured, so we’re not really trying to save my life. Quality of life is important to me. I don’t want to be kept alive just to be kept alive. She knows this and I know it. Sometimes the treatment for cancer can do more harm than the cancer itself. It’s a delicate dance.
I’m not taking this step lightly.
Strong chemo drugs do a number on one’s immune system, and I’m relying on my immune system to keep the cancer at bay.
What worries me are the brain lesions.
My cancer markers, which can indicate the level of cancer-load one is fighting, have been rising since July. In 3 years, I have never seen them do this. After chemo in 2012-2013 they dropped and stayed low. Now they are almost as high as they were before the 2012 chemo when my immune system became so overloaded that it broke down; I was hospitalized twice with infection and fever.
There is no evidence the Kadcyla will cross the blood brain barrier. But it does fight HER2 cancer more effectively than Herceptin. It not only targets the cell and marks it for the immune system, it also releases chemotherapy inside the cell and causes the cell to die.
I’m hoping that the Kadcyla will decrease my overall cancer load so that my brain is less vulnerable. There is no guarantee that this will happen.
There are people out there who are called Kadcyla “super-responders”. After a round (12 infusions) of Kadcyla, they appear to have no evidence of disease anymore.
I’m hoping to be a super responder.
The side effects are not great. I’m deliberately not reading them because I know that sometimes the idea of a side effect will give it to me.
I’ve gotten some good ideas from others who have taken Kadcyla to minimize side effects. Like eating fresh pineapple and papaya (for low platelets), taking brisk 15 minute walks every day, fresh red meat, like veal liver (for low red cell counts), dark greens, like collards (my favorite, and in great abundance this time of year in Florida), swimming (!) for muscle and bone aches. Naps.
I’ll continue to post my way through the Kadcyla treatments.
I’m planning a European trek for the Spring and need to be in shape.