Thursday, May 31, 2007

A Change in Chemo Plans

It was a tiring day at the hospital yesterday, but it felt good to be out of the house. I would rate yesterday a six on the AFI (Actual Feeling Index) scale. Since chemo ended a week earlier than I expected (see yesterday’s blog), I’ve adjusted the countdown days on the graph to when I think I may start regaining some stamina. The follow up visit with my plastic surgeon was good. No surprises.

A few people have asked since yesterday about how I feel about chemo ending early. I have mixed feelings about it. The negative is obvious. Did I get enough chemo to kill the cancer cells? No one will ever know whether this last treatment made a difference one way or another. I have been on heavy doses of chemo since December 20 2006. That is over 5 months. It has taken a toll on me. I’ve lost 12 pounds which I didn’t need to lose during this period; 7 of those pounds in the last 2 – 3 weeks. The weight loss is due to the fatigue. I’ve been too tired to consume the calories needed to maintain my weight. It makes me a bit anxious to not get the last treatment, but I think this anxiousness is more tied to ending chemo than the last treatment being cancelled. With chemo ending, will the tumors grow back? Will the one lymph node I can still feel, expand? The tests and exams over the next two weeks will help answer these questions, but even good news, if that is the result, will be tempered with… we don’t see any new growth right now. On the positive side, I’m hoping I can begin regaining my stamina within the next week. I don’t want to dwell on this, but it has been a chore to get out of bed for two weeks. Didn’t one of the Beatles stay in bed for an extended time period? Chemo can produce negative long term effects as well. For my drugs, this includes permanent numbness in one’s extremities, immune system deficiencies, and acne-like scarring. Many chemo drugs are cumulative in the body and never leave. That means that future chemo treatments may cause negative side effects sooner and the positive effectiveness is reduced. At least one of my drugs has reduced future treatment and some clinical trial options. My doctor informed me of this going into the treatment but felt a bird in hand was better than two in the bush. I agreed with him. So, it is not really a question of whether or not I could tolerate this chemo treatment for one more week. The answer to that question is that I could have. The real question is whether the benefits of the last treatment would have outweighed the negatives. For this, we’ll never know the answer, no matter what happens going forward. So, together, my chemo doctor, his staff, my spouse, and I made the decision to pass on yesterday’s treatment.

I’m thinking back on something Lance Armstrong said during the “Living with Cancer” special with Ted Koppel on The Discovery Channel in early May 2007. Lance said his secret weapon in winning 7 Tour de Frances was cancer. No matter how tired, cold, and miserable he and the other riders were during the race, he knew real pain more than anyone else that was competing. The cancer taught him to fight that pain and move past it. It is hard for most people, myself included, to relate in any real way to Lance Armstrong. But, I can relate to this concept in some strange way. Cancer, if I have bought some substantial time, has made me a stronger person. Take care everyone.

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