Cycle Five - On Wednesday, April 22, Gloria received the Phesgo shot, which marked the start of her fifth cycle. The next day, she began her round of 16 radiation treatments - somehow we had misunderstood and thought there were 15 of those.

Gloria's weight has been slowly rising - up to a whopping 118.6 lbs. She needs about 15 more. She is slowly losing the ability to compete in a Gollum look-alike contest. Her once-shiny knob has acquired a frosting ... with the cutest little tuft in the back.

On Wednesday, May 20, she had her start-of-cycle-six Phesgo shot. There were minimal side effects this time.

The day before, we met with Dr. Koeneke. We spent much of the time talking about his family's recent vacation in Costa Rica - a place Gloria spent two years.

The long-term plan is to keep her on the Phesgo shots until she has had a total of 14 or until some reaction occurs indicating she can no longer tolerate them. At that point, she'll go on an estrogen-suppression pill for maybe 5 years.

SOZO - The one new medical experience this period was particularly painful - not the item itself, but getting up at 7:40 a.m. on a Monday to make the 9:30 a.m. appointment. Gloria has never been bad about getting up early - even in the very wee hours to catch a 6 a.m. flight to Wisconsin - but she just holds her tongue.

And that appointment - are you ready for this? - was at Maximum Performance Physical Therapy and Fitness. No, she isn't starting a fitness program. Stephanie, one of the co-owners, has long had an interest in the intersection of how to stay fit and healthy while undergoing treatment for cancer. We were sent in her direction by Dr. Bell, the radiation guru. People who have had the sort of treatments Gloria has had are at an elevated risk of developing lymphedema as a consequence of damage to her lymph circulation system.

Once again, the "Catch 22" aspect of cancer treatment medicine raises its head! Radiation of the lymph nodes will likely kill off the cancer cells that may have traveled there from the breast, but the unintended scarring combined with node removals may interfere with lymph flow. The consequence may be a pooling in the related area - in this case, her right side upper arm near the shoulder. While it is unsightly, morbidity of the tissue may arise, followed by an infection. Other than the use of compression bandages and massage, there is little that can be done. Additional surgery may produce relief in some cases, but it is generally viewed as incurable.

Dr. Bell is a fan of surgically removing more area lymph nodes in an effort to rid an area of cancer, but Dr. Doering is not, feeling the amount present in Gloria's case was small and radiation and chemotherapy would likely sweep them up. The greater number of nodes removed, the heightened likelihood of lymphedema. Once again, it's another roll-the-dice situation - which would a person rather take the chance on?

The "magic number" of node removals where lymphedema reaches a certainty of 50-50 is considered six. Since Gloria had only one removed and tolerated radiation well in 2022, she should be in a good place.

I decided I will put that in a later separate post. I am pretty certain most folks skip all the science stuff I include anyway!

Update Future - I’ve decided this will be the last "regular" or planned update.

Closing Thought and a Question - When a person is young, medical interventions are typically aimed at a return to "normalcy." As we age, it is common to develop a small number of "maintenance" medical interactions - Pap smears, blood pressure medication, etc. But if we are lucky enough to reach old age, our awareness of where this is all going becomes more of a constant companion. Some may find this depressing, but I don't. It's just another phase of life with its own peculiar benefits and challenges.

However, there is a question we two have been pondering. One of the things that has changed during our life is advertising for legal services and drugs. Once upon a time, neither was allowed. But with the amount on the airwaves today, I wonder how television ever survived without it!

Personally, I find the ads for law firms quite entertaining. In almost every case after watching one, I know if I needed a lawyer, he/she would NOT be my choice.

But our question involves cancer treatment drugs. The next time you see an ad for one, notice how many of the people who are supposed to be cancer patients are bald. In the real world, approximately two out of every three cancer patients lose their hair from the drugs. For that matter, about half of men experience baldness as they age just as the consequence of having the Y chromosome. So why are baldies virtually nonexistent in the related ads? Not exactly truth in advertising, is it?