Wednesday, March 30, 2016

May the Odds Be Ever In Your Favor

The odds are not always in our favor.  Back in 2007 when I was first diagnosed with breast cancer, my oncologist went over my pathology report with me and told me that, if I did surgery, chemotherapy, radiation, and hormone therapy, I had a 40% chance of surviving, disease-free, for 10 years.  While those are not the absolute worst odds, they certainly are not the best.  Still, I fully intended to be one of those 4 in 10 who beat the odds, so I followed every recommendation and was totally optimistic that I would be throwing a party on my ten-year anniversary of being cancer free. I only made it eight years.

Sometimes optimism is not rewarded, but is that really a problem?  Would my life have been any better had I been anxious and nervous about a recurrence over the last eight years? What good would the worry have done?  What possible benefit would it have given to my life? I can't really think of any, so optimism tends to be my default position.  I always assume things are going to work out, until they don't work out.  And even when they don't work out, I still somehow assume that they will, eventually, work out.

I have to be honest and tell you that the odds are, once again, not in my favor. If you had seen the first PET scan I had at the beginning of the year, you could be forgiven for thinking some dark thoughts about my prognosis. A PET scan works by having the patient drink a bunch of glucose solution. Cancer cells love glucose, and they draw it in quickly.  Then the patient is injected with a special dye that has radioactive tracers in it.  Those areas that absorbed a lot of glucose, mainly the cancer cells, will glow brightly in the imaging result from the tracers. I had an awful lot of very bright spots. Too many to count. My scans looked a bit like a Christmas tree.

I had another PET scan on Tuesday to assess the effectiveness of my treatment so far.  I don't know what the scans will say. Although my tumor marker numbers have been going down rapidly, the odds are still stacked against me. I don't know too many other people who have had a total response after just 12 chemo treatments.  My oncologist has already hedged her bets by scheduling me for a Taxol infusion this week when I go in for my Herceptin and Perjeta infusions. She can always cancel it but she knows that the odds are that I will probably have to go a few more rounds of the weekly Taxol. I know of some women who have had weekly Taxol infusions for 5 to 6 months or more. I know that some women never reach remission.

I can't say that I haven't had some "scanxiety", but I also believe that our bodies listen to what we tell them. I think our minds are more powerful than our bodies. So I've been telling my body that I am strong, I am healthy, and that I feel great!  And you know what? It mostly works! Just try yelling it out to yourself right now with gusto and sincerity! Don't you feel just a little better? Personally, I find a good fist pump to be an especially convincing addition.

I'm ignoring the odds. I'm going to keep telling myself that everything is going to be OK. Because no matter what happens, it usually is.

Wednesday, March 16, 2016

Numbers are just Numbers

I got my CA27.29 tumor marker numbers last Friday, and I was pleased to learn that they went down further to 141.  That's down from a high of 850 when I started. I also had another tumor marker called CEA that was tested. The normal range for this marker is 2.5 or less, but I started at 48.1, and now the number has dropped to 7.6.  It's all very good news with both numbers dropping by about 85% from the beginning.  But I guess I'm getting greedy as I really wanted to see my numbers even closer to normal. Isn't it funny that just a few weeks ago, I was thrilled to have seen my CA27.29 numbers drop to 408.  But now I'm sort of disappointed with 141. We always want just a little more, don't we?

There are lots of possibilities for why the numbers aren't yet in normal range, and that's why the markers alone are not used for diagnosis or treatment decisions. What I need to focus on are all the obvious signs that cancer is retreating. I need to remember where I was just 11 weeks ago.

In those early days just after my diagnosis, I was feeling pretty weak as the tumors in my lungs must have been growing pretty quickly. They caused me to be seriously short of breath and susceptible to terrible coughing jags. We were up at a friend's cabin near Lake Superior over New Year's Day, and I took a walk up to a scenic ridge that has always been a favorite spot for me. I had to stop several times on the way up to catch my breath and let my energy rebuild. It took me twice as long to reach the ridge as it normally would, but I needed to get there just to prove to myself that I could still do it. Standing on top of that ridge, looking out over the deep dark blue of Lake Superior, I tried to be positive, but I felt a bit apprehensive over what the year would have in store for me. I knew I would be starting chemotherapy soon, and I knew from past experience that it probably wouldn't be easy. I already felt pretty lousy, and I wondered if I would ever feel really good and really strong again.  

I was reminded of that moment this past weekend. We were at our friend's cabin once again, and I found myself climbing that very same ridge. Even though it was a Saturday afternoon, which is usually my point of lowest energy during my chemo cycle, I didn't have to stop once. I reached the top with a smile on my face as the sun shone down on me through the pine trees, and I felt an enormous up-swelling of joy and gratitude as I gazed out at the sparkling blue lake. I realized that it didn't really matter what the numbers were, because what really matters is how I feel. I'm still not in perfect shape. I still have some weird tightness in a couple of spots in my lungs, and I still have a bit of pain where my liver was biopsied. I still have a bunch of scraggly fuzz for hair, and I still have a weird metallic taste in my mouth from chemo. But here's the truth. Even though I'm still in chemotherapy, even though my numbers aren't "normal" yet, I feel good again. I feel strong again. I feel like me again. I'm glad to be back.