Today Karen begins her new chemo drug, Gemzar. We once again pin hope to the fates and soldier on for the next several months before we find out if this will be the magic potion that slows the cancer. 

The radiation she just finished last week was supposed to be a direct treatment to relieve the pain of specific tumors in her hip. Still waiting on that miracle to take effect.

She's discouraged and worn down this week. Fatigue from the radiation, learning that the cancer is spreading again and the hip pain that seems unshakable is overwhelming her usual positive attitude when beginning new treatment regimens.  

On the positive side Karen has some of the side effects from the discontinued chemo beginning to resolve. Hair is starting to come in again, skin isn't breaking down and the neuropathy isn't advancing.  If she could just get some relief from the hip the quality of life would be much improved. We're meeting again for a follow up with the hip specialist in mid October to revisit the hip replacement option.
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Note: I wrote this while Karen was getting her infusion. Several hours later she's feeling nauseated despite the anti-nausea meds given with the Gemzar. They all have side effects but nausea isn't an auspicious sign to begin this cycle with. 

Photo; William Evertson - Karen with Pipi Longstocking wig

Finished the last radiation treatment today. Ten treatments to the right hip. Karen hopefully will feel pain relief in the next week or two. Time will tell on this.

The New Tack now that the cancer is back is more systemic treatment, ie a new chemo drug. This time we'll be trying something called Gemzar. In this case we won't know if it's working until a few months down the road.
The radiation is effective for isolated tumors but Karen's cancer has spread to multiple areas so the best treatment is systemic.

Unfortunately a particular chemo sometimes loses it's effectiveness over time. Or the side-effects become too much. The last one gave us nine months...it was a good run.
The struggle continues and Karen continues to struggle.  The summer is coming to an end and with it some fond memories of enjoying sweet little days at Rogers Lake. The idea of a hip replacement is on hold while we evaluate the radiation. 
If there is a good outcome and she gets some relief perhaps we can travel to see some fall color. Small joys and things to look forward to are important. Even though we can't plan we still dream.

Photo - Karen Evertson - Sails - A tile mosaic collaboration by Karen and Bill 

Just when we thought the ducks were back in their rows the PET scan shows renewed cancer growth. Asleep like Rip Van Winkle for the last eight months it's back. New activity in ribs and a lymph node in middle of chest and the hip.

Karen suspected. The hip problem; not healing fully from the break last winter seemed to indicate that something wasn't right.
She has started a series of radiation treatments. Hopefully they will reduce the pain and Karen can use the walker more as much of our travel is in the wheelchair
on a more positive note our trip to Ithaca went well and it was great to see so many friends. Cancer care certainly takes a village.

​photo- Eileen Hagerty- Karen and friends

Finally got to consult with the Yale Orthopedic doctor specializing in both cancer and hip replacement. Wonder of wonders he suggests that we try radiation first.

Our radiologist was scheduled to begin that treatment regime on Karen's hip a month ago. Her regular Orthopedic doctor weighed in for more info first. He was worried that radiation while it may work against the tumors in the hip it slows healing of fractures. 

August turned into a month of scheduling x-rays, MRI and PET scans, second opinions and waiting. 

Now we're armed with Yale docs input. His opinion seems conservative enough. In fact, last December both hips had small fractures and the left was irradiated early on and healed enough so that it doesn't cause her pain. It's worth a try on the right.

Tomorrow we meet with our oncologist to review the hip recommendations and get his opinion on PET scan comparisons. The PET tells us how fast (or slow) the cancer advances and ultimately whether our treatment options have been working.
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We did take a chance over Labor Day weekend and traveled to Ithaca for our annual visit with very dear friends from college. Our oncologist who very much values a balance of treatment and quality of life was a bit nervous about the possible recurrence of spontaneous bone breaks. Ultimately Karen wanted us to not worry about the worst that could happen but hope for the best. We had a lovely and memorable weekend. Our friends are some of the loveliest people anywhere.  
Cancer support...it takes a village.

Photo - Eileen Haggerty - Karen and Louise Foster

Nothing moves at more than a snails pace in the world of doctor appointments during the summer. We had hoped to have an opinion on the potential hip replacement by now and the appointment isn't until next Tuesday (sept 6). Karen's pain has been increasing so this doesn't seem to be resolving on its own, leading us to assume the worst.
What that worst might be ranges from spontaneous breaks to full blown return of aggressive cancer. At least a PET scan is scheduled for tomorrow to learn how active the underlying cancer is, although we may not find the results of that until next week. The cancer has been very inactive for months now; the Taxol chemo working. Unfortunately  the side effects have forced a halt to that therapy. So she's getting no treatment until the hip issue is resolved.
The only advice we have at present is to use extra care and don't place any weight on the hip until tests are back and treatment options sorted out.  The same advice we've been following for over a month.
Our big quality of life decision this week is whether to travel five hours to Ithaca, NY for our annual reunion with college friends. Friends come from all over and we've managed to keep up the contact for 35+ years now. Karen is determined to go despite the risks of overdoing it. I'm nervous but equally determined to do whatever I can to help her do the things that make her happy and fulfilled. We know that we shouldn't constantly be guided by the worst that could happen, but it's difficult. Thank our lucky stars for great supportive friends.

Photo: William Evertson - Karen with Flower