Challenges, decisions: 90 days of chemo wasn’t as effective as we hoped


COOPER, Iowa, July 21, 2017 — In early June I wrote that I had reached the 55-day mark on my oral chemo I started back in April for my adenoid cystic carcinoma cancer.  And on July 11, I reached 90 days — the mark that brought on a new CT scan and a new game plan.

But let me tell you about the last 40 days of my oral chemo experience. As I promised, I read a lot. I kept my gardens up as best as anyone has, I suppose.  And every morning at 6:30 a.m., I took four small chemo pills, took a walk with my husband Chuck and prayed.  I prayed for courage, strength, healing and health.  Many of you prayed with me and I felt those prayers — and I appreciate them.

As the chemo days went by I started noticing more side effects.  My hair stopped growing, so did my nails.  The rash on my arms became so bad I couldn’t expose myself to any sun, so I resorted to long sleeve shirts and a lot of sun block lotion.  Then, in the last two weeks, I developed big blisters on nearly all my toes and both heels! Oh my!  These got so big and painful I couldn’t wear shoes.  This made our morning walks impossible, and I was wearing loose-fitting sandals and then slippers to work.  I tried not to complain.

I had two blood vessels in my left eye pop, creating an almost zombie-like look.  All the time I was checking in with my primary care provider Sara Fleecs or with oncologist Dr. Matthew Hill.  We were on top of everything.  Dr. Hill finally took me off the chemo to give my body a rest and let some of the side effects run their course and disappear.

And then on Wednesday, July 12, the left side of my face went numb while in the car on my way to dinner in Des Moines.  Instead of dinner we went to the emergency room at Iowa Methodist Medical Center, UnityPoint Health/Des Moines.  My blood pressure had jumped, but not to dangerous levels. After a frustrating 5½ hours there, lab work and a CT scan of my head, it was determined that I was not having a stroke.  In fact, what I was having is still a mystery, and a frustrating one at that.

The next day I reported for the earlier-scheduled, post-90-days-of-chemo CT scan of my abdomen and pelvic area.  And then we waited.  A call from Dr. Hill later in the day gave me the news that I had no new tumors but two had a “slight progression” in growth.  Since the report was not more specific than that, Dr. Hill ordered a report with a more detailed comparison of my previous scan, last April. 

Overall, we all felt somewhat optimistic. No new tumors was really good news and a “slight progression” in two of them seemed manageable.  We reported this news to family and a few close friends, but we waited for the more complete results and an appointment with Dr. Hill before writing this.

That meeting this past Tuesday, July 18, didn’t go quite like we would have liked.  I’ve taken a couple days to process it all and am ready to move forward, first by sharing it with you all, and then by following Dr. Hill’s orders for what comes next.

The good news?  There are no new tumors, and I continue to have no real “symptoms” from the actual disease, and that means that the ACC has not progressed very much.  Except for the recent side effects from the chemo, I’m as healthy as someone with cancer could be.

Womens Park Carla Offenburger.JPG

Carla Offenburger, taking a bicycling break in the Women’s Park alongside one of the Little Miami Scenic Trails in Yellow Springs, Ohio, in June.

The more challenging news?  Of four small tumors that I have, all in the general area of my abdomen & pelvis, two showed just a little growth and are not worrisome right now.  Two more, one of them on the liver and one in my lower right pelvic area, grew about 100 percent from April to July.  That sounds like a lot but really means they grew from being roughly a quarter-to-a-half-inch in size on up to being a little less than an inch in size. They’re not dangerous yet, but the growth indicates that the chemo drug did not work.  Since we went into this knowing the chemo treatment was a shot in the dark, this wasn’t a total shock to us.  It was, however, terribly disappointing.

We’ve learned that throughout cancer treatment, we should always be asking  two questions: 1) Is it working? And 2) is it tolerable?  If either answer is “no,” we’ll make changes.  And Dr. Hill says that anything over a 20 percent increase in tumor size indicates the drug isn’t working.

I went through 90 days like any cancer patient does, hoping that the chemo was working, because I was prepared to answer “yes” to the side effects being tolerable.  I dreamed that we would be able to continue on, without much inconvenience, and I could live my somewhat normal life.  Morning walks, road trips, work, fun.  You know, things we all want.

I’ve thrown myself a few pity parties, cried myself to sleep once, and sworn a lot at the painful blisters on my toes — and now I know I wasn’t getting better by putting up with them. (You can tolerate side effects a whole lot better if you know the treatment is working.)

I’ve also been overwhelmed with gratitude for my family, especially my sisters.  One bought me a few long sleeve UPF-protective shirts to wear when I am walking or biking to protect my rash-covered arms.  The other bought me Under Armour sandals with Velcro straps across the top so my blistered toes don’t touch any part of the sandal when I put them on.  And I can’t even look at Chuck without knowing he is a warrior in disguise.  He is the man with the shield in front of me and the kick in the rear to keep me upbeat and positive without end.  And there are my close friends who have listened to my relentless whining over the past few days.  I am blessed beyond measure.

So, we’ll keep moving forward.  Chuck and I are reminding ourselves of a nugget from the book “50 Days of Hope: Daily Inspiration for Your Journey through Cancer,” which I continue to read over and over.  The nugget? “Don’t deny the diagnosis, (but) defy the verdict.” We are focused on living by that.

Here’s where we are headed as we defy the verdict:

Dr. Hill has taken me off the chemo drug trametinib permanently.  He says it takes about three weeks to get a drug like this out of my system, so the blisters should clear up in another week or so. 

During this “resting” period for me, Dr. Hill is going to be busy.  He has referred my latest scan and report to liver surgeon Dr. Qasim Chaudhry and radiation interventionist Dr. Olaf Kaufman at Iowa Methodist in Des Moines, both of whom have done procedures on me in the past two years.  Drs. Chaudhry and Kaufman will determine whether either or both can do further work on the tumors, especially the two more active ones.  Dr. Chaudhry will be considering whether he could remove the tumor from the liver, and Dr. Kaufman will probably be considering whether he can do another “ablation” on any of the tumors — using long needles for freezing or burning them so that they dissipate.

And Dr. Hill has already started looking into the chemo drug “keytruda” for possible treatment.  The genetic work-ups I had in late 2015 will be used again to see what cancer “mutations” are present in my cells and if they could be effectively treated with keytruda.  This drug would be administered by infusion every three weeks.  As with any chemotherapy treatment, there are all kinds of requests and approvals necessary, so we are grateful that Dr. Hill is on top of all of this.  I know and trust that he has my best interests in mind when he talks about treatment options and maintaining my quality of life.  Dr. Hill is another blessing!

In the near future, we’ll have to be making some decisions — surgical procedures, new chemotherapy regimen, or both?  When all this may happen is, of course, pending what is determined by the team of physicians reviewing what is best for me.

Of course, immediately after my appointment, both Chuck and I went to our computers and researched this keytruda drug.  There was a great article in the New York Times about it.  It was successful during its trial stages ,and has now been approved by the FDA as a drug that works on attacking tumors rather than specific cancer types.  Chuck discovered that this drug is the one that former President Jimmy Carter was successfully treated with recently.

We’re doing one more thing — flying to Las Vegas in late August for a concert by Rod Stewart. (I’m a lifelong fan.)  Any treatment decisions will be around this, for sure.  And I’m going to keep my 6:30 a.m. walking time with Chuck (when my blisters are all healed up) and I’m going to continue to pray for courage, strength, healing and health.

There is nothing but hope in our household.  Have some with us, please.

25 thoughts on “Challenges, decisions: 90 days of chemo wasn’t as effective as we hoped

  1. Defy the verdict — courage, strength, healing and health! Prayers coming your way!

    Debra Carle, Des Moines

  2. I’m so sorry to hear this news. The plan in place is a good thing. My hopes and prayers are always with you and your beautiful family. Love you, Murph.

    Kathy Hoover Murphy, Des Moines

  3. Fortitude: The strength to persist, the courage to endure. You and Chuck both have Fortitude! You’re both very loved and very prayed for! “And yet she persisted”

    Georgie Libbie, Windsor Heights, IA

  4. We will be praying with you for all these attributes — courage, strength, healing, and health. Your positive and “Forever Young” (Rod Stewart) attitude only helps you through this battle and impresses many! Enjoy the concert and know many are in your corner.

    Amy Lawton, Grimes, IA

  5. We have hope with you, and send prayers. Your courage and strength are strong weapons in this fight.

    Robyn & Arden Stokstad, Des Moines

  6. Yes indeed we are with you on the journey of life. Prayers and love. Thank you for sharing.

    Barbara Cunningham, Shenandoah, IA

  7. Thanks for sharing your story, Carla! Happy you have such a great team of dedicated healthcare professionals to kick cancer in the butt. We have so much admiration for your courage during this difficult time in your life. We will continue to keep you in our prayers!

    Marcia and Rick Wanamaker, Des Moines

  8. Of all the things your sisters want to be doing (I think I can speak for Chris also), a few shirts and sandals so you can walk and be out in the sunshine seems extremely minor. I want to take on your worry and stress for a few days, and figure out the way to a major league belly laugh together, I will find some old pictures and try for a sisters’ day to share and laugh over. I’ll get back to you on that…

    Tammie Amsbaugh, Des Moines

    • Tammie, I only mentioned one thing you’ve done — I forgot about the band-aids! You and Chris have done so much for me. The sisters’ day sounds grand. The old photos, maybe not. Ha.


  9. Thanks for sharing, Carla. You continue to be in my thoughts. I am happy to hear you have such faith in your doctors. This has to be huge. Your Las Vegas trip sounds fun!

    Mary Huggins, Urbandale IA

  10. Carla, you are awesome! I continue to pray daily for healing for you. Keep up the fight — so much to live for! What a blessing to be a part of the Offenburger clan! And have fun in Vegas!

    Carol Mogolov, Des Moines

  11. Holding you in my heart and prayers. I admire the way you are handling all of this. It sounds like you have a remarkably adept medical team working for you and an incredibly strong support team of family and friends to keep your spirits and resolve strong. May God hold you in his hand and watch over you and Chuck.

    Mary Beth Costello

  12. What a journey you’re on, Carla! I’m sorry that you are on it, but glad that I know you and Chuck well enough to know how strong and determined the two of you can be. I’ll continue sending positive thoughts your way.

    Renee Bridenstine, Ankeny IA

  13. I’m offering a large bowl of hope for your breakfast today, and a plate of love with prayers on top. I’ve had some and it’s delicious.

    Susan Judkins, Des Moines

  14. Keytruda sounds as if it’s loaded with possibilities for you. Your courage infuses all of us, Carla. Keep us posted on your progress.

    Rick Morain, Jefferson IA

  15. Your plan of continuing your morning walks with the mantra “Courage-Strength-Healing-Health” along with a fun Rod Stewart concert to look forward to is a “wise plan.” I continue to lift the two of you up in prayer.

    Sue Green, Cedar Falls IA

  16. You are, have been for all of the 15 years I have known you, and will be for the next 15, an inspiration to us all. Hope Rod Stewart (or Chuck) will sing “Mandolin Wind” for you.

    Scott Purvis, Gallup & Robinson Inc.

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