The decision, in detail

Let the rambling begin!

Well, the time has come for us to take action. I'm looking forward, and holding on to the thought of healing and well being as firmly as I can. These next few years will be a challenge to maintain the vigilance that is likely needed. And I feel as if I am gearing up for a marathon.

My treatment plan? Short answer: no chemotherapy, maybe radiation, and definitely hormone therapy.

A longer description:

I have a body that is challenged by environmental factors, constant internal factors due to medication reactions, and chronic illness. With the added boost of cancer, my sensitive body is almost in a free fall.

It's been four weeks post mastectomy. I'm recovering very well. Still, I am unable to stay still, and am very driven. I have life to live and I don't intend to spend any more time stationary than I am forced to. This means my healing seems to be happening quickly, even though I know I'm pushing myself. I still have troubles with strength and there is a constant need to stretch. Even now, I'm finding that I can do things that involve my right hand in fits and starts, usually not more than 10-15 minutes at a time. Then I have to stop and stretch.

Decisions. I feel it is imperative for people to make major decisions with fear taken out of the equation. Many times it isn't possible to take it completely out...so I settle for not letting my fear dictate what I do. This is very much true for the decisions I'm making right now.

The recommendations that have been made to me by the oncologist: chemo, class 3; radiation; and hormone therapy.

Because the cancer I have is aggressive, the chemotherapy drugs are the highest in strength. They take a blood draw each time you go in for the chemo treatments to make sure you have enough strength to handle the poison they inject. Yes, chemo kills cancer cells...but it also kills healthy cells. The chemotherapy recommended to me is a three chemical cocktail. First up are two that are given together. These two are the drugs that cause hair to fall out. The third has different side effects, the third most common is neuropathy in the finger tips and toes. The oncologist is saying that if that particular side effect takes place, then she would back off to see if it helps that symptom. My current neurologist says that if the neuropathy happens, it is likely never going to leave - due to my CRPS/RSD. In other words, more pain for the rest of my life.

Quality over quantity. That is what I'm choosing.

Knitting, drawing, beading, wire working, and general art is where I find enjoyment. I've always been passionate about expressing myself through art. I find refuge in the process of creating. I absolutely find peace, centering, and a type of meditation from knitting. I can't imagine life without the use of my fingers. But more...I have a wheel chair. I do have to use it every so often, and I truly wish I didn't have to. If I didn't have the use of my fingers, how would I wheel myself around? How would I feed my kids and family? How would I keep in contact with my friends? How would I do the few things I'm able to do now? Add more limbs to the RSD palette, and I'm a mess. A true mess. My quality of life would tank considerably. And if I have flares that put me in the fetal position on the couch now...how would I be able to function if more than just one area of my body was screaming in pain. If it was a high percentage of return, in years, and would add many more to my life, then I might have considered taking the chemotherapy. As it is, the bump in percentages (and yes, I know we are talking mindless statistics) does not out weigh the devastation I would likely go through.

In speaking to a couple friends who have gone through chemotherapy, there are about 5 years of intense fatigue after the treatment. Some recover faster, of course. And others have fatigue that lasts the remainder of their life. Chemotherapy brain is a real thing, too. Too many adverse side effects trail chemotherapy for me to find the time out weighs those effects.

That leaves radiation and hormone therapy.

Radiation is something that I am not taking off the table yet. I am waiting for the consult appointment to be made, and will let you know if what I have written here has changed because of the information i get in that consult. Radiation is a much more targeted science now. But it still isn't a great thing. It's intent is to zap cells hoping they get the microscopic cancer cells that might be remaining in the mastectomy area. The reason I'm just going for a consult is because I still have two spots in my left breast that showed wash out (a phenomena that accompanies cancer tumors), in the MRI that I had taken a few months ago. The follow up scan of those two spots will be done in December. I am going to wait until the results come in from that scan to decide on the radiation. If they find tumors in December, then I will likely look at radiation as a possible treatment. That is the main question I want answers to when we go for the consult. How effective would radiation be on small tumors? Can we zap both breasts at the same time. The part that gives me pause is that chest radiation tends to have more adverse reactions/side effects. So I am less eager to have this done.

Radiation can be paired with the hormone therapy, and the chemotherapy must be taken on its own. Therefore, I am comfortable waiting and seeing if there is a true need to have the radiation.

Again, if percentages were higher, as to how much more quality of life they could give me, then I would definitely consider radiation in my treatment plan. However, I'm finding the bump in statistics due to the two therapies mentioned so far is less than I had hoped for.

That leaves hormone therapy. I am going to go with this type of treatment. First, since we know the cancer I have is responsive to hormones, then if we block my body's cells from receiving  hormones, then cancer growth will be hindered. It will send me into a solid peri-menopausal state, but it will also (hopefully) give me more time to fight the cancer. I will take the hot flashes, the night sweats, the moodiness, and the brain fog, if it will slow the growth of the cancer cells I likely have running through my body. The hormone therapy will continue on for at least 5 years.

What do the statistics say? With my chosen treatment path, I have a 64.4% of surviving 5 years and a 28.7% chance of surviving 10 years. This is taken from plugging my information in to the database Predict.nhs.uk. Here's to hoping my percentage will be higher than those listed here. I have the determination and stubbornness to survive and thrive.

My belief is that by choosing the treatment path I am choosing, I will be given more time. I believe I will have more energy now and a better chance at being able to enjoy my family and all this life has to offer me.

Quality over quantity.