"Don't spend time worrying about how you are going to die. Worry about how you are going to live today"

Friday, January 14, 2011

Chemo or not to chemo, that is the question

So I have been waiting for the results of the Oncotype DX test to find out the likelihood that my cancer may return in the next ten years.  This test will also help my doctor determine if chemotherapy would offer benefits to me.  I got the call today with good/not so good news.  The test has three ranges low risk of recurrence (scores 1-17), intermediate rate of recurrence (scores 18-31) and high risk of recurrence (over 31).  When I met with the medical oncologist last week, she said based on my current situation if the score came back in the low range she would not recommend chemotherapy as the benefit would not outweigh the risks.  She also told me that if my score came back in the intermediate range that she could not tell me if chemotherapy would or would not benefit me as there is just not data to make that clear.  If the score comes back high, chemotherapy would be recommended.

I have been praying and praying that the score came back low so that I could avoid putting my body and my family through the chemotherapy.  I just can't imagine my four year old son having to be scared by all of this.  I can't imagine losing my long, long hair and my beautiful eyelashes.  I know that seems vain, but as a woman, those are all things that make use feel feminine and attractive.  It's a part of who I am in some ways.  Don't get me wrong, my hair doesn't define I am a woman, but the thought of being bald makes me completely uncomfortable.  The thought of having everyone that sees me know that I have cancer really makes me uncomfortable.  My illness should be able to be kept private - not publicly advertised.  Why don't they just tattoo "I have cancer" on my forehead too?

So after a long time of praying, I got the call today and my score was 17.  So technically it is in the "low risk" range, but why did it have to be the highest number in the low risk range?  So at a score of 17 my oncologist is going to say that there won't be a benefit of chemotherapy, but at 18 she can't tell me if there is or isn't a benefit?  How am I suppose to feel OK with a score of 17?  Of course, it is Friday and the nurse called me today.  I asked for the doctor to call me back, but no phone call today so now I have to spend the entire weekend pondering this very thought.

I am so tired of reading about cancer and making decisions with no guarantees of anything.  I feel like I am walking on a narrow plank in complete darkness at times and just waiting to fall off.  Everything seems to be such a "fine line" or with just enough uncertainty to make you keep questioning your choices.  I am trying to do EVERYTHING I can to save my life and be here to raise my young son. Why does this have to be so hard?  Why can't anyone tell me something really solid to make all of this clearer? 

When I think of the whole experience of going through chemo, it scares me to death.  But somehow when I think of not doing it, I am scared too.   The purpose of chemotherapy is to attack any cancer cells that exist anywhere in your body.  So at this point there is no way of knowing with 100% certainty that no cancer cells left my breast and moved somewhere else in my body.  If I have the chemotherapy now, I have the opportunity of blasting those remaining cells no matter where there are in my body for good.  If I get no chemotherapy, those cells could already be somewhere else waiting to grow and spread my cancer.  I guess I feel like doing "EVERYTHING" I can do includes chemotherapy.  How will I live with myself if this comes back and I did not choose the chemotherapy?  By then, the cancer will be worse too. 

I don't want fear to continue controlling me.  I am working on having more faith, but these are tough choices that only I can make.  These choices are scary and would put incredible fear into anyone.  Once I make these choices, I have to live with them.  "What can I live with?" is what I keep asking myself.  Down deep I know I will never forgive myself if I don't do chemotherapy and the cancer shows up again somewhere in my body.  I also know there is no guarantee that won't happen if I do chemotherapy.  I guess I know what I should do, I just don't want to.  I need to have this very emotional, scary conversation with my medical oncologist and have her explain why I shouldn't think this way.  I know the chemotherapy has long term risks to my body and I have to consider that too.  I guess I am back to doing what all breast cancer patients do, waiting for more answers.

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