Thursday, January 10, 2008

reports of my (imminent) death are greatly exaggerated

I have this book with a flowchart in it. It shows how cancer cells mutate and grow. It has lots of little arrows pointing to the possibilities.

Cancerous cells can be treated and eradicated or turn into a cancerous tumour.

A tumour can be zapped with chemo and disappear or it can metastasize.

Once cancer is beaten, a person may be "recovered" or they may have a "recurrence."

But there is only one arrow leading from "metastases" and it points towards "death."

This flow chart really upset me when I saw it (it's in a freakin' cookbook).

And it pissed me off.

Then I went to the National Conference for Young Women Living with Breast Cancer. There were only a handful of us there with metastastic breast cancer (six or seven out of a few hundred, I'd say). But one was a conference organizer. And we all looked pretty damn good for people who are supposed to be dying.

More of us are getting breast cancer. And we're getting it at younger ages. But we are also living longer.

And living well.

My oncologist and I talked about this, yesterday. As I have said before, I've had "spectacular" results with my current treatment regimen. Figuring out next steps, though, is a bit of a guessing game (the following is from

Many women can live for years with metastatic cancer that's under control. For these women, living with a diagnosis of metastatic breast cancer is like living with a chronic disease. It can go into remission, be active sometimes and not others, or move quickly. It frequently involves trying one treatment after another, ideally with breaks in between treatments when you feel good. The goal of treatment is to help you feel as well as possible and live a longer life.

No one can tell you how long you will live with metastatic disease. That's because every woman's experience is different. Some women live for more than a decade. Others live for just a few seasons. But new and more effective treatments keep being developed. This means that you may do much better today with metastatic disease than someone who had it only a few years ago.

In this phase of breast cancer, the treatment goal is to extend life as long as possible with the best QUALITY of life possible. This means relieving symptoms and putting cancer into remission with the fewest side effects.

I have already gone from a three week cycle (with one week off from treatment) to a four week cycle (with two weeks off from treatment). Now, my doctor and I are discussing moving to a cycle where I would receive only one treatment (herceptin and vinorelbine) every four weeks.

I have a lot of faith in my oncologist, who says that many women have had success on this kind of cycle but that we have no way of knowing exactly the right amount of chemo to keep my (very aggressive) cancer at bay. We also don't really know the truly long term effects of herceptin (which can potentially be damaging to the heart) because the drug is just too new.

The side effects of the drugs I'm on are relatively mild but I am feeling emotionally and physically ground down by ongoing treatment. Chemotherapy attacks the healthy cells as well as the cancerous ones and my body and soul have been paying the price. My heart leapt at the suggestion that I might get more of a break in the near future.

So there are no easy answers. But the questions I am having to ask are a whole lot more pleasant than ones I thought I might be facing a year ago. And I'm a damned-sight better off than I would have been had all this happened to me even five years ago.

And I do know this: metastasis may lead to death (we are all after all going to face death at some point) but until then I plan to live fully and well.


Babz Rawls Ivy said...

This is by far my favorite post. Your courage and bravado is shining through. Girl, you are a badd ass! This post resonates strength and real love for life. You are how I want to be. Eyes fully focused on what is important and living your life like it's golden. The 1st 2 rounds of drinks are on me in San Francisco!

Anonymous said...

All this and raising kids too. You're a saint in my book.

Anonymous said...

You totally rock! I think you have more guts than many women:) Keep up the faith.

Anonymous said...

Thanks so much for sharing what's real for you...especially the part about living fully and playing well, I'd love to hear more about that!

Rebe said...

Being "young" and having breast cancer is very frustrating. I made sure I did a clinical trial, because there is so little research in pre-menopausal women. I'm glad you are in a successful course of treatment, and hope for your continued success. Stay strong!

Anonymous said...

Everyday is a new day. No one knows what waits ahead of them, no one. And that includes those who are in the "healthy" never had anything group.

I've said it before, and I'll say it again, you're an inspiration. :-)

Anonymous said...

Your attitude towards winning a permanent remission is as important as everything else your going through. Keep on the positive truly does help.

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Jomd said...

Laurie I want to give you a virtual hug and applaud your courage----
I recently got diagnosed with breast cancer--stage 2--it's really hard to wrap my mind around this new reality and I'm dreading the chemo.

I wish you all the best-----Like you, I don't intend to go gently into that dark night.