The Swing of the Pendulum

I’m continuing to teeter back and forth about what kind of chemo to choose, AC or FEC. I spent hours researching last night and got to sleep very late as a result.

Here’s the situation: Multifocal invasive ductal carcinoma leading to mastectomy. The pathology report showed a 1.7 cm tumor and a .9 tumor, both grade 3, both HER2NEU negative, ER and PR positive. There was also extensive angio-lymphatic invasion. However, the good news is that all nodes were negative.

Add to mix some concern about my heart stemming from a family history of aortic aneurisms. Plus my mother died of congestive heart failure following AC for breast cancer, but she had a lot of AC. That was the only chemotherapy available then and she went through it three times. And she was stage 4 when she was first diagnosed.

The choices according the one oncologist, Dr. L.:
AC plus taxol, four sessions of each, two weeks apart or
Taxotere plus Cytoxin, eight sessions, two weeks apart

The choices according to another oncologist, Dr. V. (the one I prefer):
AC only for four sessions, three weeks apart or
FEC (fluorourcil, epirubicin, cyclophosphamine) for six sessions, three weeks apart.

The Disease Free Survival (DFS) rates (assuming I follow chemo with hormone therapy afterwards for five years) are the same for AC and FEC. FEC has more side effects, but half the risk of heart damage or leukemia several years down the road.

AC+T improves my DFS by 2%. Taxotere is relatively new and there are no longitudinal studies to know what the risks really are more than five years down the road. However, Dr. L. prefers it to AC+T for me due to the heart risks of AC. He says that since there were two tumors, the aggregate size is really >2cm, which technically puts me at a stage 2, and therefore needing a more aggressive regimen

Dr. V. thinks I'm still at stage one, if only barely. Dr. V. thinks that AC+T or T+C is overkill at this point. I tend to agee. I'm not crazy about doing chemo at all, but I've gone to great lengths to assemble a medical team that I trust and can rely upon. They ALL agree that I need to do chemo. Dr. V. recommends FEC, with AC as a second choice but is leaving the ultimate decision to me.

I keep swinging back and forth. I have until Thursday to truly make up my mind. At this point, I'm tending towards FEC, despite the fact that there are more short term side effects associated with it and it will go on a full six weeks longer than AC. Having spent six weeks recovering from a mastectomy, I have a great awareness just how long six weeks can be. I would really like to get back on my feet and get my life back again sooner rather than later, but perhaps I'm too impatient.

I keep taking out my pendulum and checking and it swings towards FEC, or at least it has the last three days in a row. After all this weighing and sifting evidence, I seem to be relying on a pendulum. My left brain is protesting, but all signs are pointing in the same direction, much as I would like to have the shorter course.

Moira (from the BC group) called me last night and gave me information about Look Good, Feel Better, a program for women with cancer to help them with make up and wigs. They provide free cosmetics and cosmetologists volunteer their time to show women how to apply make up. I think I shall check them out.

Lynn (from the BC group) is coming over tomorrow to do some EFT with me. We’re going to work on her dread of going to radiation treatment. However, she said she’s already doing much better with it since our group on Thursday. She’s working out a reward system for herself and listening to meditation tapes and giving herself positive suggestions. I don’t know if there’s much more I can add to the mix, she’s doing so well with changing her attitude for the better. However, it will be great to see her. It’s so important for all of us to help each other through this and keep a positive attitude.

Despite my quandary about which treatment to choose, I’m doing much better in terms of mood and outlook. The election cheered me up no end. I can stand to read the newspaper and listen to the news again. Oregon now has a democratic senate, house, and governor, so the era a gridlock is over and we see encouraging signs of change all over. And I’m so happy to know our country has a chance to move forward again towards peace and prosperity.

I know that I’m safe, I know that I will be fine. I just have to give up the illusion of control. I am surrounded by love and peace. My support group is amazing and I love being with the women that come there. I draw inspiration from them.

The second MRI showed no cancer in the left breast so I’m good to go for chemo. The pink wig is at the ready, my house is clean and organized, I have lots of books and films to keep me entertained. I have two banjos to play whenever I want. I have friends who are willing to hang out with me when I need it and leave me to myself when I need it. Life is good. So I’ll feel a little ill for a while. I’ve had the flu before and I survived just fine.

The people I work with couldn’t be nicer or more supportive. I’m taking leave and it turns out that I’m eligible for supplemental disability, having signed up for it last year. I’ll get 120% of my salary after a waiting period of 30 days. It’s nothing short of amazing. If this had happened three years ago or more when I had no health insurance or a dependable income stream, it would have been horrible. The universe is giving me many gifts; I just have to open myself enough to understand how blessed I really am.