Oh Christmas Tree!

My second first chemo, a throwback, and some Bibbidi-Bobbidi-Boo magic

I know the picture above has absolutely nothing to do with chemo or Christmas trees, but it's cute and made me smile, so there you go! Now, for a short recap of my second, first chemo infusion. You're probably wondering if I've already started to lose my mind - why do I keep saying my second, first chemo? Well, as I explained previously, I'm part of a Phase II clinical trial. I'm going to get slightly technical in this explanation, so if you're not interested please feel free to skip ahead to the next section!

Clinical Trial - why does it matter so much to me?

Right, so why exactly am I excited to be, for all intents and purposes, a guinea pig? As you may recall, my cancer is considered triple negative, meaning it isn't "fueled" by an overproduction of estrogen, progesterone or a protein called HER-2. Unfortunately, the best standard of practice that has been developed for IBC patients, in regards to a chemo regiment, doesn't result in the best response from triple negative patients. Essentially, what doctors are looking for is called a pathological complete response which means that when surgery is performed and a pathologist looks at the tissue, they cannot find evidence of active cancer cells. The pathological complete response in triple negative IBC patients using the current best standard of practice is approximately 14%.

You're probably thinking - but yeah, they removed that tissue so it's out of the body. Does it matter that a cancer cell is active when it's already out of your body?

In a couple of words, "hell yes". Micro parts of cancer can and do "flow" through the rest of the body and can result in distant metastases which are difficult to detect until they've developed into tumors. Essentially, if there is active cancer in the tissue that's been removed during surgery, that means that chances are higher that there is active cancer still left in my body which can lead to a recurrence and/or a distant metastases, which I'm definitely trying to avoid.

So why am I rolling the dice and taking part in a clinical trial? The clinical trial I am taking part in is actually a follow-up to one conducted from 2008-2013. During the previous clinical trial, two drugs (Panitumumab and Carboplatin) were added to the best standard practice (Paclitaxel and Anthracycline). The addition of these two drugs resulted in a jump in pathological complete response in triple negative IBC patients from 14% all the way to approximately 44%. For those of you familiar with pharma and research, you know that such a jump is almost unheard of. The challenge with the previous clinical trial though is that they don't know if it's one of the two drugs or a combination of the two that created this positive result.

The clinical trial I'm participating in now aims to answer that exact question. Participants are split into one of two arms of the trial: Arm A includes both Pantiumumab and Carboplatin in addition to Paclitaxel and Anthracycline while Arm B includes only Carboplatin in addition to Paclitaxel and Anthracycline. Fortunately, the fates smiled on me this one time and I was assigned to Arm A meaning that I don't have to worry about whether the jump in response was actually as a result of the combination of the two drugs since I'll be getting them both anyway.

As a part of the trial, the first chemo that I received on 11/29 was a single dose of Panitumumab so they could study the response of my cancer from just the single drug alone before moving forward with the rest of the protocol. My second, first chemo that I keep referring to, which took place on 12/06, included the cocktail of three drugs (Pantiumumab, Paclitaxel and Carboplatin) that I will be receiving some sort of mix of over the coming 12 weeks. The Anthracycline will be used in the second three months of my treatment.

My second, first chemo was a much more challenging experience than my first. The infusion itself was absolutely okay, but the days following and the side effects were not easy. It's a harbinger of what's to come during these next six months. Chemo side effects are cumulative, for example fatigue will get worst with each infusion, and new ones will appear over time as more of the drugs accumulate in my system. If the first real week of chemo knocked me down for nearly two days, what does the future hold?

I totally realize that I'm worrying about something that I simply cannot control. I also know that I promised to keep my mind occupied, but have to admit that it's easier said than done. For now, simple distractions work, but only time will tell for the future.

Simple distractions - Christmas trees and presents (at the front door)

In keeping with the theme of my love (obsession?) with all things holiday, there was of course going to be a Christmas tree at home this year. While this may seem like an absolutely normal occurrence for most of you, the Doshi household is anything but stereotypical. Growing up, my parents put up a Christmas tree each year until I naively (stupidly, to be honest) exclaimed that the presents I received weren't from Santa because the label was in my Mom's handwriting. The moment my parents knew that I knew that Santa wasn't real, we stopped putting up a tree. They had, until that point, put the tree up each year in order to try to ensure that my sister and I wouldn't feel left out. But having immigrated from India and being Hindu, the Christian origins behind Christmas were something they wanted to respect. Not being Christian meant that it felt inappropriate to put up a tree, especially when you no longer needed to worry about your kids believing in Santa.

I am, however, all inclusive when it comes to holidays. Anything that brings people together and in good spirit is something I'm here for. And so I insisted that we have a proper (live) Christmas tree this year. It being the holiday season, there was obviously no challenge in finding said Christmas tree. The challenge, in fact, was in the decorations. You see, we still had our old decorations, but since we hadn't decorated a tree since the early 90s (and the decorations had been bought in the 80s), we weren't sure about the state of the lights or the ornaments themselves.

My mom dug up the old box from somewhere in the attic, and I proceeded to gingerly unwrap each item and test the light strings (fire extinguisher at the ready!). The first weekend of December, my sister and I decorated the tree in what ended up being a wonderful walk down memory lane.

Actually, correction, it was a wonderful walk down memory lane for her. For me, it was a rather visceral reminder that all of the visual artistic talent went to her. No, seriously, I often joke that I can't even draw a stick figure properly. It would appear that making bear ornaments was also beyond my capabilities in elementary school. The angel on the right in the picture? Well of course my sister made that in elementary school!

But it would appear that my lack of artistic talent is sufficient excuse for me to step back from the decoration process and instead, "supervise" as my sister decorated the tree. As much fun as we had putting up the tree, it definitely appeared to have time traveled from the 80s (hey Marty McFly). I think it's the tinsel that did it? Or perhaps the silver ball string that we turned into our star at the top? While it's definitely no Charlie Brown Christmas tree, my sister and I thought we should consider updating our ornaments and lights. Little did I know that a little box of magic was about to appear on my doorstep...

You see, I have a wonderful (if slightly crazy) team that I work with in New Jersey. I came home the other day to an excessively large package from them, and of course, immediately tore into it. I then proceeded to try to pick my jaw up off the ground for the better part of the evening. For lack of a better description, they had basically sent me what I have dubbed as the "everything but the tree" package. They had sent lights, ornaments, table decorations, a wreath, a star, a tree skirt, a stocking stuffed with candy, Christmas DVDs, a DVD player and more.

And so, with a bit of Fairy Godmother "Bibbidi-Bobbidi-Boo" magic and a little extra help from a friend in the Netherlands who also sent me some ornaments, my team transported my tree into this decade. It is now merrily lit each night and brings a feeling of warmth that is best described as contentment. It makes me wonder, can my world have really changed so much when so much still remains the same?