What tests and scans used to diagnose breast cancer mets?

Hi Ochno -
re PICC/Portacath : I've requested the Portacath, and can see it as a possible future appointment in the online system, but with no date. They said it would take time to get approval and to get the Interventional Radiologist availability to fit it. I guess it may never happen.
Our hosp wouldn't do my chemo via cannula, so they said to get the PICC to avoid delay. Fitting the PICC only took 1-2 hours and wasn't painful. The chap who fitted it said he also works in a private hosp and most people there get the Portacath, so maybe NHS cost saving ! He said that some nurses taking blood samples are not happy to use the Portacath but will use the PICC.
Have to use a special sleeve when showering so it doesn't get wet. Needs to be flushed once per week so I have an appt in week 3 with district nurse in local cottage hospital.

re Gem/Carbo - I had Gem & Carbo yesterday (day 1) and was told by the Oncologist that day 8 would only be one of them (I initially thought it was Carbo but I was wrong - for me it's Gem on day 8, confirmed by chemo nurse). The Macmillan UK website also confirms this regime for Gem-Carbo). So another difference between UK & Spain. ..probably another NHS cost-saving measure :-)

My chemo is done at a bigger hosp (35 mins away) and yesterday they had 4 chemo suites running, each with about 10 chemo chairs (reclining) and 3 nurses for each suite. Seemed fairly peaceful other than the beeping infusion machines.

Slept fairly well and only have slight headache and delicate stomach this morning, but eating OK. So it's not too bad so far.

Sorry to hear about your Liver taking a beating - I don't understand the blood readings but the ones I can see online for my liver are already outside the normal range due to the mets in the liver I guess.

I'm off the the big hospital again today for a kidney function test - 4 separate visits during the day to take blood samples to check the eGFR (kidney filtration rate). Apparently they do this at the start so they can tell if chemo is affecting your kidneys. Not sure when they retest.

Hope you're getting on OK after your day8 chemo !

Hola!   So glad you’ve had a good sleep and feeling okay.   Long may that continue x

The differences in care are quite significant, I suppose all individually tailored.  Well I’d hope so anyway.  I don’t even know what Spanish protocol is, I’ve had one patient leaflet during my whole treatment, think that was care of boob after radiation??  A bit dire really.

I’m going to stamp my wee size 3s about Portacath.   Can’t continue with cannulation, If it needs to be PICC temporarily then so be it. Of course will keep that up my sleeve, literally ha!

Feel so much better this time around, not so scary as I feel I know what to expect.  Day 2 is red face day and raised heart rate…guess steroid come down?   Today a little of the same but feeling okay.   Been to garden centre and been planting up my terrace.  

That’s a long day for you today after a hard day of chemo.   Kidney function never been mentioned here?   Hopefully you can rest between blood tests?  You’ll be running on empty.

I come home with blood results and send to my daughter who is a bio medical scientist, she’s keeping a close eye on all this malarkey.

wishing you a productive day and a restful weekend xx  

Hola chica!   Just checking in to see how you’re doing?  Well I hope.   Sending you loving thoughts x

Hi Ochno - a tiring day for me today - not sure if it's chemo fatigue or we just tried to do too much. I'm still not walking far (about 1km) due to shortness of breath and rib pain so we took the mobility scooter to have a picnic breakfast in Windsor Great Park, then picnic lunch at Runnymede, making the most of a little bit of rare sun, then a quick visit to son & daughter-in-law. Fell asleep when we got home.
Will have to take it a bit easier tomorrow :-)
I feel as though the shortness of breath has got a little worse since the chemo but that could be my pleural fluid building up again - I find I'm puffing after going upstairs.

Kidney test on Friday wasn't bad - they used the PICC line to take blood samples but had a bit of a struggle - nurse thinks end of PICC may be close to vein wall so is OK for pumping chemo in but not so good for sucking sample out. But she did get the samples via PICC eventually and it was painless.
Will see what happens when the local health centre takes pre-chemo bloods on Tuesday.

Hope you are managing OK with part 2 of cycle 1 and have had a good weekend, and a good couple of weeks before the next round.
Thinking of you - it's lovely to share with someone who understands what we are both going through :-)

No wonder you’re tired, that’s a busy day!   I still had pyjamas on at 8pm until we went for a little walk along the beach with the dogs.  

Hoping your PICC line plays ball, not so good if they can’t use it to take bloods easily.  Maybe some people just have the knack and make it look simple?  Not all blood tests are equal, I know now who is going to leave me bruised.

It’s nice to know I’ve nothing till next week.  Time to chill and forget about hospital appointments for a while, it’s been pretty full on.

Wishing you a good week, hope session 2 goes well x

Hi Ochno - I think your next cycle of Gem-Carbo is due today ? Hope it goes well. And I hope that you had a good couple of weeks to recover from the previous dose.
I had my day-8 Gem last Thurs - not too bad other than being very tired, plus a bit of tingly feet and slightly swollen ankles.
Had my pleural fluid drained again last week as I thought that might be causing back/rib pain but it didn't help as much this time. I'm hoping that the chemo will dry up the fluid and reduce the general bone pain, and the last few days have been slightly better so I'm trying to convince myself it's working already !
Good luck with the next cycle - thinking of you. x

Hola!  All done and dusted…a long long day, left home at 0630 and home at 6.   They had trainees assisting today, it was chaos!   Bloods very good, my liver seems to have recovered from first week’s chemo.  Just slightly higher than normal levels today.  They forgot to order some of our meds from pharmacy and had a backlog of ladies waiting not so patiently. I had an extra saline whilst I was waiting so nicely hydrated.   

The 2 weeks off was bliss, took me a wee while to get back to normal but loved it.

Sounds like you’re coping well.  Hopefully they get to the root cause of the back and rib pain.  I’m sometimes a bit like that but can usually stretch it off with very very gentle yoga stretching.   I can almost feel everything settling back into place.   

The lump on my neck not getting bigger but certainly not shrunk any.  They had a good old prod today.  Breast scar tissue and radiation damage swollen, not sure if that’s a good sign??

Portacath booked for next week.  Local anaesthetic only, think I expected light sedation.   I’ll shut my eyes tightly and dream of Scotland xx

Here’s to a few days rest and recuperation, we so deserve it xx

Little update.   Wide awake after chemo today, blimin steroids!   Portacath fitted, a bit of a mission but got there eventually with a lot of pulling and pushing.   Used for chemo today and so easy.  No faffing around dodgy veins and stop starting drip.  

PD L results negative, no immunotherapy for me.  One more infusion of Gemcarbo to go then scan to see if it’s working. Should get scan shortly after 18th July.  Taxanes mentioned as next chemo if needed.  Let’s see.  

Hi Ochno - good to hear from you - hope all is well with you.
I've just had day8 of cycle 2 of Gem-Carbo  (I only get Gem on day 8).

Glad you got your Portacath in the end and that it's better for the infusion. I still have the PICC and suspect I won't get the Portacath even though it's requested on the hospital system - the breast care nurse implied that under NHS you only get it if you have problems with the PICC.

I've struggled a bit with Gem-Carbo - my white cell count was down to 0.8 before start of cycle 2 so that was delayed by a week (luckily I didn't get any infections). So I now have a couple of Filgrastim injections that we have to do after day1 and day 8 chemos to boost white cells.
Also my Haemoglobin count is down from the bottom end of normal (115) before chemo to 74, then 81 with each chemo, so I seem to be exhausted all the time. I thought it might be the pleural effusion building up again (meaning that I breathe less well) but they checked it a couple of weeks ago (and due for another check on Monday) and there wasn't really enough fluid to justify another drain. Now I wonder whether it's just the low haemoglobin that's making me lack energy. Oncologist said they might do a blood transfusion with next chemo if it's still low. But at least I haven't been ill !

I'm hoping that the chemo (or the Zoledronic acid which they added for cycle 2) may be doing something effective as I seem to be in a bit less pain than I was at the start. Still on Naproxen pain relief but not taking paracetamol as well, and sleeping a bit better.
I'm not sure when they will do any scans to prove if anything has changed ? Seeing Onco for the first time since a couple of months ago (face-to-face on 23rd July just before cycle 3) and notice that she has ordered the CA153 marker blood test for that meeting - hope it's good news !

Have you noticed any changes in your symptoms ?

How lovely to hear from you.  I was wondering how you were doing.  It’s all such a mission isn’t it.  5 infusions down and one more to go before I get my CT scan.  I’m hoping it’s working and I can continue with it,   My side effects seem to change each time.  My liver consistently gets tanked but recovers during my week off.  I’m anaemic so a bit tired.   Nothing too major going on, I’m hanging in in there.

I see oncologist face to face first infusion of each cycle, then she just approves bloods for the second one.  It’s amazing how quickly it becomes a routine.  Had genetic testing done last week, 2 months before I get the results!  

Can’t say I’ve noticed any difference re symptoms, to be fair I didn’t have many to start with.  More breathless is all but it’s 40 degrees here…phew!   I’m in hiding from the sun. Maybe neck lump slightly smaller but hard to tell as that’s where they chose to insert Portacath tube.   

The scanxiety is setting in, I just hope it’s good news.