Pirahna with Chain Saws

I didn't feel like waiting until Tuesday when Dr. P was back in the office to learn the results of the MRI, so I called Dr. H's office on Friday. Anna, the nurse practicioner, got on the phone, and she sounded surprised that no one had been in touch with me as the results had been available and discussed among my various doctors on Thursday. She thought Dr. D, the radiologist, was supposed to call me. I guess no one wanted to be the one to tell me that the MRI detected no visible difference in the size of the tumor.

Anna immediately told me not to get discouraged. She said that Dr. H is not fazed at all by this. (Oh sure, but it isn't his tumor or his life.) She said he still wants me to continue chemo and do the surgery at the completion of the chemo. I asked if it had grown, and she said, "No." She also reminded me that the MRI could not distinguish between live and dead tumor cells. We won't know for sure until the tumor is removed. I asked her if leaving the tumor in the breast increased the likelihood of it spreading, and she said since there was lymph node involvement, the cat was already out of the bag on that. She mentioned that my tumor was fast growing, and I said, "Isn't it the fast growing cells that are supposed to respond to the chemo." I could tell by her slow and deliberate responses that she was carefully navigating the minefield of questions I was making her walk through. "Yes," she said. "That is the theory, so we may be dealing with a more... uh... tenacious entity than we originally thought."

What about the hand with 30 years of experience that was confident my tumor was shrinking? I didn't ask that question (and if I had, I wouldn't have worded it quite that way), but Anna brought it up herself. She said that when she and Dr. H first saw me, it was right after the biopsy. The biopsy probably caused inflammation and swelling that made the tumor feel larger than it actually was. That explains why everyone who hasn't felt it for awhile thought it was smaller, while I couldn't really feel a difference recently from day to day.

She kept telling me not to get discouraged. She said that we have just begun attacking the tumor and that we have a lot more stuff in the arsenal. She mentioned that many women (40%) have either a partial or complete response to the Taxotere, which is the next chemo drug that I guess I will begin next week. I reminded her that Dr. P has to order the chemo, and she promised to call me on Monday after she had a chance to talk to Dr. H and Dr. P about my schedule. If I am going to continue chemo, I don't want to lose any more time waiting around for the doctors to figure out who is going to call me. (Ouch! Am I getting a little touchy?)

So what does it really mean that there hasn't been a noticeable reduction in the size of the tumor? Maybe something, maybe nothing. Despite Anna's frequent reminders not to get discouraged, of course I got discouraged. Of course I created meaning, and of course it was unfavorable meaning. I allowed myself to shed a few tears that night. My brother, John, said that while this may be an emotional setback for me, it doesn't change the outcome which we know will be my victory over breast cancer. I told him that I guess I was going to have to get more aggressive than the pirahna, to which he responded, "What is more aggressive than pirahna? Pirahna with chainsaws?" Yea. When I was doing my visualization that night, I had a really difficult time figuring out how the pirahna would hold the chain saws though...

By Saturday morning, the moment of despair had passed. At this point, I am starting to get a little p----- off actually. I didn't lose my hair for nothing!! Tenacious entity? Well, so am I! I spent a couple of hours on the internet researching breast cancer on Saturday. I had previously resisted taking this action because I was afraid of what I might learn. Sometimes ignorance is bliss, and I was deliberately avoiding information like survival rates. When doing battle with a tenacious entity, however, one must be fully armed.

I visited reputable sites, like the Susan G. Komen website. It was a wealth of information and cited many recent articles on breast cancer research. I learned a lot. It was encouraging to see that the treatment I am undergoing is supported by recent studies. I do have confidence in my doctors and that they are current on the latest treatment modalities. Nonetheless, I developed a list of about 10 questions to ask them based on the studies I read. What is very apparent: there is still so much that remains unknown about breast cancer and so there is still much guesswork. The doctors are doing the best they can with the data that is available.

And by the way, I did stumble across the survival rates on one of the websites. For Stage II, it is about 80%. (I am assuming that it is the five year survival rate, but it didn't specify.) Of course, I am in the 80%. Also, I have decided to give meaning to the MRI results. The chemo is working because the tumor has not grown larger.