Wednesday, January 17, 2007

Fourth Chemo Treatment: Reviewing the Numbers


Here's a picture of my bed where I spend most of my time. It's very cozy there. It's hellish to change the sheets, of course but that's the only drawback. When we first moved into this house and I was given a upstairs room as an office, I realized that it also had to double as a guest room and there wasn't room for a bed. However there was space in the eaves, so I had a hole cut in the wall and a platform put in on which to put a mattress. Little did I know how important this guest bed would become for me.

Today was the fourth chemo treatment. I was feeling pretty good, comparatively, so I felt a great reluctance to start the whole cycle all over again. I had to look at the number to reassure myself that I was doing the right thing. With a grade three tumor less than 2 cm and no node involvement, 65 women out of 100 are alive and without cancer in 10 years. Thirty two women will relapse and three will die of other causes. Adding chemo (specifically FEC) means that 11 more women out of 100 are alive in ten years. Adding hormone therapy means 16 more women out of 100 are alive in ten years. (Clearly there’s more effect from hormonal therapy.) Adding both chemo and hormonal therapy means that 21 more women out of 100 are alive and without cancer after ten years. (The benefits of chemo and hormonal therapy are not additive, unfortunately.)

It looks as if I have an 86% chance of being alive without cancer in ten years, a 3% chance of dying of other causes (some disaster arising from global warming, a bicycle accident, or World War III arising from Bush’s foreign policy all gloomily spring to mind as possibilities) and an 11% chance of dying of cancer. It’s unclear about the people who have a recurrence and don’t die within 10 years. My mother lasted 13 years after first being diagnosed with a stage 4 breast cancer. She had plenty of recurrences. However, she bucked the odds through meditation. I believe that’s what kept her alive past all predictions. I’ve certainly added it to my arsenal.

I could add another 2% to the survival rate if I had opted for a different form of chemo, AC + T, but the risk of cardio-toxicity put me off that. The last MUGA scan showed that my heart is continuing to work well, by the way.

The chemo treatment went smoothly. Because of the snow many people had cancelled so there was no waiting and I was in and out of there quickly. I particularly liked my nurse today, although all the nurses there are great. Howard was by my side the whole time. Andrine drove us there and picked us up since I’m still wary of Howard’s driving abilities. Actually, since he got his eyes repaired, he’s a much better driver (go figure) so he probably would have been fine. Anyway, we got there and back with no mishap. The temperature rose enough to cause some melting, and, typical Oregon style, it will drop tonight to make the roads icy and treacherous.

On the way back from NWCS, we were talking about the artistic process. I mentioned how much I admired Gavi’s process. He and Jasper wrote a song and after recording it, Jasper wanted to alter it. Gavi said no, let’s move on and write another song. I like that. Keep moving, don’t put all your artistic eggs in one basket. Andrine concurred. She’s been reading the Artist’s Way and had a nice quote: “The unexamined life is not worth living, but the unlived life is not worth examining.”

I’m light-headed tonight, but tomorrow will be a good day. By Friday I shall feel like a truck backed over me and by Saturday, I will feel like the truck was put into forward and ran over me again. I’ve got the drill down and know what to expect. Of course, I’ll tap for symptoms. It’s the neulasta that make my arm ache so much, but it works well when I’m not overwhelmed by an overdose of chemo so I’m more than willing to put up with it. I have no need to repeat the hospital experience.

Sylvia told me a charming story about taking her father out in the snow yesterday. Her father, Pete, is suffering from memory loss and is living in a nursing home/assisted living facility. She got him dressed up to go out for a walk and he grumbled and groused about all the elaborate preparations. However, once he was outside he was thoroughly enchanted. He didn’t remember ever seeing snow. Pete grew up in the Bay Area and didn’t see snow until he was an adult; most of his adult memories have receded entirely. “I didn’t know such a thing was even possible,” he said. He was so happy. He took a walking stick that she had provided him and used it to hit branches so that the snow would come down, much to his delight, and Sylva’s. I’m aware of the joy of re-experiencing simple joys with young children, but it turns out that one can re-experience a first snowfall with an aged demented parent as well.

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