I know last week’s update was rather bleak and downbeat and based more on what I was going through pain wise at the time. Today I just want to let you all know the big picture.

I have a multi step plan from my oncologist. I agree with it all. There are two main items. Treat pain and return to systemic treatment since cancer is growing.

1) We discovered from my bone scans that I’d broken part of my pelvis. I must have stressed the area after I had x-rays in January. (When I originally fell.) So the pain I’ve been experiencing isn’t bone pain from metastasis. It’s because I fractured part of my pelvis.

So first I will see a orthopedic oncologist to get an idea of what can be done as far as palliative care for my current situation. Surgery and radiation being possibilities. I have new spots with lesions. Generally they don’t hurt, but sometimes they do. I’m doing ok pain wise but we need to change the way it’s being treated since we didn’t know we were dealing with a broken bone.

And we need to see if I can get on a bone strengthening medicine since I’m obviously prone to fall and breaking bones. Again, bones are weakened considerably due to cancer and hormone treatment which I can’t go off of.

The problem is that the bone strengthening meds can cause ONJ (Osteonecrosis of the Jaw). This we don’t want (Google it). Basically it means your jaw bone dies. I need dental work which is both expensive and will take several months. I put dental work (other than cleaning) in the too expensive, don’t do bin. So we’re going to see if it’s possible to bypass the dental issues. I might get ONJ. But I definitely have weak bones and I’ve already broken one.

2) My scans from last week show that existing lesions have grown in size and number. So I need treatment. It looks like we’re going with a platinum-based chemo therapy in addition to the one I have left. This is kind of calling the big dogs. Platinum-based chemotherapy can be quite effective but is also more toxic than “standard” chemotherapy.

I will likely start treatment soon with cabazitaxel (the chemo I can repeat) and Carboplatin (the platinum-based chemotherapy).

This is it. This will not cure me. It’ll just give me a little more disease progression free time. A little more life. Don’t be strangers.

I had a good oncology appointment yesterday. All my lab results were very good, other than ALP (Alkaline Phosphatase), which was only slightly elevated and nowhere near what it was when I was first diagnosed. In my case it meant there was likely metastasis in my bones. And that there was. See image of bone scan I’ve provided. (Black is cancer. There is a LOT of black)

My PSA is 83.70, which is technically very elevated, but my current treatment is not systemic, so no big surprise there. The velocity has slowed down, which is a good thing, as for a while my PSA was doubling every month.

After I’m done with radium-223 (current treatment) in April I’m going to be in a new phase of this whole thing. I will not have any other new treatments available to me. I can redo one of the chemos I’ve done before. I can also take a clinical trial. So we’re going to look at all open clinical trials I qualify for, anywhere in the country, and we’ll see if any of the trials is a better choice than the chemo or not.

So at the moment I don’t know what treatment I’ll be doing, but at the very least I can repeat a chemo that worked for me in a previous trial. I’ll do that chemo until it quits working or my body can no longer handle it.

So really what it’s coming down to is clinical trials and prayers. It’s so very strange because I feel pretty well now, but I could be out of treatments/trials as soon as next year. No more treatments means what you think it does. Treatments keep me alive. And all we have ever been able to do is prolong my life as long as possible, but unfortunately not as long as we’d like. Welcome to stage 4.

Fingers crossed people, and all the prayers you can muster. Good juju and vibes also acceptable.

I really, really appreciate the support. So many people have helped me in so many ways and it just blows my mind. I can’t thank you all enough.

Watching my mother mourn my father’s death was the hardest thing I’ve ever had to endure. I was 15, my sister nearly 10. Sometimes I think my sister is lucky because she doesn’t really remember any of it. My father’s death shaped my entire life, but for her, he was simply someone she never knew. Perhaps I was the lucky one after all.

My father was 44 when he died of a brain tumor. After his death my biggest concern was living longer than he had. I became obsessed with it to the point that my birthdays had no meaning, even the “big” ones — 16, 21, 30, 40. None of those milestones mattered. Only 45. But the day I turned 45 I felt no different than I had the day before. I was still haunted by the memory of my mother’s sorrow. The vision of her breaking down, crying, and overwhelmed with grief, falling into the arms of a neighbor, was just as vivid in vision as the day it had happened 30 years earlier.

My mother remarried a few years later and settled back down into a life of normalcy. She went back to school, got her Master’s Degree, and started teaching second grade in a nearby elementary school. She taught there until her retirement. I always thought her students must have been the luckiest kids in the world. My mother was an amazing woman. Love and compassion flowed through her veins. She was more than a teacher. She enriched the lives of her students. She cared for each and every one of them like they were her own children.

My sister and I were both at my mother’s bedside when she died. She succumbed to a particularly aggressive form of cancer that started in her appendix. Dying from cancer that began in an essentially useless organ seemed to me as some kind of cosmic joke. But it wasn’t funny at all. And then there was the day she was declared “cancer free,” only for it to come back three months later and finish its job. Cancer is wickedly clever like that. You’re here today and gone tomorrow. Literally.

My mother didn’t want to die in a hospital room, so she came home to hospice when nothing more could be done. My sister flew in from Philadelphia and I drove in from Kansas City. I was only an hour away, so I just drove in every morning to be with my mother and went home each night to be with my family.

I’ve always found solace in driving back to my home town. For the most part it was a beautiful drive through rural Missouri — the place where I had grown up, where life had been simple and innocent and pure, a place I had never forgotten. Any other summer I would have looked forward to the cold comfort of my mother’s iced tea, the flicker of fireflies in the yard, and the cadence of cicadas in the trees. Now they were simply ghosts of July.

Hospice didn’t last very long, but then again, I suppose it’s not supposed to. My mother quickly fell into a coma and died a few days later. I would talk to her as she lay comatose, telling her l loved her every chance I got. I rarely told her that when she was alive, but mostly because it’s just one of those things I was never very good at. I often swore to myself that the next time I would try harder. There’s always tomorrow, I’d say. Well, there is, I learned, until there isn’t.