Que sera sera

I'd intended for this post to be a continuation of surgery-day but as I have news, I'll hold off on that. What we've been holding our breath about for two weeks now is whether I would have to have chemotherapy again. Last week, I dug through my nearly 7-year-old notes to see if I could find the pathology from my last cancer because Mike and I were pretty sure that aside from it being a different type of breast cancer this time, the pathology in all other respects was nearly identical and in one case a bit worse. I did find some of my doctor's notes detailing the pros and cons of my pathology and confirmed that our collective memory was right on the money. This made me pretty sure that as I had to have chemo last time, I would have to have it this time as well.

Today we saw the medical oncologist and although I was prepared for hearing that I would need chemo, I'd really really really really (did I say REALLY?) hoped that I wouldn't have to go through that again. Alas, I will. I guess nothing prepares you well for actually hearing that the show must go on, so to speak. It also looks like I'm in for a longer ride on the toxic train this time, too. This cancer is apparently even more aggressive than the last one and so I will probably have to have between 6 and 8 treatments, either two or three weeks apart depending on which kind of regimen my doctor recommends. This means chemo will last at least through June and possibly longer, followed by 5 or 6 weeks of radiation. That would mean no "get out of jail free" card until August or maybe even September. And yes, "sayonara" to the hair. Plus, no big travel plans: no long sabbatical travel for Mike, no anniversary trip, no special bday trip for Mike, no summer on the beach; no visits to family. Breaks my heart. When pressed the doctor allowed that we might be able to sneak in one trip that we feel is really important but no guarantees. I feel a big sigh coming on.

At this point we have two chemo cocktails from which to choose. Plan A comes with a slight risk, since it would mean getting the drug Adriamycin, which has the potential to mess with your heart (it can weaken the muscle). I had this one last time and that is the dilemma - whether to give it to me again. The doctor explained that I had 240mg of this last time and research has shown that up to 300 mg and possible 400 mg over a lifetime is safe. If I have it again, that would mean I'd be at 480 mg or slightly above the maximum. BUT they can counter this effect with a drug that protects the heart but which, unfortunately, can add to the nausea that I'm already going to be feeling from the chemo itself. Another sigh coming on.

The nausea part is about as fun as having to walk a ways to your car in 110 degree heat in Tucson and then actually having to get in it when it's been baking in the sun all day. Then imagine that you forgot to put your sun shade up but you have to touch that steering wheel, that you also have no air conditioning, no water to drink - AND that you have to repeat the walk, um, let's see 9 or 10 times a day. I'm pretty sure I'm not exaggerating but it's possible!

I've been told it's a lot like morning sickness actually, but without the fun baby part at the end. Since I've never been pregnant myself, I can't compare and am just going by my memories of last time. In any case, the nausea is a given no matter what regimen I get. Under Plan A I'd be zapped with another drug at the same time as the Adriamycin - for 4 treatments, to be followed by 4 treatments of another drug called Taxol. My mom and sister have had this and they say this is no picnic either; my mother has permanent neuropathy in her fingers and toes because of it and my sister says that the bone pain that comes with it is sometimes unbearable. Everybody's different, though, so maybe I'll have it easier. One can always hope.

Plan B is a newer regimen that my doctor wants to look into, which is Taxol and another drug for 6 treatments. This would actually take longer even though the number of treatments is less because these drugs have to be given further apart (every three weeks instead of every two for Plan A). My doctor is still mulling this one. She's also ordered a heart-function test (I had this before, too) to see if there's been a change from 7 years ago. If so, then it is unlikely she would want to risk the Adriamycin. So now we're in a new holding pattern - wonder what cocktail it will ultimately be?

Chemo may start as early as next week but probably not until the week after (the last week of February). In the meantime, I need to have the heart-function test, get my teeth cleaned (they can't do this while you're undergoing chemo because of the risk of infection), get a mammogram on the other tata (because I'm due for one) and get the chemo port put in. The chemo port is something they insert under the skin between your collarbone and your tata that allows them to draw blood right from a major vein. They can also easily feed in the chemo drugs without having to find veins all the time. To put the port in requires surgery but only as an outpatient and they don't put you under. They use a local anaesthetic and some happy juice. The latter made me very chatty last time; I guess I was asking too many questions! The port is something you can actually see under the skin and for Star Trek fans out there, last time we likened it to being a member of the Borg collective. Yee ha!

On the plus side, there is sure to be shopping involved for things like scarves and hats to cover the ever-so-lovely lack of hair. The ones I had last time went from me to my mom and then to my sister so they've gotten plenty of wear and tear and it's time for a new batch. As many of you have heard me complain before, I am not a person who looks good in hats so it takes an actual shopping trip to choose them. Now, who am I to turn down a shopping trip? You never know what you might come home with :0) Also, there's the possibility of re-inventing oneself with a wig. Should I be a brunette? A red-head? or stay blond? Long hair or short? straight or curly? Votes, please!