Which Cliff?

Cancer, it turns out, is a full-time job. Especially when you're still figuring out how bad it is and how best to treat it, not to mention adjusting your expectations of life to include a mastectomy, chemotherapy and all its attendant side effects, hormone therapy (at least five years of a menopause-inducing drug if not full-out war on my ovaries) and probably radiation. And of course that pesky possibility of my life being over within the decade.

And then there's the issue of clinical trials. Clinical trials are highly regimented studies of either new experimental drugs or existing drugs used in experimental ways. The way it's explained to me, the clinical trial is the main pipeline by which advances in medicine come about. Many a cancer patient credits clinical trials for adding years to their lives. I have a friend who was told he's likely be dead in 2.5 years. He was offered the opportunity to participate in a small clinical trial. He decided it was worth the risk. Thirteen years later,  he's the only one of the participants alive to say it was worth it.

So clinical trials can be great. But then again, if they knew ahead of time that the experimental protocol would be safe and effective, they wouldn't need a study.

I'm told I'm at high risk, with a grade 3, possibly Stage 3 cancerous mass maybe as much as 5 centimeters in diameter, with a "cluster" of "involved" lymph nodes in my armpit. The operative words (forgive the pun) are "possibly" and "maybe." My risk of recurrence is somewhere in the range of 50 to 80%. My risk of not being alive five years from now is in that same maddeningly wide range. I have been combing through the literature, quizzing my doctors like they are star witnesses in the trial of the century, counseling about the choices in treatment I'm offered. What it comes down to, I'm told over and over, is that they just don't know, there's no compelling data to suggest one course of action is superior to another. I have to choose what I'm most comfortable with.

Do I gamble on surgery, get the thing out of me, or delay action another two or three weeks in order to take my chances with something that might just maybe offer a heretofore unproven benefit?

"It's like choosing which cliff to jump off of," says my friend K~.

Exactly.

I've made my choice.

I'm going forward with surgery tomorrow.

Free fall.