I don't have "too many" options. I am lucky enough to have choices.
I am very aware and very thankful of that.
But, alas, it is not easy.
It all comes down to the nitty gritty numbers and statistics. It comes down to percentages and averages and trying to decide between quality of life versus quantity of life in some cases. It comes down to that old saying "Do you feel lucky?"
Today we went to the cancer center.
We spent about 3 hours there including my blood work.
(As a side note, I have a feeling that 'blood work' will soon become secondary to me.
2011 was supposed to be the year of the rabbit. I think they messed that one up. Methinks it's the year of needles.)
It is a new centre and really beautiful. Inside looked like an airport lounge. With knitting needles. Every table had a little basket on it, and inside were knitting needles and half started projects. From what I gather, the crowd in this place is somewhat older than me. I felt like the curious toddler in a room full of adults.
I met my man nurse and he took my vitals.
I have pretty boring vitals, my blood pressure is always 90 over 60. My weight is always 120 lbs. I am always 5'3" and a quarter. (And yes, any shortie will tell you that it is always important to put that quarter in there.) As long as I can remember these have been my vitals. So, smugly I handed in my sheet with these numbers already scribbled in. My man nurse chuckled when he read it. He starts with the blood pressure. Ding Ding! We have a winner. Then I get on the scale. To my delight I was even lighter than I predicted. That's right - who's chuckling now?
Next comes my height. He measures me with his super duper electronic measure stick.
It beeps and makes sounds.
Then it flashes the number: 5'2" - whaaat? That can't be.
I was 5'3" and a quarter just yesterday.
Man nurse leaves the room and as the door closes, I swear I hear him chuckle.
In comes doctor.
Nice man, somewhat of a sense of humor, very detailed and thorough in explanations. Just what I look for in an oncologist. I still can't get over the fact that I am using the word oncologist in a sentence - and it has 'my' in front of it. But I digress. He's a nice man.
We discuss the pathology report. He tells me what I already know. I pull out my questions and he tells me they are good ones. (thank you Dana!) He starts to read me like a book, and tells me 'my type' of patient usually likes to know the statistics on my stage of cancer. That means basically how many people live and die, who have the same cancer, same grade, same stage, same age as me.
It's a morbid idea, but it's better to know I figure.
Next he pulls out sheets of stats that he printed out with scenarios. I realize then and there that he is a man after my own heart. I print scenarios too. (Except mine have to do with kids talking back to me and what time out punishment they will receive.) But still, they are scenarios. I like to look at them.
Here is scenario number one:
I do nothing more than what I already have done:
According to the medical treatment calculator I have a 12.6% expected cancer death rate in the next 15 years if I do nothing else.
That means I have a 87.4% survival without further treatment. Not too shabby.
Scenario number two:
I skip chemotherapy through I.V. and go directly on Tamoxifen.
(Still chemo therapy and I will have to be on it for 5 years (!!) but in pill form not intravenous)
According to the medical treatment calculator I have a 8.6% expected cancer death rate in the next 15 years. That means a 91.4% survival - already so much better.
Scenario number three:
I choose to do traditional chemotherapy for 4 cycles AND go on Tamoxifen chemo for 5 years.
According to the medical treatment calculator I have a 4.8% expected cancer death rate in the next 15 years. That means a 95.2% survival - getting better by the minute, isn't it?
This was supposed to be all the choices. To me it seems obvious that I will do the traditional mainstream chemo PLUS the 5 year Tamoxifen chemo (pill form). But then I wonder if I could push further. I ask if there is anything else that could get my percentages of survival even higher. I know I know, I should be grateful for all I was shown already. I am. I just wonder.
After ummm-ing and errrr-ing he tells me he will be right back. He's going to check his handy dandy treatment calculator for one more thing. He is unsure if my medical will cover this suggestion, because traditionally is considered 'too aggressive' for my stage of cancer. But he said, if I want to, we can try calling them - the powers that be.
He comes back with my fourth and final scenario:
I choose a more aggressive traditional chemo than the original one suggested, for 6 cycles instead of 4 PLUS Tamoxifen for 5 years.
According to the medical treatment calculator I have a 3.9% expected cancer death rate in the next 15 years. That means a 96.1% survival. This is as good as it gets.
It may seem simple but it's not. This last choice has me agonizing over a 0.9% survival difference. It would be a much much harsher chemotherapy and the side effects would be much more substantial INCLUDING heart muscle damage.
The other chemo did not have that side effect (plenty of others though)
I am willing to bet a lot of people would roll their eyes at 0.9% survival rate. But this is MY survival rate so I won't. I know it's only a small difference. Not even 1 percent. What are the odds? But you know what the odds were of a woman my age with my history to have my type of breast cancer? 0.03% - talk about small percentages.
All of a sudden 0.9% is not that trivial.
I will think of it some more over the next few days - even though I think I have an idea of what I probably will choose. I have to weigh all the benefits and all the risks and decide what is worth more to me. Feel free (in fact, I would love to hear it) to weigh in with your comments. Give me your thoughts and ideas. Bouncing ideas back and forth not only helps me compartmentalize the situation but also is a good way to be made aware of things I may not have thought of.
Otherwise I'll be forced to go back on Friday and bring a coin.
Oh and as we were exiting the cancer centre a very nice, very friendly, very old lady volunteer asked if we would like to see their free wigs and hats that were available to me. We followed her and found a room full of about 20 wigs (all grey by the way except for one that was salt and pepper) and a bunch of knitted hats. The friendly lady talked about how easy it was to knit and crochet these beautiful hats and scarves and I told her how uninterested in knitting I was.
"The youth these days" - her eyes seemed to say.
At the end of it all she asked which wig I wanted.
I was extra polite when I told her that none spoke to me.
Instead I chose two knitted hats.
She gave me a bunch of literature to take home and as I walked out of the centre I realized she snuck in a 'how to knit a hat' brochure in with the papers.
I guess she was sneakier than I thought.