Sunday, May 29, 2005

A Timeline of Kristen's Breast Cancer

February 2, 2001
Kristen and David are married.

Fall, 2001
Kristen feels a lump in her breast and has a mammogram. The radiologist at Cypress Fairbanks Medical suggested that the lump was not worrisome and to follow up in six months.

Spring, 2002
Kristen feels a second lump beside the first lump and has the recommended second mammogram. The radiologist again suggests that the lumps are nothing at all and to follow up in another six months.

July, 2002
Kristen instead opts to have the bothersome lump removed. After the simple lumpectomy procedure, a biopsy indicates Her2-positive Stage II breast cancer. Her2-Neu positive breast cancer is less common than estrogen-related breast cancer. Of course it's extremely rare that a 25-year-old would have breast cancer.

August, 2002
After much research and several second opinions, we made a very wise choice in entrusting Kristen's care to M.D. Anderson Cancer Center. Kristen began chemotherapy treatment (Taxol), but not before a routine port-a-catheter installation punctured her lung, hospitalizing her for six days (the procedure was done at Hermann).The plan was to have three months of Taxol followed by three months of FEC.
Separately, we were advised by a fertility doctor to freeze several of Kristen's eggs before beginning chemotherapy. The thinking was that we, as a young couple, should take precautions to ensure that we have children since oftentimes younger women who receive chemotherapy become menopausal. When we learned that taking such measures would delay the start of treatment by two months, we decided to put the matter in God's hands.

December, 2002
After the three months of Taxol (very effective) and a couple of rounds of FEC (not so effective), the tumors begin to grow again. The FEC chemotherapy is stopped and Kristen undergoes a radical mastectomy on New Year's Eve. Along with the breast, twenty lymph nodes are removed. Thankfully, only two lymph nodes proved cancerous.

January - April, 2003
Kristen undergoes radiation therapy to the left chest. This was the site of the breast cancer and the most likely place of recurrence. At the end of this treatment, Kristen was labeled NED (No Evidence of Disease) and we declared victory over the breast cancer. We were very glad to have that chapter of our lives over with.
After conferring with doctors, we felt good enough to begin thinking about children. Despite the damage of all the chemotherapy, we are blessed with an immediate pregnancy.

September-October, 2003
When Kristen went to have a persistant pain in her shoulder checked out, we're shocked to learn that the breast cancer metastasized to the liver and lungs. The lungs are populated with hundreds of tumors and the cancer covers 75-80 percent of the liver. Already large from being six months pregnant, Kristen's abdomen also has to hold a liver that has swollen to twice its size.Both the lives of Kristen and Sam are in grave danger.
Left untreated, Kristen had approximately eight weeks to live. Kristen bravely was willing to forgo her own treatment if it meant endangering the unborn Sam. Ultimately, the decision was made to administer Herceptin (a new, "smart drug") in combination with the chemotherapy drug, Navelbine. The decision was medically untested and later proved to be of national medical significance. As hoped, the placental wall "filtered" the harmful effects of the chemotherapy drug, leaving Sam safe.
The treatment worked almost immediately. The tumors in the lungs completely disappeared and the tumors in the liver were shrinking more every week. Eventually they would completely disappear.

November 18, 2003
Kristen safely delivers Samuel Stone Hartland five weeks early. Texas Children's Hospital had a NICU team ready to help what was sure to be a struggling infant. Instead they got a loud, healthy (9.9 on the Apgar scale) boy weighing 5 pounds and 14 ounces. It is an extraordinary miracle. Mother and son arrive home within a couple of days.

March, 2004
After nearly six months of immense success, the Herceptin stops working and the tumors begin to reappear. Kristen quickly begins taking Xeloda, a “smart tablet.”

October, 2004
Like Herceptin before it, after some initial success, Xeloda becomes ineffective. Tumors begin to reappear in her liver once again. An increased, more potent dosage of Xeloda is attempted with little effect. The cancer has almost taken on a bacteria-like resistance to drugs that are initially effective. Kristen begins a new, experimental drug called GM-CSF.

December, 2004
GM-CSF quickly proves to be ineffective, and is scrapped in favor of a combination of chemotherapy drugs called Taxotere, Carboplatin, and Herceptin.

March, 2005
After a couple months of mild success, the trio of drugs stops working completely. Scans indicate that the tumors in her liver have grown. Additional scans show a new site of metastasis in the bone along her spine. Most troublesome of all, there are several tumors that appear in her brain.

April, 2005
Kristen undergoes two weeks of intensive brain radiation treatment. Scans later show the radiation treatment to be enormously successful at eradicating the tumors.

May, 2005
With the tumors in the brain treated, we turn our full attention on the cancer in her liver. Her liver was swollen (she looked four months pregnant) and more than 85 percent was covered with tumors. The extreme situation called for extreme measures at a time when options were running out. Kristen undergoes a procedure called Hepatic Arterial Infusion. A very large dose of chemotherapy agent (Cisplatin) is delivered directly to her liver via an IV inserted into her upper thigh. Simultaneously, another chemotherapy agent (Doxyrubicin) is administered through the port-a-cath in her shoulder area (the location she typically received treatments). Though the infusion last only a couple hours, Kristen is in the hospital for seven days afterward, recovering from the potent dosage.