Intro to Stanford

What’s kind of funny about going to Stanford is the immediate level of “oh, you’ll be fine there” I get when people find out I’m going there now. Not to say I had any doubts at Salinas Valley Memorial Hospital (SVMH), but I can definitely tell people feel more assured. Guess that’s why you build “names” and “prestige” for a university/hospital. 

So how different is Stanford compared to SVMH? A lot! Stanford campus and medical has definitely carved its own mini city out, but that’s pretty normal for any large college. By a fluke we found parking right next to the cancer center. Somehow I got myself turned around on the map and we were driving to the building and happened to the parking lot closest to it! So we didn’t have to park in the garage and walk. Chris didn’t go in with me (wasn’t allowed) and so his thought was “what if I have to pee?” The mall (which we’ve gone to several times) is less than 2 miles down the road, but it turns out they have permanent, portable bathrooms right outside. We both used them and we kind of laughed that they’re cleaner inside than most indoor bathrooms at other places you go to! They even told you the last time they were cleaned and had a QR code so you could report if it needed to be cleaned. What 21st century portable bathroom is this?! (They were tiny, though...haha)

Chris walked me to the building and I went into the waiting room and it was spiffy and new looking. SVMH definitely felt like the 80’s construction. The Stanford rooms themselves were pretty typical. I didn’t think the rooms at SVMH were bad. They definitely spent the upgrade money in the rooms at SVMH rather than waiting room, which was fine with me. 

The funniest thing to me was the fact I was seen by the oncologist, her NP, a transcriber, and a teaching student. No wonder Stanford told me they couldn’t have anyone else in the room. The room was tiny to begin with and with 5 people in it?! Definitely weren’t following the 6 ft rule. :P The transcriber was definitely something new to me. Guess that’s when you know a medical facility has money and they can hire someone to specifically take notes for the NP and Doctor for them. Nuts. Everyone was really nice. I also met the nurse. There’s also a nurse scheduler too. 

I liked my oncologist at SVMH and the NP I saw via video chat weren’t bad at all, but I definitely felt like there was a slightly different atmosphere around the Stanford team than SVMH. It wasn’t necessarily bad, but I guess the best way I could describe it is SVMH felt a little “tired.” Granted, my oncologist at SVMH is much, much older than the oncologist at Stanford. Actually, the whole team at Stanford felt like we were within 5-10 years of each other in age. My oncologist is fairly new at Stanford too (she’s been there about 2 years?). At any rate, I liked the team. 

Oncologist said she doesn’t recommend the trial to everyone who is HER2+, but given I’m “strongly” HER2+ and hormone receptor negative, there’s a good chance the targeted therapy drugs will work well to make up for the lack of 2nd chemo drug. 

Standard of Care: Taxotere, carboplatin, herceptin, and perjeta (TCHP)

6 rounds of 4 drugs, every 3 weeks (18 weeks) via IV

Clinical: Taxotere, herceptin, and perjeta (THP)

4 rounds of 3 drugs, every 3 weeks (12 weeks) via IV

The “TC” are standard chemo drugs. Often in the FB groups, you’ll hear people talk about finishing x-round of TC and that is in reference to those 2 chemos. The “HP” are the targeted therapy drugs for HER2. 

Going clinical trial, I’ll need to sign the liability forms, but she said after the 12 weeks, I’ll go back for a MRI. If she doesn’t like how it looks, then I’ll go back for more chemo. So, it’s as I said before, if it doesn’t work, I’ll just prolong treatment. If it works, I get less chemo. Obviously hoping for best case scenario!

She said they don’t recommend CT or bone density scan for stage 2B. They just don’t find it medically necessary. As much as it would be nice to have a “base standard,” I can’t say I’m disappointed about not getting it. It’s less imaging I have to do and less cost. So, if it’s not needed, fine!

They are trying to get my biopsy samples so they can verify the pathology findings. The radiologist is also reviewing my MRI. They found 2 unusual lymph nodes in the MRI, which is what my radiation oncologist at SVMH saw too. However, the radiologist at SVMH who looked at the MRI found 3. So, who knows. Whether it’s 2 or 3, it doesn’t change anything. The Stanford radiologist is still reviewing my MRI and will make a final report in the next few days.

I will do the port insertion with them. I assume that’ll get scheduled probably end of next week. I also have to sign the forms to do the clinical trial. They think in 2 weeks I’ll be able to start chemo. 

I did forget to ask about the shot to stick me into a menopause, though...Hmm. I’ll have to message them about that. In a weird kind of way, I’m getting a second opinion. Haha   

I will also have to do an echocardiogram every 3 months. I guess the herceptin (if I remember right) can cause the heart to have issues on squeezing. They’ve found if they catch it early, they can reverse it so I’ll be doing echocardiograms regularly for a while. 

Oh, yeah, after chemo and surgery, I’ll do HP treatments for a year afterwards. Not sure if it’s still every 3 weeks or not, but they’re also much milder than TC (or only T in my case) so it’ll be easier (she says). They are IV drugs so I’ll be getting very comfortable being in infusion centers over the next year...But, that’s getting ahead of myself. The first thing to do is get through chemo. Then we’ll know which path I’m taking after that. 

Other than that, I don’t think much else “earth shattering” happened. I did take a 15 minute nap on the way there. Poor Chris. Haha I told him I was tired when we were driving up! And the car was nice and warm. Plus, no matter what age I am, I can fall asleep in a car easily. :)