I had my first date with
Bachelor Oncologist #1 today. He asked me lots of questions about myself and my interests and then we had some scintillating repartee about all the things he could do for me. Then we had a lovely dinner and saw a movie.
Okay, it didn’t go quite that way, although he did ask me lots of questions about myself and my health history and cancer experience. I felt like the whole visit went really, really fast. I didn’t feel like he was rushing me, but there was just so much information to take in and I kept feeling like I couldn’t write fast enough and at the same time process everything he was telling me. Randy was with me, so at least there was another pair of ears there. I asked the doctor if I could record our conversation, but he said that his lawyer recommends that his patient conversations not be recorded. (His lawyer, I suspect, is his brother, who is a litigation attorney in Chicago and also, coincidentally, a Loyola Law School alum.)
I don’t exactly have a treatment plan…or rather, I have a treatment plan but it’s just the barest outline of one right now. I will skip some of the details here in the interest of your time and internet bandwidth, but if you have specific questions feel free to ask.
Basically, Oncologist #1 thinks that my case indicates a common chemotherapy treatment of Adriamycin with Cytoxan (“AC”). (Unfortunately, I have now added those two words to my word processor’s dictionary.) This regimen typically starts four weeks after the last surgery, which for me means right around the end of June. My tumor was negative for both hormone receptors and HER-2 (this is good!) which means that another common chemo drug, Herceptin, is not indicated. (That’s good because Herceptin is commonly prescribed indefinitely.) The AC is administered intravenously once every three weeks for four administrations. That part of treatment, therefore, will take about nine weeks.
There are side effects to these drugs. As expected, I will lose my hair. The Adriamycin can cause heart problems and the Cytoxan can cause bladder problems. The drugs can also cause nausea, mouth sores, fatigue, and low white and red blood cell and platelet counts. I have to watch for fever, which combined with low white blood cell counts can be the sign of a bacterial infection and requires immediate hospitalization and treatment. There are various medicines that can help with the mouth sores and nausea, for example, but in general none of this sounds like very much fun. I may have none of these side effects, or many of them, but will probably have at least some of them.
Oncologist #1 also thought that radiation may be indicated in my case. I will be making an appointment with a radiation doctor to talk about the possible radiation treatments. It sounds like my choices might be to start a two-week radiation treatment before chemo begins, or to do one after chemo that takes six weeks. I will know more about that once I’ve seen the radiation doctor.
I also spoke with him about genetic testing. It is much more complicated than I originally thought because there are many difficult decisions that flow from the results of genetic testing, such as decisions about whether or not to remove your breasts and/or ovaries. I will be revisiting those subjects soon, but first I have to wrap my mind around the rest of this information.
At the end of the appointment, the doctor asked me if I had thought about getting a second opinion. I told him that I already had an appointment with Oncologist #2 and his reaction was quite heartening. He obviously respects this doctor and basically said that he would agree with whatever she said. That made me feel like I definitely chose the right person for a second opinion. That appointment is set for a week from today.
Next steps: Other than the second opinion, in the next couple of weeks I will see a radiation doctor and get an echocardiogram to make sure my heart can take the Adriamycin. I will then return to Oncologist #1 in two weeks and we will determine the exact plan of attack, including when, where and how. I will also begin to think about genetic counseling and depending on how I’m feeling about everything else I might make an appointment with a genetic counselor.
I am feeling pretty overwhelmed by all of this information right now, and I am just trying to figure out what it all means, how it will all work, and how I can fit it all into my schedule. I’m still not exactly sure what this means for my class schedule or how much help I may or may not need. Those might be questions that I will only be able to answer with time and experience, however. I’d prefer to have it all planned out, but I’m learning very quickly that I don’t really get to plan any of this out. Cancer, apparently, pretty much has its own schedule and as much as I’d like to be, I am not the boss of it.