Ch-ch-ch-ch-changes

About four years to the day after I started chemo at DF to treat metastasized breast cancer in my liver, I’m still in remission.

Yay!

I’m still getting treatment every three weeks, though as I’ve explained before, I now get two monoclonal antibodies (trastuzumab and pertuzumab)—“mabs,” for short—without any actual chemotherapy (taxol, in my case). Since May 2017, I’ve been driving or taking the train up to Boston (about 1.5 to 2 hours each way), checking in at DF, getting blood work every 6 to 9 weeks, waiting an hour (or 2, or 3) for my drugs to get mixed in the on-site pharmacy and then get into a chair for treatment, getting treated, and then driving/training back home. Even when every single thing went like clockwork, it was at least a 6 hour day.

Last fall DF started offering my treatment as a shot rather than an infusion. The infusion via my port has never been a problem for me. I don’t have pain when the needle is inserted or removed from the port and though the whole infusion takes an hour, it’s easy and painless.

However, the shot was an intriguing alternative. It is a single shot in the thigh that contains a special formulation of both mabs together. It takes 10 minutes to get the shot, vs. an hour for the infusion.

Now, this shot option is not for everyone. It’s a massive shot: 10 mL of volume delivered via a big-ass syringe, by hand. It takes 7-10 minutes for the nurse to deliver it, sitting perched next to me, trying to keep a steady pressure the whole time.

In my experience, it’s really not that bad. It stings as the needle goes in and stings worse when the needle is removed. Sometimes it gets pretty uncomfortable for a few seconds if the nurse pushes a little too fast. Only once out of about 8 treatments did I have any significant pain. After that one time, I had major bruising on my thigh and felt soreness that required ibuprofen for about a week. Most of the time, though, I just had some light bruising and mild soreness for a couple days. Given the time saved, I felt this was a good trade off.

But it bugged me that I was spending 4+ hours of a day going to Boston for a 10 minute shot. So I talked to my oncologist, Dr. F, and she informed me that there was a new clinical trial for HER2+ breast cancer patients in which the shot would be delivered to the patient’s home and administered by a visiting nurse.

Cue the hallelujah chorus!!!

“Yes!” I practically screamed in response to Dr. F’s question about my interest in this option. Yesyesyesyes, please!

They signed me up, told me how the whole thing would work, and I was super excited. Not only would I not need to travel to Boston, but this would be done in my own home. it sounded perfect.

Alas, this was not to be. No sooner did I enroll in the trial than the visiting nurse working on the trial in my region quit. And, strangely, the trial sponsor wasn’t able to line up another nurse over the course of several months. Finally, I had to resign myself to going back to Boston until they could sort this out.

Enter my brilliant mom. She asked why I couldn’t get my treatment in Rhode Island, where I live, instead of Boston. I had asked this same question of a previous oncologist at DF, who had said that wasn’t an option. Dr. F, however, was fine with it. She referred me to a colleague in RI (another Dr. F, who I’ll call Dr. FRI).**

Long story short, I’m now under the care of Dr. F and Dr. FRI, which allows me to get my treatments in RI, a mere 20 minute drive from my house. They don’t use the shots here in RI, but that’s just fine, since my overall time commitment is more than halved from when I was going to Boston. Even better, I’ll continue to see Dr. F twice a year for my CT scans and echocardiograms, which maintains my connection with DF.

Should I have another recurrence, I’ll head to DF directly. But for now, I can add a little more quality to my life while giving my body what it needs to keep those little cancerous beasties at bay.

I’m writing this as I receive my first treatment in RI. Im in a small satellite clinic, which means that there’s ample (free!) parking and very few patients. My oncology nurse, Nurse M. is great, and we’ve already bonded over our shared love of border collies. She warned me that her weakness is remembering to bring requested snacks, but if that’s the worst thing about this set-up, I’m in good hands.

The process here is pretty similar, with a few very minor changes. When you’ve lived the cancer life as long as I have, this type of transition is gravy.

The snack selection meets with my approval, too

Feeling so fortunate to have these options! I don’t know if the clinical trial will ever come together, but I’m content with this new situation. You might even say I’m infusiastic about it…

Heh heh.

**Moral of the story, dear reader: keep asking. One doc’s “absolutely not” is another doc’s “sure, no problem.”