Chemotherapy and IVF Treatment

I have been healing well with my surgery and Im looking forward to a few more weeks when I can do normal things again! I have started taking little morning walks without a wheelchair in the neighborhood to get some sun and to get my strength back.  I just hope my appetite will come back soon. 

CHEMOTHERAPY
We finally met with the Medical Oncologist Dr. John Glaspy on April 7, 2011.  He gave us the overview of the chemotherapy regimen I will have.  A combination of Taxotere (treatment for symptoms of locally advanced or metastatic breast cancer) and Cytoxa (which treats several types of cancer in combination with other drugs to treat breast cancer.  It will be given by infusion that will last about 4 hours through intravenous. It will be given every 3 weeks and I will be given the maximum dose of 6 cycles, which will last for six months.

To alleviate the pain of being given an intravenous line each chemotherapy session,  they will install a Port-a-Cath. It is a device that will inserted in your chest during a one hour surgery. A port is a small disc made of plastic or metal about the size of a quarter that sits just under the skin. A soft thin tube called a catheter connects the port to a large vein. Your chemotherapy medicines are given through a special needle that fits right into the port. You also can have blood drawn through the port. When all your cycles of chemotherapy are done, the port is removed during another short outpatient procedure.

Some people feel the pain when it is first installed but later on they are thankful because they do not need to get poked each time an IV line is done.  Also all the blood test will be done through the port.  They take blood test each chemotherapy session.

A day after the chemotherapy, I have to come back to the hospital to get a Neulasta injection.  It is used to reduce the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection).

Unlike many years ago, the side effects of chemotherapy is vomiting, nausea, anorexia and hair loss.  They has developed many medicines that will help with nausea and vomiting.  I will be taking -Decadron twice a day before and after chemo (which may cause restlessness and insomia) . 
-Compazine every 6-8 hours but which may sleepiness
-Ativan every 4-6 hours which may cause sleepiness
-Zofran every 12 hours for vomiting

The doctor was outright in telling me that I will lose my hair about 1-2 weeks after the first chemo.

Other side effects are constipation, diarrhea, mucositis (mouth becoming tender), Neuropathy (numbness, tingling of hands and feet), Nausea, Fatigue which increases with each chemo session, bone pain within 48 hours after infusion which can last 2-3 days, weight gain.

FERTILITY AND MENOPAUSAL ISSUES
One side effect of chemo is women can become infertile after the treament.  At the same time, pre-menoupausal women such as myself will go into early menopause.  Which is why we are in under the care of their cancer fertility clinic under the care of Dr. Mousa Shamonki for IVF or In-Vitro Fertilization.

Dr. Shamonki did an ultrasound of my ovaries and found 15 viable eggs that can be retrieved.  I haven't been ovulating since I got pregnant in June 2008 and havent mentruated since then.

They have started me on egg stimulation regimen consisting of daily injections of Menupur which is  follicle-stimulating hormone (FSH), which helps stimulate egg production; and luteinizing hormone (LH), which helps the eggs mature and release (ovulate). I also inject Gonal RFF Pen used to help ovaries make more eggs. It is used in ovulation induction.  I do this injections every night at home for 10 days.  Jim has also started taking medicines to prepare him for the sperm collection.

On the 5th day, the doctor will do an ultrasound to see the progress of the egg production.  On the 10th day or when it is determined via ultrasound that the eggs are viable for harvesting, I will undergo an IVF surgical procedure to remove the eggs from my ovaries. 

The process continues, eggs and sperms will be fertilized and become embryos, it will be frozen until the time they will be ready to be implanted in me after five years of my cancer treatment. 

I'm also under the care of a oncology gynecologist who monitors my ovaries for possible cancer every three months because I have 42% chance being BRCA 2 positive gene mutation (breast and ovarian cancer gene mutation).  After I am done with IVF, my doctor is recommending removing my ovaries to lessen the chances of ovarian cancer.  It will still be possible to get pregnant with IVF after removal because my uterus will still be normal. 

The costs of IVF treatment for cancer patients is very expensive but we were blessed to have been approved by Sharing Hope, a national organization providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.  It is because of Lance Armstrong that this organization under Livestrong was made possible. He suffered cancer himself and has vowed to help cancer patients.  They are shouldering a big part of the costs of the treatments and giving the medications for free costing about $5,000.  just he medicines itself is so expensive!

My IVF treatment will be done next week hopefully by April 21 and my chemotherapy is starting on April 25. 

After chemo, I will meet with the radiation oncologist to discuss the radiation therapy treatment.  I will be getting radiation treatment everyday for about two months.

Yesterday, my sister finally went back home to Singapore and it was one of the saddest moments of my life.  She took care of me selflessly.  She came here in a week's notice. Spent more than a thousand dollars to fly out here. Gave me showers, changed my gauze dressings, dressed me up everyday, stayed with me in the hospital, took care of James all day for a month, prepared all my meals, ran errands, slept with me, woke up in the middle of the night to give me my medicines on time, tucked me in bed because i needed special bed wedges for my wounds, most of all comforted me in the most difficult time of my life dealing with cancer.  I don't know what I could have done without her.  I wish she never left.  But I know she has a life of her own to deal with too.  I couldn't stop crying for an hour when we dropped her off at the airport. I love her to the moon and back. I just wish she was here with me forever.

I'll miss you so much, May.

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