Sunday, November 14, 2010

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.

28 comments:

r3 said...

I tried to post a comment and it got lost. But I think I can remember:

It would be my choice, too. I realize it would not be everyone else's.

Thank goodness you are in such great physical shape (seriously, I'm sure your heart/lung function is phenomenal). This will be a boon to you in regard to anesthesia recovery and recovery from the procedure in general.


And mentally, you are so resilient. Still, this is going to be hard. My thoughts and best wishes are for you. My fingers and toes are crossed.

r3 said...

P.S. You are the epitome of the Peaceful Warrior. Corny as it sounds, you have that proactive zen that most of us hope we can muster under similar circumstances.

Kelly said...

Thank you so much for taking the time to share your story with us. Truly. With all that you're dealing with, I hope that blogging helps you sort out things, too.

You are in my thoughts and best of luck with your surgery.

Anonymous said...

I have never commented before, but want to wish you the very best of luck tomorrow, a quick recovery and many, many years of full, productive life.

Hugs, Ani

Anonymous said...

Dearest Amy, I am thinking of you and holding your well-being in my heart. I am wishing you the best possible outcome: to continue this magical journey for a long, long time.

with Love, Chanda

Emily said...

Im thinking of you, Amy.Take your pain meds. no need to try to be tough after surgery, you will get better faster if youre not in pain.

xx

Anonymous said...

You must feel some small relief for having made the decision...clear your mind as best you can and think of the future...the long, long future. You have every right to be optimistic!
Peace~Love. Kerry

missedconceptions said...

You are a tough cookie and will come through this, just like you have weathered bad things before.

My thoughts are with you, Amy.

Anonymous said...

I have been reading your journey for a very long time. Thank you for sharing your life with us. Just know when you go into surgery tomorrow that there are more people than you know thinking of you.

Jen

Anonymous said...

I'll be thinking of you tomorrow.
Em

Daniele said...

Thanks for continuing to share your life with us Amy. I'm thinking of you. You are such a brave lady, resilient, determined. I always end up feeling hopeful when I read your posts. "Although the world is full of suffering, it is also full of the overcoming of it." Thinking of you and wishing you all the best for today and your recovery after your surgery. xx

Anonymous said...

Just a reminder that those who have fulfilled the survival rate today had their treatment that many years ago. Today's expectation could be so much greater. Mom

Nancy said...

i am so proud of you.. will be thinking of you all day and hoping that everything goes smoothly. call me if you need anything! so much love

Paula said...

Your logic is sound, as always. I would have made the same choice myself. So many of us are pulling for you, hoping for the most successful surgery possible today and a swift recovery.

Think of all the tools available today to see and eradicate your cancer that were not available even 10 years ago. You have the best tools available to you, and you will get past this and get back to living your life.

Anonymous said...

Amazing post. Amazing woman. I am thinking of you this morning and sending all my positive thoughts your way. Although you never know until it's you, I feel that I would have jumped off the same cliff. Knowing the cancer is contained (no mets) I would have wanted surgery as soon as possible to remove it.

Let us know when you can how you are doing.

Anonymous said...

Amy, You are in my thoughts today. I am wishing you a super successful surgery and a really quick, pain free recovery. You're a strong woman. Don't forget you have lots and lots of friends behind you. We love you!!!

Anonymous said...

Sorry...that last comment was from Dot...I forgot that if I wasn't logged in here, it would come up as anonymous. Still sending lots of love.
Dot

Shannon said...

Oh Amy, I'm so sorry you are going through this. As several have said, I would've made the same choice as you did.

Thinking of you and wishing the very best possible outcome today.

Anonymous said...

My thoughts are with you today!

Anonymous said...

Amy - I don't think I've ever commented here, but I've been reading your blog for several years.
I'm very impressed by your ability to take what comes.
I'm thinking of you today and wishing you the very best going forward with recovery, treatment, health, and hope.

gycif said...

There's something exciting about free fall, esp. when you are physically fit and determined to ride this out in courage and style.

Our hearts and prayers are with you and family.
Love,
Gayle

Suzanne said...

Oh Amy. I had no idea. I am floored. You've been through so much and you are so strong.

I admire you more than ever. Be brave and know that strangers are sending their love to you. Having read your blog for at least five years, I feel I know you and that a friend is in need. I am sending you strength and love. Big hug to you and J.

Anonymous said...

docs can be wrong they said my daughter would die then after surgery had 50/50 chance and she is doing well not cancer but they can be wrong
tbear213

Anonymous said...

I am thinking of you and wishing you well.
l.

Tash said...

I have crossed everything I can cross and I wish you not only the best of luck, but a pain-free, easy recovery. You are in my thoughts (hugs)

Take care of yourself.

Lisa Carey-Moore said...

Dear Amy:

You are so eloquent it is painful, but beautiful. Scary. I believe in you: that you CAN survive and thrive. I will be thinking of you Amy at every turn in the coming months.

A little happy episode: my two kids, Quincy 6 and Mackenzie 8, swim now. They practice 3 times a week with a team. I marvel as they progress, and laugh (secretly) as they struggle with things like flip turns and the fly. Quincy emerges most practices with a greatly distended belly due to all the water he swallows...But most of all, watching them is a time for me to remember how good swimming was for me (though I not too good at it). How it gave me friends, and a group in which to feel safe during the not too comfortable years of high school. Thanks for being part of that group of friends. May you find some strength in water in the months to come!!! Crying counts!

xoxo Lisa

Jeff E said...

Amy - Hoping that you'll get through this and feeling intuitively like you will. You seem to have a lot of folks in your corner, which can't hurt. Make it through, and tomorrow is another day...

Jeff

Anonymous said...

Warm, healing thoughts coming your way today from California.