A lot can happen in a week of cancer treatment, and it's been quite the week. Last Friday, I had my first appointment with my oncologist since my surgery. It was a pretty rough one, to say the least. Because my post-surgery pathology showed that I had quite a bit of residual disease left (i.e. they still saw living cancer cells in my tumor/6 of my lymph nodes), my oncologist is suggesting a particularly aggressive course of additional treatment to attempt to prevent a recurrence*. Namely, she is considering 6 months of oral chemo after my 25 radiation sessions and would like me to do 10 years of the most extreme of hormone suppressants, which involves taking a pill every day for the next ten years, during which I will not be able to get pregnant.
I had a lot of feelings after the appointment. Among them, fear, frustration, sadness, and, perhaps most of all, anger. It's hard not to think about how my cancer was about one-fifth of the size of the disease that I had left me AFTER four months of pre-surgical chemo when I first felt it. It's hard not to envision those two doctors telling me I was okay, that my tumor was just a normal fibrous, mass, and not scream, cry, and think of what could have been. It's hard not to think that they have likely increased my risk of dying from this cancer by a substantial number of percentage points. I'm fucking angry at how much I was let down by those two doctors, and it's enraging to see ads and promotions about the importance of early detection in breast cancer. I did detect my cancer early. Twice. And I was not taken seriously. And this is me– a highly-educated, white, middle-class woman seeking care at one of the best universities in the world.
Pair all these feelings with the extreme pain and discomfort of the fills to my tissue expanders, and it was a shitty Friday-Tuesday. But after the anger subsided, I started to do what I do best- my research. I looked into the studies that prompted my doctor to recommend an additional course of chemotherapy, and started exploring clinical trials offered at Sloan and elsewhere that combine new immunotherapy treatments with the traditional standard of care. I am now armed with the knowledge that the additional chemo may benefit me by a margin of about 3%, only significant at the 95% confidence interval, which, as a researcher, gives me pause as to whether the additional toxicity is worth it for me. Meanwhile, there are other types of treatment that seem appealing to someone with my subtype of cancer and BRCA2 mutation status. I won't get too into the weeds, but I'm reaching out to principle investigators at Sloan to see if a clinical trial may be a good fit for me during my radiation therapy. There are still decisions we will have to make in conjunction with my care team, but I do feel better armed with the knowledge that I've acquired about everything from capecitabine to aromatase and PARP inhibitors, and generally getting the lay of the land in the latest state of play of breast oncology research.
So that's the latest shitty news. Throughout my range of feelings, I tried to stay somewhat busy to change my perspective and keep my mind off things. Last Friday after my appointment, I saw my friend Liz, then headed to a protest for my research. As my therapist said, it was good to see people with rightful anger take action :
On Saturday, Greg and I had a nice morning walking around and shopping in the city, and he was trying hard to keep a smile on my face with his usual antics:
That evening, Katie took me to a really fun, fancy pop-up dinner and we caught up. And despite a very painful expander fill on Monday, by Tuesday, I tried hard to get in a better headspace. This was especially important as I switched gears on Wednesday, when I started teaching the second half of a planning methods class at Columbia. Here was my professor-cancer-chic look:
On Thursday, Jeremy and Crystal planned the sweetest date for Greg and I- a trip to La Vara, a wonderful restaurant in Cobble Hill, and tickets to see a taping of Fleabag through the National Theater Live. It was lovely. On Friday, I had dinner with my parents and we watched the Nats (lose, unfortunately). Last night, I went to the Queens Night Market with a gang of friends. We ate delicious things, including Persian, Singaporean, and Tibetan specialities:
All of this is happening while fall is in full force in NYC, and on even the literal and proverbial darkest, rainiest days, the city is looking quite fine:
Like I said, the ups and downs of cancer treatment. As we move into a new week, I am trying to operate in the framework that my surgery is over, that my cancer is gone, and that everything I am doing from here on out is to keep it that way. It's hard, but I'm trying hard to stay busy, stay positive, and move forward.
*See why this is so important in my last post re: Breast Cancer Awareness Month.
I had a lot of feelings after the appointment. Among them, fear, frustration, sadness, and, perhaps most of all, anger. It's hard not to think about how my cancer was about one-fifth of the size of the disease that I had left me AFTER four months of pre-surgical chemo when I first felt it. It's hard not to envision those two doctors telling me I was okay, that my tumor was just a normal fibrous, mass, and not scream, cry, and think of what could have been. It's hard not to think that they have likely increased my risk of dying from this cancer by a substantial number of percentage points. I'm fucking angry at how much I was let down by those two doctors, and it's enraging to see ads and promotions about the importance of early detection in breast cancer. I did detect my cancer early. Twice. And I was not taken seriously. And this is me– a highly-educated, white, middle-class woman seeking care at one of the best universities in the world.
Pair all these feelings with the extreme pain and discomfort of the fills to my tissue expanders, and it was a shitty Friday-Tuesday. But after the anger subsided, I started to do what I do best- my research. I looked into the studies that prompted my doctor to recommend an additional course of chemotherapy, and started exploring clinical trials offered at Sloan and elsewhere that combine new immunotherapy treatments with the traditional standard of care. I am now armed with the knowledge that the additional chemo may benefit me by a margin of about 3%, only significant at the 95% confidence interval, which, as a researcher, gives me pause as to whether the additional toxicity is worth it for me. Meanwhile, there are other types of treatment that seem appealing to someone with my subtype of cancer and BRCA2 mutation status. I won't get too into the weeds, but I'm reaching out to principle investigators at Sloan to see if a clinical trial may be a good fit for me during my radiation therapy. There are still decisions we will have to make in conjunction with my care team, but I do feel better armed with the knowledge that I've acquired about everything from capecitabine to aromatase and PARP inhibitors, and generally getting the lay of the land in the latest state of play of breast oncology research.
So that's the latest shitty news. Throughout my range of feelings, I tried to stay somewhat busy to change my perspective and keep my mind off things. Last Friday after my appointment, I saw my friend Liz, then headed to a protest for my research. As my therapist said, it was good to see people with rightful anger take action :
On Saturday, Greg and I had a nice morning walking around and shopping in the city, and he was trying hard to keep a smile on my face with his usual antics:
That evening, Katie took me to a really fun, fancy pop-up dinner and we caught up. And despite a very painful expander fill on Monday, by Tuesday, I tried hard to get in a better headspace. This was especially important as I switched gears on Wednesday, when I started teaching the second half of a planning methods class at Columbia. Here was my professor-cancer-chic look:
On Thursday, Jeremy and Crystal planned the sweetest date for Greg and I- a trip to La Vara, a wonderful restaurant in Cobble Hill, and tickets to see a taping of Fleabag through the National Theater Live. It was lovely. On Friday, I had dinner with my parents and we watched the Nats (lose, unfortunately). Last night, I went to the Queens Night Market with a gang of friends. We ate delicious things, including Persian, Singaporean, and Tibetan specialities:
All of this is happening while fall is in full force in NYC, and on even the literal and proverbial darkest, rainiest days, the city is looking quite fine:
Like I said, the ups and downs of cancer treatment. As we move into a new week, I am trying to operate in the framework that my surgery is over, that my cancer is gone, and that everything I am doing from here on out is to keep it that way. It's hard, but I'm trying hard to stay busy, stay positive, and move forward.
*See why this is so important in my last post re: Breast Cancer Awareness Month.
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