Tuesday, July 6, 2021

Cancer = A Constant Turn of Events

Shortly after writing my last medical update, things turned topsy turvy for me. Like, within a week, I got very bad news and since then the news just keep getting worse. (I'm reminded of the book, Mr Topsy Turvy, and had to include the cover here.)

April 16 I had my quarterly CT scan of the pelvis/abdomen, and full body bone scan. For the first time since staring chemo in March 2019, the scans showed progression - the thing that Stage IV patients fear every day. They had found tumor growth in one of my vertebrae (T5) and also in my right pelvis and my hip. This meant that the chemo, which had been working for 25 months, had now failed. I was sent to get a PET scan, which would show how active the cancer cells are and give a better sense of the scope of the disease. On the PET scan, it shows that I now have a lesion on my liver (that wasn’t present on the CT scan from 6 days earlier) along with the many masses I already have in my lungs and the previously described new tumors in my bones, including now including the T6 vertebrae. So, onward to a new chemo.

Luckily, the chemo recommended was a series of pills. No more infusion! No more going to the hospital every week! I was just prescribed to take 7 pills every day for one week, take a week off, and then another week of pills, and so on. And…the chemo pills, called Xeloda, would not cause hair loss! Even better, this was a medication that could pass the blood/brain barrier and help with staving off brain tumors.

I started that regimen in the beginning of May, and other than diarrhea, very dry skin (especially hands and feet, which were painful at times) and extreme fatigue, I had very few side effects. But I found myself taking multiple naps and sinking into a bit of a depression because of my lack of energy.

Things were rolling along until I had my quarterly MRI on the brain on June 24. Unfortunately, despite the fact that I was on Xeloda for 6 weeks, many, many brain tumors have increased in size (instead of being stable in previous scans) and I got 3 new tumors that are especially large and causing symptoms. The main symptom is that sometimes, for no reason, my left arm and hand will just fall asleep and it won’t feel like my arm. It’ll feel like a “dead arm.” It only happens for a few minutes and then resolves, but my neurosurgeon says that this symptom makes sense given the location of the new tumors.

Even scarier… one of the tumors in the brain is in the leptomeningeal space - where the brain fluid is. This means that if any tumor cells have broken off, they can travel to my spinal cord. Here’s a list of symptoms that can be caused by this:
  • Headaches 
  • Nausea (feeling like you’re going to throw up) or vomiting (throwing up) 
  • Difficulty thinking 
  • Double vision 
  • Dizziness 
  • Difficulty speaking or swallowing 
  • Pain in your arms and legs 
  • Weakness or lack of coordination in your arms and legs 
  • Loss of bladder or bowel control 
  • Seizures 

As of now, I only have the “dead arm” as a symptom, which could possibly be because of the other tumor (which is on the part of the brain that controls sensation.) To find out of I have leptomeningeal disease I was given three separate MRIs on July 2 (back to back - I was in the loud, claustrophobic machine for over 90 minutes!)

On July 6 I have another PET scan to see if the Xeloda is working on the rest of my body. My guess is no - the nurse practitioner called last week and said she saw more bone growth on the MRI, but I’m not certain where or which vertebrae.

My oncologist has said that if I have progression in any area I will have to change chemo again, this time to Trodelvy. That one causes hair loss, which I’m very upset about. I lost a lot of hair after my last brain radiation and I have been desperately trying to grow it longer over the last year. And many of you know about the difficulties I had with hair loss in 2015/2016 with my initial bout of cancer. Did I mention that I’m getting married in late August? I’ll likely be losing my hair before then. I will be going wig shopping this week to prepare myself, thanks to the services of the 5 Under 40 Foundation (who support cancer patients who were diagnosed under the age of 40.)

Regarding the brain tumors, I’m meeting with a specialist July 7 who is known for his work in proton therapy, which allows them to radiate a very specific area without affecting other areas of the brain. That, also, causes complete hair loss but it looks to be promising in terms of effectiveness. And then I meet with my oncologist on July 8 to get blood work done and make a final plan for my care, based on the results of the MRIs and PET scan.

So right now I’m just in a suspended state of fear and anxiety, waiting for results which will determine my fate. I do try to stay positive but hair loss may be the breaking point. I have worked so hard to overcome many challenges that have kept me from being a musical theater performer in the last 2 years (other than COVID, obviously.) From pneumonia, to the year of recovery from my paralyzed vocal cord, to the enormous weight gain due to (anti-inflammatory) steroid use… my appearance and stamina have been severely tested. To lose my hair is another setback to manage.

Because it’s not just head hair that you lose - you lose EVERY hair. Eyelashes, eyebrows, leg, arm, body hair - all gone. So I’ll have to paint on eyebrows and glue on eyelashes to even look normal, let alone be ready for professional auditions.

I felt like I had *just* rounded a corner with my challenges, and now I’m facing all of this and it all feels excruciating. I’m angry and scared all of the time. Luckily I have a great therapist, wonderful friends, and family who are supportive. There are some important people who have actually disappeared from my life since my being diagnosed Stage IV - but those of you who have stuck by me are my heroes. You know who you are. I am grateful. 

I’ll be sure to wrote another post when I know more about my condition. Thanks, as always, for listening and loving me. It makes all the difference in the world.




So many wonderful people have asked me what they can do to help as I navigate this devastating disease. So I’ve put together this list of things that I will need as I continue treatment.


Donations:

You can donate via my Go Fund Me account here: https://www.gofundme.com/erin-cronican


I will be using any money raised to help with lost wages as I go through treatment and to handle any medical expenses that might not be covered. It will also relieve some of the pressure off Brandon from having to carry so much while I’m in treatment.


Gifts:

  • Gift Certificates for massage therapy, facials, pampering 
  • Amazon gift cards 
  • Anything you think might brighten my day (I love handmade/artisan stuff - Etsy, etc) 

My address:

165 E 87th Street #3FW
New York, NY 10128



Mail:

I love getting cards and things in the mail, so anything you want to send would be appreciated.



Thank you so much for helping me manage this diagnosis with grace, ease, and a little bit of fun. It means the world to me.




Erin Cronican is a Stage IV breast cancer patient, whose career as a professional actor, producer, and career coach has spanned the last 25 years in New York City, Los Angeles and San Diego. She has appeared in major feature films and on television, and has toured nationally and appeared Off Broadway with several plays and musicals. She is currently the Executive Artistic Director of The Seeing Place Theater in NYC. For more information, please visit www.erincronican.com or www.seeingplacetheater.com.

Sunday, April 11, 2021

An Update on Cancer and Daily Life


It’s been a while since I’ve shared what’s been going on with me medically. I forget as I live with this disease day in and day out that many people have no idea what it’s like to live with terminal illness. In some ways it’s harrowing, and in other ways it’s just what is considered normal for me now and I don’t think much about it. Here are a couple of days of significance over the last few months:


January 19, 2021

Today I was at the doctor for 6 hours. That’s a short day for me. Within that 6 hours I had three different appointments, had two CT scans, had 3 needles stuck in me (one shot, one blood draw, and one IV for a scan), had a plastic mask molded to my head in preparation for radiation, and waited for 2 hours in one of the intake rooms. On the bright side, I got to watch both the series finale episode and the series premiere episodes of Friends, plus two others, which were on the waiting room TV. But lordy, y’all - my patience REALLY wore thin. I found out later that the computer scanning systems were down, so they had to type out by hand anything that would normally be scanned.

The appointments today were to address two major things happening to me:

1) My neurosurgeon discovered four more (small) brain tumors two weeks ago. These are called brain metastases - cancer that traveled from the breast and metastasized into the brain. My treatment for this is stereotactic radio-surgery to deliver radiation to those specific parts of my brain with the tumors. And today was a “simulation” day when they took a bunch of scans and created a plastic mask that’s molded to my head which will keep it still while they do the treatment. That mask is no joke - it’s hard plastic that covers my face, head and neck (everywhere except my eyes & nose. VERY uncomfortable especially for someone with claustrophobia.) 

An example of the mask they had me wear


2) My platelets have been dangerously low due to chemo. Low platelets can cause internal bleeding for no reason whatsoever, so it’s really problematic. Here’s a story for you: I had a new nurse during chemo one day, and at the end he said, “Why don’t you get that shot that helps with platelets?” People, I have been dealing with low platelets for over a year and I have never heard of a shot to help! I asked my oncologist about it the next time I saw him, and he had never heard of that shot either. So he called up the hematology department, and low and behold - there IS such a shot, called NPlate. Just goes to show, listen to your nurses and be sure you advocate for yourself. If I hadn’t pushed about how frustrating the low platelets were, I wouldn’t have known that there was a solution. Anyway, today I got tested to see if the shot they gave me last week worked. After chemo my platelets didn’t go up, but they also didn’t go down, so they gave me a new dose today and I’ll see next week if it helped.


Back to now, April 11, 2021:

Three Tuesdays a month I have chemo (when it’s not being canceled due to low platelets.) What was once 6 hour days has turned into 12 hour days. Story time: About 6 months ago I was in the middle of getting chemo when I started to feel itchy on my hands. I thought it was odd but didn’t really think anything of it. Then I started getting a pain in my back, which was concerning. I then started feeling itchy in my mouth, so I got a nurse and said, “I think I’m having an allergic reaction.” All of the sudden all of the nurses started shouting, “Allergic reaction!” And “Carbo! Carbo!” (Which is the drug which was in the middle of being infused with.) They tore the infusion pump away from my IV, dosed me up full of Benadryl, grabbed an anaphylaxis kit, and stood by staring at me waiting to see if the reaction would clear. By this time I had a rash all over my whole body and my blood pressure was through the roof (the activity around me was terrifying!) I got better within 30 minutes, and I soon learned that becoming allergic to Carbo is relatively normal after a certain amount of treatments. In fact, they were surprised it hadn’t happened sooner.

This is such a problematic occurrence that I have since been transferred away from my normal breast cancer center to receive care at a large cancer center within the complex, which is better equipped to handle the possibility of anaphylaxis/reactions. I am now on what they call a desensitization protocol, which involves giving me Carboplatin in very small doses over the course of 6 hours (instead of the normal 1 hour.) This is in addition to the 5-6 hours of prep time and the other infusion I have of Gemzar (a second chemotherapy.) The worst part of it for me is not the time extension, but the fact that they have to give me Benadryl, which I do not respond well to at all. I have to be given Ativan in advance of the Benadryl to stave off some of the worst side effects for me (which is intense muscle twitches and difficulty breathing.) With the Ativan those things don’t happen, but I still get other side effects that seem more intense than normal people’s - I can’t really speak for about an hour (my mouth muscles don’t work properly) and my mind can’t really grasp anything complicated for a few hours after taking it. So I can’t really read or work, I have to just zone out watching TV, or by sleeping. Not the way I like to spend my day.

They recently gave me a brain MRI to see how the lesions were responding to January’s radiation, and the good news is that there hasn’t been any growth of the tumors in the 2 months since. It takes about 6 months to know if the tumors are fully killed, and what’s weird is that the lesions don’t go away - radiation results in dead brain tissue that lasts forever. The great news is that I have had zero symptoms from the tumors, which means that I haven’t lost anything due to the tumors or radiation. This is all thanks to us being vigilant and testing every three months. Unfortunately, the chemo I’m on cannot cross the blood/brain barrier, so my brain is sort of a free-for-all for cancer. I will continue to get tumors and the trick is just to find them early enough so they can be radiated before symptoms show up.

Other than that, things feel pretty great. I don’t have trouble breathing unless my blood counts are low, and this tells me that my lungs are still hanging in there. I don’t have any bone or abdominal pain, which leads me to believe that I’m still clear in my bones and liver. I have scans again on April 16 to see if there’s any progression of cancer anywhere that I can’t feel. And I have to warn you - that day will come when this line of chemo will stop working. Because cancer is smart and eventually learns how to grow in the face of chemo. I’ve been VERY lucky to have been on my same regimen for 2 years - that’s rather unheard of. But there are many other regimens to try when this one stops working.


Ok…


So many wonderful people have asked me what they can do to help as I navigate this devastating disease. So I’ve put together this list of things that I will need as I continue treatment.


Donations:

You can donate via my Go Fund Me account here: https://www.gofundme.com/erin-cronican

I will be using any money raised to help with lost wages as I go through treatment and to handle any medical expenses that might not be covered. It will also relieve some of the pressure off Brandon from having to carry so much while I’m in treatment.


Gifts:

Gift Certificates for massage therapy, facials, pampering
Amazon gift cards
Anything you think might brighten my day (I love handmade/artisan stuff - Etsy, etc)


My address:

165 E 87th Street #3FW
New York, NY 10128


Mail:

I love getting cards and things in the mail, so anything you want to send would be appreciated.



Thank you so much for helping me manage this diagnosis with grace, ease, and a little bit of fun. It means the world to me.




Erin Cronican is a Stage IV breast cancer patient, whose career as a professional actor, producer, and career coach has spanned the last 25 years in New York City, Los Angeles and San Diego. She has appeared in major feature films and on television, and has toured nationally and appeared Off Broadway with several plays and musicals. She is currently the Executive Artistic Director of The Seeing Place Theater in NYC. For more information, please visit www.erincronican.com and www.seeingplacetheater.com.


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