Results of the April 22 CT scan show the appearance of a new 1.8cm tumor in the lower part of the right lung. We determined that the effectiveness of Herceptin + Taxol has decreased. Recommend changing treatment to Herceptin + Navelbine or Herceptin + Capecitabine (Xeloda). The chance that either of these will be effective is about 20% and main side effects are decreased white blood cell count and inflamed veins for the former and decreased white blood cell count, diarrhea and hand-foot syndrome for the latter. After these drugs, using Lapatinib (Tykerb) which is due to be approved in Japan within the year, is in range.
As there has been a recent tendency for ejection factor to decrease, we're concerned that some heart damage is beginning to show due to the long term use of Herceptin. We'll re-check in a heart ultrasound in early June.
So, I didn't get any Taxol on Tuesday but I did get my weekly dose of Herceptin as my heart ejection fraction level from the last ultrasound, although lower than previous scans, was still within an average range. I asked for a week to think about the options as I thought I'd better read up a little more on the effectiveness and side effects of each before jumping in to anything. I'm leaning toward the twice a day oral Xeloda even if I still go every week for my Herceptin IVs. I have to make a list of pros and cons though.
The tumors that we were zapping away at with the Taxol have virtually disappeared, so I'm glad that it did work so well while it worked. The new tumor appeared after my January scans though, while I was still on Taxol, so I guess it's farewell Taxol, hello feeling in my fingers and toes (already returning after the three week break I had). The CT scan did confirm that there are no metastases to other organs or bones too. Costs will remain 44,000 yen a month max. after refunds so I won't have to worry about cost limiting my decision anyway.