Friday, August 31, 2007

Questions On People’s Minds

It must be hard for people to know what to say when I tell them my cancer has come back. Their first impulse is to offer encouragement, say that I beat it before so I’ll beat it again. They also show sympathy and sadness that this is happening to me and my family all over again.

If I were a friend of mine, here’s what I’d be wondering: How bad is it? Are you going to die? How long do the doctors give you? Like a journalist, I’d want to know the facts of the case, and that would help me deal with the emotional and mental aspects of what I was dealing with.

But it’s pretty tactless to ask such questions. So maybe I should just answer them here now and get the ugly facts out of the way.

How bad is it? Pretty bad. I was initially diagnosed at Stage IV (or IIIC, depending on the staging system we go by), so I didn’t have much of a chance to start with. Now that the cancer has spread to the lungs and all over the chest less than a year after treatment, we know that the chemotherapy wasn’t that effective and that this cancer is extremely fast-moving and aggressive. At the rate it’s going, we can expect it to spread to other major organs and the bones within a year.

Am I going to die? Yes, earlier than I thought I would. Worse case scenario is that this cancer will just run rampant and I’ll die within a year. Much better scenario is that the various chemo drugs we haven’t tried yet will keep me going for several more years, maybe even more.

How long do the doctors give me? My doctor hasn’t told me how long I can expect to live and I haven’t asked her. But the average woman treated for metastatic breast cancer lives for 24 months.

That was information. Facts without me in them. Here are more complete answers.

How bad is it? Not so bad. It’s not in the brain, liver, or bones yet. Yes, the cancer will probably get there, but it’s not there now. Chemo might be able to keep the tumors in my chest under control. I’m going to look into a new procedure called Radio Frequency Ablation that might be able to zap the tumors in my lungs that can’t be cut out with surgery. Maybe RFA can also zap the tumors throughout my chest. In other words, we have more tools and weapons to fight with.

Am I going to die? Yes, earlier than I thought I would, but maybe later than the average woman with metastatic breast cancer. I’m not much of a gambler, but I’d put money on me beating the average for sure, and maybe beating the odds completely. I think it’s completely possible that by some freak of nature or miracle of medicine, I’ll live another ten or twenty years.

How long do the doctors give me? My doctor’s giving me the benefit of the doubt, saying that I can be in the “one percent” that makes it. The average woman in my situation lasts 24 months. But so far, I haven’t been this average woman. I haven’t had the average side effects, chemo response rate, surgery recovery rate, or attitude. I haven’t come upon the depression that cancer patients are supposed to go through. I haven’t cried much more since my diagnosis. I just saw a program about people living with cancer and they talked about depression and crying a lot. These didn’t apply to me. And while most women bemoan the loss of their breasts and hair, I didn’t much care. I was even looking forward to being bald again this second time around. So maybe I’m just not the average cancer patient, and those average survival rates don’t apply to me.

I wonder if there are other questions my family and friends have that they’d like to ask but feel uncomfortable asking. I’m pretty open and honest about cancer, as I’ve been with my life pre-cancer. So if anyone reading this Blog has questions they want to ask me, I encourage them – click on the “Add a comment” link on this Blog, or just e-mail me. If nothing else, maybe these questions will give me some ideas about what to talk about in my Blog since, after all, this is supposed to be for friends and family.

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