I mean who doesn’t love a good old Huey Lewis and the News song…..Stuck with you, Hip to be Square, Heart and Soul, Do You Believe in Love….the list goes on and I see myself making rounds around the roller skating rink back on Midlothian Turnpike! But I never in a million years envisioned reading the lyrics of “I want a new drug” and literally understanding every word!
At first diagnosis, we were full steam ahead with kyphoplasty (a crazy amazing surgery to repair a broken vertebra), 20 weeks of AC/Taxol chemotherapy, a lumpectomy, and 30 rounds of radiation. I was diagnosed with Metastatic Breast Cancer in August of 2019 and finished radiation in April of 2020. Upon completion, it was time to start on Letrozole, an aromatose inhibitor to block estrogen, Lupron shots to shut down my ovaries, Xgeva shots to strengthen my bones, and a CDK 4/6 medication only FDA approved in the last 5ish years which has been proven to help slow progression and add to long term survival for MBC (Metastatic Breast Cancer) patients. You’ve probably seen all the commercials for Verzenio, Ibrance, and Kisqali – they have MBC patients dancing around the room, smiling, and just running around doing all sorts of fun stuff. True, I am estatic for the medications that target my specific sub type but at the same time, could we possible just make more true to life commercials.
You’ve seen all of the warnings at the bottom of the screen—“ side effects may include” and then a long list making you question, wow, why even take that? Those people are crazy, right? Well, I’ve learned, not so crazy! When the alternative is worse than the side effects, you find yourself taking chances and what I’m finding there’s always an opportunity to back up and punt.
I started out on Kisqali-the newest of the three CDK inhibitors. I was excited because clinical trials were showing good “progression free” extensions & longer “overall survival” data. Because Kisqali can cause Long QT syndrome issues, the first month on you get regular EKG’s to monitor your heart rhythms. Mine was great—whew, side effects avoided! I started out on a roll – not super fatigued, no appetite issues, GI issues, or low blood counts. I thought, wow, this is not at all what I expected and I was quietly, prematurely, celebrating. I was getting labs every two weeks to monitor the new medication because frankly it is some hard core stuff. Just when I thought I was the Queen of Kisqali, my liver enzymes started to spike. I was devastated when I was told to take a week off of the medication. I just knew the cancer was going to see an open door and just let itself go back at it. Each drug has strict guidelines for deciding with a treatment break is necessary or a dose reduction is needed. The objective was of these guidelines helped me understand the process. I tried dose reductions and treatment breaks but in the end I had to move away from Kisqali when my liver enzymes just would not cooperate. Dr White called in an MRI on my liver just to rule out Mets in the liver. All clear so medication change it was.
Next stop was Verzenio. I had read about the GI issues associated with Verzenio but I had been thought chemo, how hard could it be? Hmm, don’t answer that!