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April 2012

Round 5


Yesterday I completed Round 5 of chemotherapy. It went well, but it was a really long day at MGH, starting with bloodwork at 9:30, meeting with the nurse practitioner to review my lab work at 10 (white blood count was good this time, but red blood count was low, leading to anemia which explains the severe exhaustion and under eye circles I had all last week!). But I got the go-ahead for chemo anyway, and that started at 11. It took about 5 and a half hours all in because with this new drug - Taxol - you have to start with some pre-infusions including saline to prep the veins, Decadron which is used to treat cancer, and Benadryl to prevent a reaction that some people have to the Taxol (red face, itchy throat, and severe lower back pain...thankfully, I didn't experience this). I did fall asleep within about 10 minutes of the Benadryl hitting my bloodstream, however, so I was out of it for the 3-hour Taxol infusion that followed. Aside from being a bit groggy when we left, it was much easier than previous treatments, without the sick hangover feeling.

With just 3 more infusions over the next 7 weeks, the end of chemo is now in sight. But I have to say, the anxiety about my treatment outcomes is growing now as well. It's easy in the beginning to sort of coast along, joining the ranks of the nearly 300K cases of breast cancer in the US this year, follow doctor's orders, and assume you'll "beat" it. It's a difficult diagnosis to swallow of course, but when you're getting treatment at one of the best facilities in the world, with tons of experience and well-established protocols, it's easy to imagine this will just but one tough year out of your life and then things will go back to normal. Until you're in the thick of it.

I'm now 3 months into this journey, and this is what I've learned so far:

  • No two cases of breast cancer are alike. Women get it for different reasons, detect it at different times, get varying treatment protocols, and respond differently to them. While there's no shortage of fellow patients and survivors to talk to in person and online, and while it can be comforting to know you're not alone in this, it can be challenging - and even misleading - as well, because their experiences won't necessarily predict your own.
  • Information is a double-edged sword. Some stories and data can give you hope, while others just cause unneeded stress. Earlier this week I looked up breast cancer survival rates because someone had asked and I didn't know the answer. I assumed they were high, again because it seems like so many people get this and beat it, and I was shocked at what I found: for Stage IIIB cancer, which is what I have (yes, my original Stage II diagnosis was changed after subsequent testing found a fair amount in my lymph nodes), the 5-year survival rate is only 41%. This is why I don't like to read up on the topic, people! But in all seriosness, it's important to note that the 5-year survival rate (the percenage of people who live at least 5 years beyond diagnosis) is based on people who were treated at least 5 years ago. Improvements in treatment since then can mean more favorable outcomes now, and many people live much longer than 5 years out. More importantly, these numbers don't take into account that some of the deaths are from causes other than breast cancer. That said, survival rates cannot really predict what will happen in any one person's case. It reminds me of an article someone shared early on that discusses all the numbers and choices that cancer patients need to face (and offers up a good reminder: "The 'median survival' number is not fate. It is simply a middle point. Let’s say a doctor tells you that the median survival for your type of cancer is one year. That means half of the patients lived less than 1 year. But half lived longer. Shoot to be part of the latter group."
  • You really just have to take things one day at a time. I'm a planner and researcher by nature, but I've found that for my own sanity I've had to cede control on this one, trust that my treatment will work, and just tackle things one day at a time. There are no exact, prescriptive cures for this - it's a lot of trial and error, often with strange side effects and reactions that no one could predict and sometimes can't solve. So you just have to do your best and hope that it all works out in the end.

But for now I'm just looking forward to some nausea free weeks...it's nice to have my appetite back!


Round 4

Hooray! Yesterday marked the halfway point in my chemo treatment, and my last encounter with the Red Devil (Adriamycin, the potent red drug that causes the worst of the side effects) and it's partner-in-crime, Cytoxin. But they seem to have done their job because my tumor feels smaller and softer (fingers crossed). The next four rounds consist of a single drug, Taxol, which is apparently easier to tolerate (less nausea) but is coupled with Benadryl so there is some fatigue.

After a stressful start yesterday (a mix up in appointment times had us scrambling to get over there before my oncologist boarded a plane, and then we had some difficulty locating a good vein for the infusion), I ended up pretty well. So far the worst of it has been crazy dark circles under my eyes, which can happen when the infusion floods your veins and causes tiny capillaries to burst, leaking blood under the skin. Just like a bruise, actually, and apparently it can happen all over your body but you only see it under the eyes, where the skin is thinnest.

And speaking of eyes, I had a great week last week - no real side effects beyond fatigue and a runny nose - and I still have my eyelashes and eyebrows (although they said the Taxol my take off the rest of 'em!). So to celebrate, my friend Maria and I did a girlie outing to Saks and had our makeup done at the Trish McEvoy counter (something I'd never done before).

Here's Julie working her magic...


...and the end result:

And a very happy shopper! Until I ran out of steam two hours later :)

Also, I've been keeping a photo diary of my journey thus far - everything from the beautiful to the bizarre - right here.