A decisive step forward

It seems fitting that election day would be when I:

met with my oncologist
enrolled in a clinical study
got an echocardiogram
saw my acupuncturist/naturopath
bought a raft of dietary supplements
got a prescription for a wig 

all in order to prepare for staring chemo on Friday. WHOAH.

All this time my surgeons were talking vaguely about radiation first, so I just thought chemo was a ways off still. And, it seems like everything so far has been about waiting a week or two weeks.

My oncologist, Dr. B, (who I love) has other plans.

My first reaction was "Wait! I'm not ready!" but then I realized that starting now had some distinct advantages. Like finishing sooner.  And, starting it on Friday I lock into a Friday chemo schedule, which is helpful as it means I get to recover over the weekend. (The other option is Tuesdays. Apparently everyone reacts to chemo differently and many people feel the effects the worst between 3-6 days out, which would tip the balance in favor of Tuesdays, but Fridays are an easier day to be gone from work and if I luck out and don't need to miss work outside of infusion days, then Fridays are a better deal for all).

The clinical study is a phase III trial trying to figure out the relative efficacy between two types of common chemo protocols for my receptor type. Both branches are already approved and widely accepted therapies - so there is no question of whether one will work or not. There is a bit of question if one has better (which means fewer) recurrence rates, overall.  I will be followed for ten years (though no more frequently than I would typically be for my type of cancer.) Since both branches are already approved protocols, I don't get anything really "covered" by the study outside, except for some more rigorous genetic testing, which I'm interested in getting.

My hunch is that genetic mutations and markers that are individualized to each cancer patient are going to be the hallmark of future care. In this way, allopathic medicine is going to come to resemble alternative medicine a lot more in the future in that it will more carefully look at each patient as a specific individual whose body reacts to a host of things based on multiple factors.

More about the study. There are some minor variations in the two branches (notably, one branch contains adriamycin, an effective chemo drug that might have some long-term implications for heart damage, though I am understanding my dosage would be lower than the small percentage who have had this happen) but on balance, the outcomes are around the same in the short term. They both reduce the chance of recurrence by a huge percentage over just having surgery. The side effects of nausea/fatigue vary from person to person but sound like they are roughly equivalent. One is every two weeks for 8 sessions. The second is every three weeks for 6 sessions. If you read online about them, certain people swear by one or the other as "way easier".  

I'm not going to concern myself with that at the time, because they both seem like they are dealable. 4 months. That's not very long.

They both get me out the other side of being bald in mid March.

Not so bad.

I could certainly choose not to do the trial and opt definitely for a regimen without adriamycin, just to make sure about the heart thing.  However, as both the daughter and wife of  academic physicians, I feel some loyalty to academic medicine. I've always gone through University medical systems, all my life. It gives me a slight sense of purpose, really. This cancer is so stupid and pointless, I want to at least make sure I can participate in giving someone else some benefit by my having it.

Yes, it was a decisive step forward, and I have to say, I am feeling better than I have since my surgery. I'll tell you straight:  it's been a bit of a trudge since my results came back. I wasn't exactly depressed, but I was sliding in that direction. I felt it, and was valiantly trying to do something about it (guided meditation! affirmations! exercise! diet! etc.) but there was that little tug of negative spiral.

I know there are hard weeks to come, but there is something that feels just right about The New World Order being decided, and understanding a bit about my next few months.

I'll go to bed looking forward to waking up to a changed country tomorrow,  feeling a bit of restored faith in my world (Obama, E. Warren, 3 States legalizing gay marriage...) and ready to GET-R-DONE.