The trip to Dana Farber did not make any of this easier. Instead of down-to-earth, plain-spoken doctors confirming the course of actions prescribed by my local docs, I was presented with yet another option: a clinical trial involving an experimental drug not yet approved for early-stage breast cancer, a drug that is actually probably about to have it's FDA license revoked for use in late-stage breast cancer. It's an expensive, politically controversial drug at the forefront of emerging science, a new way to attack cancer by compromising it's blood supply. Doctors and scientists are very excited about it. This drug, Avastin, seems to be adding to the lifespan for folks suffering a variety of other cancers.
If I do this trial, I'll have chemo before surgery, basically the same exact chemo I would have had closer to home, plus Avastin. Apparently there is no statistical difference between surgery first or chemo first in terms of how long I might live. Though this isn't true for everyone, I'll lose my breast either way.
The Dana Farber docs confirmed that the course of action prescribed by my local docs was perfectly good.
I spoke to my Dr. Z (my local surgeon) and Dr. R (my local oncologist), and they say they wouldn't discourage me from doing the clinical trial.
Here's the thing: it's a risk. There are a lot of unknowns.
But I'm already at risk. "High risk" says Dr. R.
Dr. Z says "No pressure. You can cancel surgery Monday morning, five minutes before we start. It's fine."
I need a month to think this over. But a month to think it over is a month where cancer has the reins. Not an option. So instead, I will decide in four days.
Of course, this all assumes that the PET scan I'm getting Friday doesn't raise red flags about metastatic disease (cancer spread in other regions of my body). If that's the case, everything changes again.