One More Step, Then Another, and Another...

I feel like a bad line in a war movie, you know, the one that goes something like "Come on you grunts, whatsa matter, you wanna live forever?" just before they go charging into a hopeless fight and certain doom. Well, yeah...I DO want that, thank you. I want to pack up my bags, tell everyone that it's been a slice, and go back to living the life I had before Sept. 7. Unfortunately, I don't get that option. Everything comes back to the fact that it will never be the same, that I don't get to have a "do over," and life starts up again, but from this point here on. No turning back, only re-inventing the future everyday from here on out.

The finality of the surgery is what got to me yesterday. Hearing my surgeon pronounce me "an excellent cosmetic result," made me wonder "And what planet are you on, doc?" Reading the long-awaited pathology report, my cancer distilled into two typed pages of techno-medico-speak. I've heard people talk about out-of-body experiences, but reading about former pieces of my body described as "fresh" tissue samples just made me a little queasy and sad. It's not me, (but it used to be), and the new me looks good for what it is, but it's still not me. I cringe.

Today, more poking and prodding, this time with the wacko plastics crew. I've decided that these people are the court jesters of the medical profession. (Bill says that he thinks that they just REALLY enjoy their work). To be fair, they get the unique position of making everything better. OK, it's not the same, but certainly what they do makes the most of what's left after the deadly serious oncology people get through with you. They do have more fun in this peculiar parallel "Universe of Cancer" that overlays what used to be normal life.

I've been living in this parallel universe for about 3 months now, and while it's been interesting, I'm homesick for the old world I knew. I keep looking for a worm-hole to take me back, but as all sci-fi fans know, the things that happen in the alternate world impact and influence events in the normal timeline. There is no going back, only the future you choose in the world you are forced to inhabit.

So, switch modes, back to positives, stop whining and push on. Stitches come out today! No more poking me and pulling and itching and scratching! I see a future that includes soothing lotions and chafe-resistant powders. They tell me it is good that I have so much skin sensitivity left after the surgery (as opposed to being completely numb), but the downside is that my skin feels like a constant rug-burn, like someone buffed me with 220-grit sandpaper. After the stitches go away, I can finally treat that and get some relief. My arm function and strength continue to improve and the collarbone aches and upper chest muscles are calming down too. All good.

The path report, other than being a little creepy to read, was right where I suspected it would be all along. I am thankfully a Stage Ic, on the right side of the cusp of Stages I-II. I have an appointment with an oncologist in Kingsport on Dec.10 to discuss what comes next. My histology was medium grade, medium mitosis, medium differentiation. My lymph nodes were all negative. My metastasis is X--unable to be determined. So for those of you who follow these things, I am a T1c, N0, MX. All pretty good news.

Dr. Brenin says that I am therefore a candidate for a new type of diagnostic post-surgical test called Oncotype DX. This is a test that looks at 21 different "snips" of genes (SNPs, which stand for single nucleotide polymorphisms) and is used as a more individual predictor of the chance of recurrence; also what types of chemo drugs are likely to be most effective and which ones are likely to not increase statistical chances of survival. This might be a way to better tailor a chemo regimen and assess risks versus benefits of specific chemo protocols.

Some side effects of chemo are well known and well publicized--the nausea and hair loss, for example. But the ones that scare me are the ones you don't hear about until you are forced to choose chemo or not chemo--things like neuropathy (which I already have a significant amount of from the spinal stenosis) and heart muscle damage. So much of medical treatments available now come down to a "quality of life" issue. Just how much are you willing to put up with to increase your chances of beating the cancer for good? Would I risk heart damage for a 2% increase in my chances? Probably not. For 15%? Maybe. Would I take a possible 25% chance of heart damage to gain a possible 54% decreased chance of recurrence? I have no idea right now, though I suspect these are the kind of choices I am going to have to make and live with (or not). This stuff (especially for someone who is not entirely comfortable with numbers anyway) is the real challenge of cancer.

In the beginning of this process, when I was still crying everyday, several times a day, I think I summed it up for Bill this way: "OK, so let me get this straight--they're going to surgically mutilate me, then they're going to poison me, then they're going to shut me down hormonally and then they're going to target my genes and zap those with manufactured antibodies, have I got that right????" It's truly unbelievable, isn't it? Kind of like trying to kill Rasputin--first they tried to poison him, then they shot him a bunch of times, then they tied him up and threw him in the Neva River, where he finally actually died of drowning. And yes, I feel like that some days.

But for whatever else it is, this is my life, and I still get to choose how to live it. I'm not being graceful about it, but I am trying to be grateful. It's not over, but some of the worst of it is over. It's not perfect, but it's what I've got, and I'm going to make the most of it.