Wednesday, October 31, 2007

TV Interview Replay

To those of you in Singapore, I’m sorry I didn’t give you any warning about when the TV interview was going to be on. But I’m told now that it will be replayed on Channel News Asia on Thursday, November 1 at 5:30 p.m., if you’re still interested in watching. It’s a 30-minute program called “Get Real”, and my bit is the last segment.

I’m not sure what time it will be on in other Asian cities that get Channel News Asia.

Thanks for your interest in the program.

Tuesday, October 30, 2007

Interview Aired!

I just saw the interview I did for the current affairs program about dying. I thought it represented me pretty accurately. They chose the parts I think I would’ve chosen, if I were the producer.

For those of you who missed the program, some choice quotes:

“I don’t know, how do you do this dying thing? I’ve never done it before!” (So much for sounding intelligent and thoughtful!)

The presenter asked, “How do you live, knowing that you’re dying?” My answer: “By living right up to the moment I die.”

I don’t even know if that makes any sense. What I meant was, I’ll keep living day to day, doing normal being-alive things like grocery shopping and playing with the kids. Unfortunately, I don’t think I’ll actually get to do stuff like this up until the moment I die. I think there will be some downward spiral in my physical condition, so toward the end, I won’t be able to speak or sit up in bed, let alone do the shopping.

I’m really curious about just how the ending will play out. I want to be mentally prepared if it’s going to be a long, drawn-out painful process. I guess I’ll have time to get details about all that later on.

For now, I’ll keep doing the shopping and kissing my kids too much.

Monday, October 29, 2007

Doing the Interview

The interview wasn’t nearly as natural and comfortable as my initial conversation with the producer was. It’s one thing to answer someone’s questions; it’s another to answer those questions again, while trying to remember what I’d said the first time. I’m afraid I’m going to sound like an inarticulate babbler. All those years of being an on-air TV and radio reporter didn’t help me at all!

It was really important to me that I came off sounding intelligent and sensible so that what I had to say would be taken seriously. I hope I haven’t blown it!

And one surprise addition – they interviewed Tony as well. He said some things that he’d never even said to me. He admitted that he felt depressed at times and felt the pressure to be strong for me and the kids. I didn’t know that.

I didn’t have a chance to talk to any friends with breast cancer before doing the interview, but I talked to a good friend whose opinion I respect. She said her gut instinct when I told her the program was about dying was to tell me not to do it. But when I told her my reasons for wanting to do it, she changed her mind completely and encouraged me.

Here were my reasons for wanting to do this.

1) Take the terror out of dying. I think it’s possible to die with readiness, dignity, and class. I want to set an example for my friends and family and show them that death is a part of life (Didn’t the “Lion King” teach us that?) and we should learn to appreciate life without fearing death.

2) Show that people can live with cancer and have hope for a cure and a future, without being in denial about death.

3) Set an example for my friends with breast cancer and show them that they, too, can be strong.

I’m also hoping this will help me in my project to set up a doctor/patient communication skills training program in Singapore. If people in high places see this program and recognize me when I call them up to discuss my ideas, they might be more willing to listen to me as someone other than just a complaining patient.

I might look like a bit of a media hound because this will be the third interview I’ve done about cancer. But I’ve never had a problem with people using the media for a good cause. I know some people slag off celebrities who adopt causes and accuse them of doing it for their own public image. But if you can use your fame to draw attention to starving children or abused animals, why not?

Sunday, October 28, 2007

TV Interview?

I got a call from the local news channel today. They want to interview me for a current affairs program about death and dying. I was taken aback at first when the producer told me what the show was about. “Dying? I’m dying?” was my immediate thought.

The producer had found out about me from a newspaper article featuring members of my Breast Cancer Foundation Dragon Boat team. In that interview, I’d mentioned that women with metastatic breast cancer lived an average of 24 months.

The TV producer explained that the purpose of the program was to take the fear out of death and make it a less taboo topic. In most Asian cultures, certainly among the Singapore Chinese, people just don’t talk about death. They think it’s bad luck or just can’t face the idea of death at all.

The show would include two other people besides me. One is an elderly woman who isn’t sick, but is preparing for her death. The other is a woman whose father recently died.

The producer spoke to me at length about my attitude toward death and I was very comfortable telling her everything honestly and candidly. I told her I’d let her know tomorrow whether I’d agree to the interview or not.

I’m worried about two things. First, Tony. How would he feel about his wife talking on TV about dying? Second, my friends with breast cancer. I’m worried that if they see me talking about death, they’ll think I’ve given up, which is far from the truth. I’m also worried that they’ll see my fate as their own. “If Shin can’t beat it, maybe I can’t either.”

By huge coincidence, just before the producer called me, I was on the phone to a friend who has gone through breast cancer treatment and told me, “You’ll be okay, Shin. If you fail, I’ll fail.” I tried to tell her that her case was completely different from mine – she was only Stage I, which has a five-year survival rate of 100 percent.

I asked Tony how he’d feel about me doing this interview and in typical Tony fashion, he said, “You should do it. You’d look cute on TV.” Gotta love him. I haven’t had a chance to talk to any of my friends yet though, so I’ll have to decide tomorrow what I’m going to tell the producer.

Friday, October 26, 2007

Chemo Menu Choices

I had my weekly chemo treatment yesterday, followed by the G-CSF white blood cell booster shot today. I felt wobbly and achy in the legs when I went for a walk tonight. Usually, it takes a couple of days after chemo before I start to feel weak and tired. So I guess the cumulative side effects of chemo are creeping up on me.

Next week, I’m going to try getting the chemo without the one remaining side effect drug, Zofran, which is for nausea. I just want to see if I can do without it. I’m also going to get the G-CSF shot immediately after chemo, on the same day. That’ll save me an additional trip to the hospital every week. I just hope that my white blood cells will respond as well getting the shot 24 hours earlier.

Boy, I really like being able to decide how I get to do my drugs. It’s like looking at a menu. I’ll have two main courses and do away with the side dishes and appetizers, please. And I’ll have my dessert today, rather than wait until tomorrow.

Luckily, I have a doctor who doesn’t let ego get in the way of doing what’s best for her patients, including letting her opinionated patients have a say in their treatment.

I just read about a new chemo drug for metastatic breast cancer that was approved by the FDA this week. I read that story with the excitement of a fashionista reading about what’s new this season. I thought, “Ooh! Maybe I can try that one too! Add that to my menu!”

It looks like I have a lot of goodies on the chemo menu to try yet, and I’m looking forward to sampling each one on my way to a cure. Okay, maybe “looking forward to” isn’t quite right. In my pre-cancer life, I tried not to think about the high fat content and sugar levels when choosing from dessert menus, so I won’t think about the nausea, organ damage, and other possible side effects of the chemo for now.

Thursday, October 25, 2007

Reality Show Idea

I have a great idea for a TV reality show called, “Save My Life”. You get somebody with a terminal illness, say… me. Then you get a bunch of candidates who claim they have the cure for cancer.

Line up the practitioners of energy healing, meditation, visualization, color light therapy, soul journey therapy, reiki. Then the foodists who advocate liver detox diets, raw food diets, juice diets, grapeseed diet, herba mate, wheatgrass, spirulina and so on. And if putting the right stuff INTO your body’s not enough, you can go for the ones that take the nasty stuff OUT of your body with colonics and coffee enemas.

Then there are the religious folks who say prayer will cure cancer. Praying Christians, chanting Buddhist monks… we can throw those into the mix too.

And finally, there are those miracle workers who defy categories. These people were born with a “gift”, a mysterious ability to make cancer cells disappear without any medical procedures. Let’s have those as well.

So we take all these candidates and give each one a month to get rid of my cancer cells. I would offer myself up as a guinea pig for the good of all cancer patients and their caregivers who are going bankrupt paying for all these alternative treatments. If they fail, the world will see them for the fakes that they are. If they succeed, they can franchise their operation and the money will roll in. Meanwhile, I’ll be cured. What’s not to like?

I DO believe some of these alternative therapies work to help our bodies fight cancer. I don’t believe any ONE thing can CURE cancer, not even conventional medicine. I can get the best surgeons, the latest chemotherapy drugs, and the most high-tech radiation therapy available, but if I drink, smoke, eat junk and sit on my butt all day and wallow in my misery, cancer will win. Likewise, I can have every priest and monk in the world praying and chanting for me, do the colonics, eat only raw veggies, and meditate all day long, but my cancer will not go away.

I don’t trust any ONE solution. I’m my only solution. So I’ll take the best that conventional medicine has to offer. I’ll take the alternative therapies that make sense to me. And I’ll have faith. Faith in the human body’s amazing ability to heal itself, faith in the good intentions of people around me, and most of all, faith in myself. Yes, I will still die. But I’ll do it INTELLIGENTLY.

I still think the reality show idea is a good one. So to my friends who are in the TV business, feel free to use my idea.

Wednesday, October 24, 2007

“It’s Not Fair!”

That’s not me talking; it’s Toby. I’m not sure how a two-year-old forms the idea of fairness in his mind, but he’s been saying this a lot lately. When I say it’s too late to read another book at bedtime, when I won’t let him have chocolate milk for breakfast, when I say he can’t have dessert until he’s finished his dinner, almost anytime he doesn’t get what he wants, he says, “It’s not fair!” And with such indignation, too.

I think even at this early age, kids have a clear idea of the way things should be. He’s so adamant that he should have his dessert without finishing his dinner, no amount of reasoning will convince him otherwise. His sister gets her dessert, therefore he should have his too. Nevermind that Josie’s finished her dinner. That’s not the point. She gets dessert; he should get dessert. In his world, little boys should get dessert when they want it.

I don’t think we completely grow out of this idea of fairness. When people who get cancer say it’s not fair, they have an idea of the way things should be. In their world, people who eat a healthy diet, exercise regularly, don’t drink or smoke, help little old ladies across the street and don’t cheat on their taxes shouldn’t have such a terrible thing happen to them. They ask themselves (or God, or the universe), “Why me?”

And the righteous indignation that Toby adopts in challenging the unfairness of the world is as naïve at the age of forty-two as it is at two. Who says little boys should get dessert whenever they want it? Who says only lazy, unhealthy, cold-hearted people get cancer? How does fairness come into this at all?

I think what Toby’s really saying when he cries out this new favorite phrase of his is, “Hey! I thought I knew what this world was about but now you’re changing the rules on me and I don’t know what’s going on anymore!” Okay, maybe I’m reading between the lines a bit, but isn’t that what we really mean when we say something’s not fair? Our preconceived notions of the way things should be are turned upside down and we’re left struggling to find out why, while desperately clinging to our notion of life as we knew it.

I never asked, “Why me?” or cried, “It’s not fair!” I’ve read enough about cancer to convince me that there are too many factors and unknowns in this to even ask such questions. Besides, remember what our parents used to say to us: “Life isn’t fair.”

And when you have cancer AND you can’t have dessert whether you finish dinner or not, that’s a double whammy. Toby will someday understand. Meanwhile, he’ll just have to live with having a mother who dishes out injustices instead of ice cream.

Tuesday, October 23, 2007

Go Forth and Blog

This Blog has turned out to be a great way to keep in touch with friends and family. I just ran into an old friend whom I hadn’t talked to in a year, but she’d been checking my Blog and knew what’s been happening with me.

I think everyone should keep a Blog. That way, if your family or friends ever want to see what you’ve been doing, they have a Web site to go to, to find out about your lives.

One of the best e-mails I’ve gotten lately was a step-by-step account from my sister of how she spent her day – eating breakfast, feeding the dog and cats, going to work, making dinner, etc. It may seem boring to her, but it made me feel like I was with her going through her daily life. I loved it. It’s the little things that color in the outlines of our lives, after all.

I don’t think we should wait for Christmas or for someone to get married, give birth, move to a new country, or even die to get in touch with people.

So I encourage all of you to go set up your own Blog. Google “blog”, and you’ll see dozens of sites where you can set up your own personal Blog for free.

I’m a real Luddite when it comes to computers, but I’ve become a big Blog believer. Say that five times really fast, then go set up your own Blog. And send me your new Blog address!

Monday, October 22, 2007

Cancer Good for Health

I ran the Great Eastern Women’s 10K this morning. I finished before they took down the street barricades, which is a good sign. I had 40 years to get into shape and it took cancer to get me off my lazy butt and do a run.

I’m more fit than I’ve ever been in my life. (Except for the cancer.) Oh, the irony of it. Since the diagnosis, I’ve started running, I’ve given up drinking (Impossible! But yes!), and I’m as healthy as a rabbit, most likely because I’ve been eating rabbit food. Cancer has been very good for my health.

And cancer has been good for my friends’ health. Some of them have started exercising, many are eating healthier food and cutting down on alcohol, and one woman I hardly know has quit smoking because of me.

I guess cancer is your body’s way of saying, “Hey! I’m not invincible! I might give out on you some day, so take better care of me!”

It’s heartening how many people run marathons, climb mountains, do cross-country cycling trips to show support for someone they know who has cancer or some other disease.

So, funny as it sounds, cancer can be good for our health.

Click here to see a funny faux-news video clip from The Onion, a news satire Web site, about just this.

Thursday, October 18, 2007

Chemo #7, Medical School

My blood counts were good enough to get chemo today. I think my new strategy of getting the white blood cell booster shot (G-CSF) after, rather than before chemo, is working. This is the first time in weeks that I haven’t failed the blood test and had to get a shot to artificially boost my counts enough to get chemo.

Now that I’ve cut out all those side effect drugs, I’m awake and alert during chemo whereas before, I was knocked out for an hour and a half and didn’t know what was going on. Now I’m writing down how long each drip takes and can see what dosage the nurses are giving me.

One nurse saw me taking notes and asked me why I was recording everything. She asked if I planned to write a book someday. I guess she’s not used to her patients taking such an interest in their treatment. I told her I was studious during my pregnancies as well, and those were not life-and-death situations. I’m trying to keep myself alive as long as possible, so I feel I should know as much as I can about my treatment.

One of the side effect drugs I cut out was magnesium sulfate. At the hospital in Sydney, they said I didn’t need it. My doctor said it was to prevent peripheral neuropathy, a tingling sensation in the fingers and toes, which is a side effect of the chemo. I searched the Internet and found no convincing connection between neuropathy and magnesium sulfate, so I asked my nurse about it. She said a new article had come out showing that magnesium sulfate reduces the risk of neuropathy. I asked her for the article and read it. The study cited in that article is about an entirely different drug from the one I’m getting.

Is this nurse confused about the chemo drugs? Or maybe she assumes the chemo drug in the study and my chemo drug will react the same way with magnesium sulfate?

The article was in an oncology journal and full of medical terms, so I had to decipher it as best I could. This should be my new job: a cancer researcher. I should try to learn the medical terminology and the basics of the human body and how it works. So I bought a little model of the human body with the circulatory, digestive, and other systems displayed in a 3D model. I got it for me and Josie. We can put ourselves through medical school together.

It comes down to this: I now have the most important job I’ve ever had -- that of saving my own life. The doctors will do the best they can, but I won’t leave it to them. As I’ve always said, they have hundreds, thousands of patients to think about. I have only one. They might have more medical knowledge than I do, but I have something they don’t have – a personal, vested interest in making sure this patient lives as long as possible.

Wednesday, October 17, 2007

Cancer and Other Struggles

A recent Blog comment has gotten me thinking about pain that people live with everyday. “Anonymous” commented on my October 8 Blog that she learned her husband has been unfaithful to her. I know infidelity is a common thing – movies and TV shows treat it like it’s normal and accepted in our society. But when it happens to you, I think it can break down your ability to have faith in anything, including yourself.

I’ve written in an earlier Blog about things worse than cancer – living in a war zone with the threat of bombs and sniper fire around you everyday, not being able to provide food and shelter for your family, being homeless and jobless with no hope of making life better for you or your children.

I know cancer survivors who were abandoned by their spouses or girl/boyfriends after they were diagnosed. I have a girlfriend who is going through cancer treatment AND a messy divorce at the same time. Her husband’s argument for getting custody of the kids? She’s going to die of her cancer soon. I have a friend who thought she might lose her newly adopted baby because she was diagnosed with cancer. Why would an adoption agency give the baby to a woman who’s going to die?

I have a friend who, in the space of a year, was diagnosed with Multiple Sclerosis, lost her two-year-old to SIDS (Sudden Infant Death Syndrome), saw her husband through an accident that nearly killed him, AND had a teenaged daughter whose boyfriend tried to rape her. How do people survive such blows and get on with life? And this woman is one of the most positive, cheerful people I know.

I’m awed by the strength it takes for people to live through heartaches like these. Sure, we’re not threatened by bombs and guns. We don’t have to turn to prostitution to buy food for our kids. We don’t watch our children go to bed hungry every night. These are the REAL problems people have in faraway places or on the evening news.

But in some ways, struggles with basic survival might be easier than struggling with matters of the heart. Trying to find food for your kids is a concrete, tangible, and universally acknowledged problem. Struggling with an unhappy relationship can be a lonely, scary tunnel of despair.

I’ve asked myself if I’d trade in my cancer for a life without Tony and the kids. Would I prefer to have cancer with them or be cancer-free without them? No question: I choose cancer.

“Anonymous” is right. I have a lot. I’ve always considered myself luckier than most and I still do, even with cancer. Cancer is not necessarily a greater struggle than some of the other struggles that my friends are going through. In a way, I’m luckier than my friends. When you live with cancer day to day, people praise you for being brave. When you’re complaining about divorce or a cheating husband, people aren’t that impressed. Well, I’m impressed with my friends’ strength and wisdom in coping with their problems. Sometimes, I think I have it easy.

Tuesday, October 16, 2007

Arrogance, Ignorance, and Flyers

Ever since my first cancer diagnosis in December 2005, I’ve been carrying around flyers that show women how to do breast self-exams. I give them out to my girlfriends, school mothers, even ladies at the supermarket check-out counter. I gave one to my banker to give to his girlfriend.

My reason for engaging in this unsolicited information distribution (which I’ve always found annoying) is that if I had been given one of these flyers back in July 2005 when I first found a lump in my breast, if I’d been nagged about getting my lump checked, if I’d known half the things I know now about breast cancer, I’d have ignored my doctor’s diagnosis that the lump was just a clogged milk duct and I would have gone for a second or even third opinion. Then maybe I’d have found out about my cancer before it spread beyond the breast to the lymph nodes and I’d have longer to live.

Last week, I handed one of these flyers to a mother at Josie’s school. She took a cursory glance at it and handed it back to me, saying, “I don’t need it.” Maybe she didn’t need it because she was a seasoned breast self-examiner. Maybe she already had breast cancer and had a mastectomy like me and didn’t have any breasts to examine. But I got the sense that she suffered from the same arrogance and ignorance I did before cancer hit me.

Two years before I was diagnosed, a friend of mine was diagnosed with breast cancer. She didn’t tell me about it herself; I heard about it through a mutual friend. At that time, I knew nothing, really ZERO, about breast cancer. I thought my friend wanted it to be a secret so I didn’t even ask her about it. I was so clueless that learning about a friend’s breast cancer didn’t ring any alarm bells when I found a lump in my breast two years later. I was arrogant enough to think that cancer had nothing to do with me. I was ignorant enough to think that Asians with small breasts and healthy lifestyles just don’t get cancer.

Since that time, I’ve learned a lot about breast cancer and the factors that put women at risk. I’m in just about the lowest risk category possible and I STILL have breast cancer. For the SECOND time.

So I’m going to be annoying and keep handing out these flyers. I’m going to keep talking about breast cancer to anybody who’ll listen. I’m going to make breast cancer so much a part of who I am, that if anyone I know ever has a lump or any other sign of breast cancer, she’ll think of me. And, I hope, she’ll be smarter than I was and have it checked out.

Here are some sobering statistics: One out of eight women in the U.S. get breast cancer at some point in their lives. In the U.K, it’s one out of nine. In Singapore, it’s one out of twenty. So the chances are pretty high that someone you know will be diagnosed with cancer. Someone other than me, that is.

Since my diagnosis, one other mother at Josie’s school has been diagnosed. And I learned that another mother had breast cancer the year before. That makes THREE mothers at the school diagnosed with breast cancer in the past three years. And this is a tiny school of only 110 kids. I’m going to feel personally responsible if any other mother at the school is diagnosed with late-stage breast cancer, so I’m going to be a gadfly and keep it up with those flyers.

Tuesday, October 9, 2007

Panicking About Time

A friend of mine asked me if I’m panicked about time, now that my cancer has returned. I’m not, but I wonder if I should be.

Given that the average metastatic breast cancer patient lives for 24 months, we could say I have about that much time left. But that average includes patients whose cancer returned many years after the first diagnosis. Mine came back less than a year after my initial treatment was finished. So logically, I’m on the lower end of that 24-month range. So I should be panicking about time, getting my affairs in order (what exactly does that mean?), writing letters to my kids, giving my stuff away, apologizing to people I’ve pissed off during my life.

But it seems I’m not taking this dying thing seriously. I haven’t done any of the things that I should or would be doing if I really had less than a year left. In fact, I’ve started a few projects that could be long-term.

Sometimes I get really worried that I’m going to get stuck suddenly with very limited time, sick and in no state to write those letters to the kids. And then I’ll be sorry that I wasted all this time doing silly everyday things.

Then again, I don’t want to start preparing for my death because 1) it’s morbid and pessimistic, 2) it’s logistically difficult because I have two young kids to look after and just don’t have the time, and 3) it’s overwhelming because really, how do you prepare to die? Is there a manual on this, with chapters telling you what paperwork you need to get done, how to book a funeral, who to invite to the deathbed? Maybe I should write one, except by its very nature, anyone who’d write this stuff from experience would be dead and would have no reflective tips to give after-the-fact.

This is a real dilemma. How do you live while you’re supposedly dying? Tell me, all of you reading this Blog. What would you do in my position?

Thursday, October 4, 2007

Chemo #6, Doing It My Way

My blood counts were good today, so I got my chemo. But I got only one of the side effect drugs instead of the seven my doctor had been giving me. And I got a slightly higher dose of Herceptin than I used to get, and a higher dose of Navelbine (chemo) than I got in Sydney.

All in all, I think I’ve taken into consideration the advice and methods of my doctor, the doctor and nurse in Sydney, and the information I’ve read on the Internet and come up with my own customized treatment for myself. I feel good about that. Of course, it could turn out my dosage is all wrong and I’ll develop horrible side effects, in which case I’ll be rather annoyed with myself. But for now, I think I’ve come up with the best treatment tailored for me. And, as my doctor admits, we’re all pretty much just guessing anyway.

Tomorrow, I go back for a G-CSF (Neupogen, Gran, Filgrastim) shot, which will boost my white blood cell count. Chemotherapy kills white blood cells so the body sometimes needs some help replacing them after chemo. Until now, my doctor has been giving me the G-CSF shot the day before my chemo if my blood counts were too low, which is what happened yesterday. But now we’re going to take a prophylactic, or preventive approach and I’ll get a shot the day after chemo, to prepare my white blood cells for my next chemo.

It was my decision to have the G-CSF shot the day after chemo. My doctor gives the shot on the same day as the chemo because she believes an American study that shows no difference in efficacy whether the shot is given the day of or the day after. But it seems to me that chemo would kill off the new white blood cells injected in the G-CSF shot if they’re given at the same time. My reasoning is that these blood cells would have less chance of getting killed by the chemo if they were not injected straight away.

I might have a faulty understanding of how this works, but in the absence of any counter-argument or clarification from my doctor (other than one American study), I’m going to go with what makes sense to me. Luckily, my doctor has no problem letting me decide to do it my way, even though she does it another way. I think she trusts that I’m informed enough to make this decision, given that there is no solid evidence that one way is better than the other. I’m thankful that my doctor doesn’t let ego get in the way of letting me do it my way.

I still don’t feel any side effects, and it was quite nice to walk out of the chemo clinic feeling alert and energetic. I ran more than ten kilometers tonight – my all-time longest run. I’m training for a 10K women’s run in three weeks’ time, plus another one for the Singapore Marathon in December. I won’t be running the marathon, just the 10K event. I hope to work up to a marathon by next year. It seems a pretty common thing – people who get cancer want to run a marathon. There’s the obvious symbolism, of course. But for me, I don’t have a lot of things on my list of “Things to do before I die”. Finishing a marathon seems like an easy one to put on the list. Besides, it shows optimism. It presumes I’ll still be alive next December.

Wednesday, October 3, 2007

Chemo Missed Again, Plus Lessons Learned

I went for my weekly chemo treatment today but my white blood cell count was once again too low, so I just got a shot of Neupogen to boost my white blood cells. I’ll go back tomorrow to see if my counts are up enough for chemo.

I had a long conversation with my oncologist – the most satisfactory one I’ve had so far, in terms of getting the information I wanted.

I asked her why my treatment in Sydney was so different from what I was getting in Singapore, specifically the dosage of the chemo, as well as the number of side effect drugs.

The conclusion was what I’d said before – that in Singapore, they take a more pre-emptive approach and overmedicate to prevent any possible side effects that might come up, whereas in Australia, they wait to see if there are any side effects before giving medication for them.

But my oncologist elaborated in much more detail the reasoning behind her decision to pre-medicate so that I’m aware of her thinking process and can make more informed decisions. Better communication is all I needed.

It seems my doctor follows the American approach in aggressively eliminating even the slightest risk of allergic reactions to the chemo or other side effects. She was giving me five drugs for nausea and two drugs for potential allergic reactions to Herceptin. I’ve had two doses of chemo now without these side effect drugs and I’m fine. She said allergic reactions can build up over time, as in the case of one of her patients who was fine on Herceptin for the first several doses, then developed a strong allergic reaction and was unable to breathe. I suppose that might be a minimal risk, but I can see why a doctor wouldn’t want to take such a risk. That’s especially the case in the U.S., where malpractice suits are quite common. So that explains why she had me on so many side effect drugs.

In Australia and Europe, it seems they’re much more cost conscious because they have national health systems. So doctors and hospitals are encouraged to keep costs down by NOT prescribing drugs until they become necessary. If I’m in the 95% that do NOT have any side effects, then I’m getting all these additional drugs unnecessarily, at greater cost to me (but not the national health system). But we can’t know whether or not I’m going to have a side effect until I actually have it. The problem is that in some cases, by the time a patient exhibits a side effect, it’s too late to do anything about it. There’s the dilemma.

I’ve decided to take the middle ground between the two approaches and get just a few of the side effect drugs. If I later develop side effects, I’ll have no one but myself to blame.

I’ve also learned that some of the reasoning behind my doctor’s approach to treatment comes from very recent and less publicized studies that the Australian doctors are either unaware of or are choosing to ignore. Opinions are so varied among doctors, hospitals, and countries about which approach to take that there’s no absolute correctness to any one approach. And many drug treatment protocols are based on just a handful of studies with just a handful of test patients. Still more frightening… some are based on pure guesswork, with no concrete scientific evidence at all.

My doctor told me about one lung cancer drug that has been withdrawn from the European market because it has shown no response in the patients tested. But among Asian patients, the results have been very good. Why does this drug work in Asians but not in Caucasians? Is anyone studying this? Probably not. Meanwhile, doctors in Asia are prescribing a drug that has been taken off the market in Europe. And Asian patients in Europe might not be getting a drug that could help them. Very complicated.

So it seems there’s no right or wrong in this. The Australians have their methods and reasoning and so does my doctor. I found the Australians more convincing because they were more communicative and articulate. But now that my doctor has provided more information to explain her approach, I find myself landing somewhere in the middle.

I’ll probably need to do a chemo session in the U.S. when we’re there during the Christmas holidays. Then I’ll have one more country to add to my collection. Maybe I should plan a chemo trip to Europe as well. I wonder if I can apply for a research grant for comparative chemo by country using me as the subject…

Tuesday, October 2, 2007

Visit to Healer

I went to a professional healer today, at the urging of two friends. He has supposedly cured a number of people of cancer. I’m a bit skeptical about most alternative therapies, but I thought I should try him out because my friends swore by him.

He asked me some questions about my cancer and offered some observations such as, “You have at least six tumors”, then later on in the session, “You have more than ten tumors”. This wasn’t too difficult a deduction since I’d told him the cancer was all over my chest and in my lungs.

He told me a few other things about myself. He said I had no “joy”. I told him I thought I was a pretty happy person, cancer aside. He said I might be happy, but I didn’t have “joy”. He didn’t elaborate.

He had me lie down on a massage table and yanked at my arms, legs, and cracked my neck. He said this was to release my energies. He had me float my hand over my heart and asked if I felt any warmth. I tried to feel it; I willed myself to feel it. But I didn’t.

He said I needed to believe in his methods or they wouldn’t work on me.

This is the same circular logic that gets me stuck with Christianity. Either you’re in the circle of faith or you’re out. And if you don’t have faith, which by definition is belief without reason, then you can’t be saved. I wish I could have faith, but I don’t. It’s just not there. I don’t know how to get it, but I’m pretty sure I’m not going to be able to buy it at $120 an hour.

The healer said I had cancer because I didn’t “know myself” and if I were to “find myself”, then I’d be cured of my cancer. This idea of finding oneself is so vague and subject to so many interpretations. I find this obsession with finding one’s “essence”, whatever that means, can be quite egocentric and selfish. This is what bothers me about Buddhism. I never liked the idea of these monks forsaking the world, abandoning their families and loved ones, so they can go sit on some mountain and reach nirvana. Isn’t that the ultimate in self-centeredness?

I think we’re always learning new things about ourselves and some people are more self-aware than others. I think finding oneself is like finding happiness – it’s the process that’s important and people aren’t meant to sit back at some point in their lives and say, “Aaah, I’ve found myself. I’m truly happy.” Because once you reach that point, what are you supposed to do next?

This healer might have helped many cancer patients, but so have doctors. I’d wager that the percentage of cancer patients saved by conventional medicine far exceeds the percentage saved by alternative therapies. I’ve heard many stories about miraculous cures, people whose cancers completely disappeared without any medical intervention. I believe that’s possible through a confluence of events, including environmental and lifestyle factors – the same myriad factors that came together to cause the cancer in the first place. We can’t explain them because they’re too complex. They’re miracles.

If you believe in miracles, then miracles will happen for you. A rainbow is a miracle or a sign from God. Or it’s the result of the refraction and dispersion of sunlight by moisture in the air. It’s more beautiful to think of it as a miracle, so I don’t begrudge people who can see it as such. They might be the lucky ones. But I can see a rainbow’s beauty and still appreciate the science behind it. I can see myself being cured of this cancer and appreciate the science behind it – a science which I believe is in itself a miracle.