Dear Friends and Family -

I write this viewing our lovely garden at the peak of my favorite season. I was at the doctor last week. My general blood work remains steady and I feel good generally. My tumor marker number (CA 27-29) is creeping up which is not what we'd like to see. I've been told the tumor marker numbers are not necessarily reliable. Mine seemed to be so far. It was 122 before taking the medication and steadily decreased until February when it bottomed out at 42. Since then it's slowly risen. Last month was 51, this month 54. If the number is below 38 it means there is no active cancer. The only way to know if the medication is still working is for scans to be taken (CT and bone) and compare results to the last set. I had scans in May and will have them again in August or September.

I thought quite a bit about if I should continue to send monthly updates when so little changes in the blood work. Really, the only concrete information is in the scans which are every 3-4 months. I think I will write, mainly because there is more to having metastatic breast cancer than just monthly doctor visits. Plus, if you don't want to read them you don't have to!

My medication and dosage is remaining the same. Ibrance is made by Pfizer and they have switched to a tablet instead of a capsule. No difference other than you don't have to take it with food. Minor, right? I would have thought so. I've woken up in the middle of the night thinking "what if there is something different about the medication in tablet form that won't make it as effective?" I know rationally that all of it was rigorously researched, that's how science works. Our minds are not so rational. Each evening when I take my medication I'm both happy to have it still working and thinking, damn, another day. How many more days will the medication work? I hope years, but there is really no way to tell. I feel like I have some weird timer ticking and I don't know when it is going to go off. This is always present in the back of my mind. I can only imagine the cortisol surging through my body. I seem to have more trouble sleeping and it's hard to say what is causing it. As many of you know, lack of sleep is highly problematic on many levels. I'm working from home so at least there is a little flexibility in how early I need to get up and it's easier to rest during the day.

On a lighter note, I had an absolutely lovely birthday. Thank you to everyone who sent wishes or merely sent positive thoughts. I'm so happy to celebrate each day and another year is wonderful. I love summer and have been enjoying our beautiful garden (thanks to Glen, see photo for small sample), bike rides, and daily walks. Tinkerbell and I enjoy quiet mornings while I savor my coffee and she naps on my lap.

Our summer plans - like yours - were turned upside down and we are enjoying the season in different ways. Evelyn got her driver's license in late May and so she and Maddy have a new freedom. Evelyn is socially distant hiking with a friend on a regular basis and Maddy has started back to the dance studio a little bit, also socially distanced. I've actually ventured out to a few small grocery markets and that's plenty for me. If the weather cooperates we are considering a few days of camping later this week and we may head up to Steamboat to shelter in place in a hotel and enjoy the many outdoor activities available there later in the month. I'm so grateful to have access to and the ability to take advantage of such a rich environment locally.

We are anxiously following Dr. Fauci and hoping for a vaccine. Of course, a cure for breast cancer would be nice too. Please stay safe. Socially distance, wear a mask, and live life to the fullest.

Much Love,

Donna & Glen