cancer – day 32
Well, that was an interesting appointment. The medical oncologist was not as personable as the radiologic oncologist, but certainly knowledgeable. He was a little pressed for time, I think, which made it a bit difficult to interact with him because he didn’t elaborate unless I asked elaborating questions and it’s hard to do that while you’re taking notes and trying to absorb what someone just said when it’s such foreign material as this. But, here’s what we know now . . .
The fact that my cancer may be hormone-receptor positive is both a good thing and a bad thing. It means that hormone therapy can help, but also that the cancer can be dormant a very long time and still recur, even 20-30 years later. This oncologist said my probability of recurrence is about 20% right now, having had surgery. I believe he meant that as a 20% probability within the next five years, rather than over the course of my entire lifetime. Because he also made a point of telling me that “recurrence will happen,” even if it’s not for twenty years. And that I will have to be on the lookout for this constantly, for as log as I live. OK, I can deal with that. It never really occurred to me that wouldn’t be the case actually, once we got the cancer diagnosis. Isn’t that pretty much the nature of the beast?
So anyway, the chemotherapy is to reduce the probability of an acute recurrence, meaning, a cancer recurrence within five years of the original cancer. Some unfortunate side effects of chemotherapy on a hormone-receptive cancer is that it damages the ovaries so they don’t produce enough estrogen, which unfortunately is important for bone density, blood pressure, and cholesterol. Oh, and the damage would probably also lead to early menopause, so we had to have an entire conversation about whether I’m married, have kids, plan to have kids, and all that. Seeing as I was adopted I’ve never had a problem with the idea of adopting kids if some day I wanted them but couldn’t bear children, so that doesn’t bother me too much, though I do not like what I’ve heard about what menopause does to your body. Just another “oh well” in the process though. Another thing about the cancer is that it’s likely to recur in the ovaries, and we talked about possibly having my ovaries removed in the future. Who knows, that’s so far down the road at this point. But still, better to know it’s out there than get blindsided a year from now.
Going through chemotherapy reduces the 5-year recurrence risk by about 5-6%. After that there’s another drug therapy called tamoxifen (not sure how that’s spelled yet), which reduces the risk further, as does radiation treatment, so that my ultimate 5-year recurrence risk, after doing everything possible, is about 10%. For the 5-year recurrence.
You know, 10% doesn’t sound like much until you think about lining up ten women you know and saying, ok, you’re going to lose one of them. All of a sudden, 10% sounds like a lot. And 20%, well, let’s just not bother focusing on the 20% possibility, because we’re definitely going to go the chemo route, and do everything the doctors want to reduce the risk of recurrence as much as possible.
My heart condition is a concern. The medical oncologist ordered another special heart test, which they’re doing before, in the middle, and again after chemo. I have to read up on this one more, it’s called a MUGA, and I have to go to a nuclear medicine facility to have it done. That appointment got scheduled for Friday.
Then I go back to my surgeon to have a receptor port put in before I start chemo treatements. The port is a little thing they put just under my collar bone and then use to inject the chemotherapy drugs into, instead of sticking me with IV needles every time I go for chemo.
The creepiest thing at the oncologist’s office was when they had me wait in the treatment room until they could draw my blood for the CBC. There were eight or so patients getting chemotherapy. A couple were chatting at the far end, while the others read magazines and such, with their little IV bags hanging up above, and all looking scary pale and worn. I was the youngest person in the room by at least 30 years, if not more. And for some reason this scene really creeped me out. I couldn’t wait to get out of there.
I’m going to see another medical oncologist too, one down in Sacramento, I think with the Sutter Cancer Center. (The guy today was in Cameron Park, half-way from Sac to Placerville.) This next appointment will be basically a second-opinion sort of consult, and I don’t really expect to hear anything significantly different, but I think it will be good to meet with another specialist about my treatment anyway.
Oh yeah, and I have a crummy cold, with a cough that went straight down into my chest to get gunky. No fun.