The good, the bad ........and the ugly?

Always best to start with the good news ,and it is GREAT news that the CT scan is clear :-)
No sign of any tumours ( we will just bypass the fact that anything under 10mm doesn't show up) and the node (s) that were being zapped by the radiotherapy have shrunk back to normal size.

In December my CA 125 was 17 - remember anything under 35 is fine, and that had been increasing all of last year. However I took a blood test on Monday and its risen to 29 , still in the "safe" range but still not the best news.

There are many reasons why the CA 125 markers fluctuate, it's an indication of inflammation in the body , not always to do with Cancer cells, but any infection can cause a high reading.

Equally the test is just a marker and not necessarily accurate, however I seem to be fairly sensitive to the test and so far a rise in the CA 125 could very well mean that the cancer cells are active.

It was good to talk my consultant KG, especially as there had been an MDT meeting that morning, and although I wasn't originally on the Marsden list she asked questions about the the next phase of treatment.

There was talk of possible trials that I may be eligible for, particularly as I have the BRCA gene, ones that involve PARP inhibitors in particular Olaparib.

Olaparib is pronounced oh-lap-a-rib. It is also called by its brand name Lynparza. It is a type of biological therapy drug called a PARP-1 inhibitor.

It is a treatment for ovarian cancer. It is for people who have a change in a gene called BRCA.

You may also have it as part of a trial for other cancers.

How olaparib works
PARP is short for Poly (ADP-ribose) polymerase. It is a protein that helps damaged cells to repair themselves. Olaparib stops PARP working.

Cancer cells with a change in the BRCA gene rely on PARP to keep their DNA healthy. So, when olaparib stops PARP from repairing DNA damage, the cancer cells die.

Or it maybe another round of chemotherapy , but not straight away. There is no point in trying to have chemo with microscopic cancer cells, it just won't work, and I'll feel terrible.

So, the plan is to wait... Have another blood test in a month, see what the tests read, and act accordingly.

That old game.

That was the afternoon visit to the hospital, the morning visit was at the breast clinic, seeing another consultant MS. A very nice young man, who talked about the pros and cons of surgery.
Carrying the BRCA.gene means I have a very high risk of getting breast cancer ( I don't do things by halves) , and so I needed to talk to him about the possibility of a full mastectomy, or is it worth the upheaval of another operation ?
I did struggle a bit when one of his first questions was " so, what's your prognosis "?
We decided that at the moment we would leave things be, and just monitor the situation , in his words " I may have bigger fish to fry" .

As always in these sometimes tense, serious situations there often is a comedy element ( or is that just me?) When the 'young' consultant tells you how many 'grams' of breast tissue you have (approximately) , and you're not sure if that's the combined total of both breasts .............too embarrassed to ask...........and even worse it's not even as much as a pack of butter!

He did say politely that it may not be as big an operation as it would with other ladies, but still it's fairly major surgery. Unfortunately it doesn't matter if you have 100g or 1,000g of tissue it only takes one cancer cell.

I now need to do my own research into PARP inhibitors , and I do hope to meet up with the genetics team when they come over to Jersey.

So, the the Big C has once more raised its ugly head, just when I thought I'd get a year off.

Still, there are always others that are worse of than me, and that is true.

In the words of a great philosopher ...

“Sometimes, if you stand on the bottom rail of a bridge and lean over to watch the river slipping slowly away beneath you, you will suddenly know everything there is to be known.”

A A Milne




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