Better Living Through Chemicals

Met with my oncologist this week (accompanied by another wonderful, patient friend), but first spoke to her very bright resident, who presented me with a problem: although I had pretty much decided not to have a biopsy of my spine and to go ahead with chemo, she recommended having one done because the presence or absence of bone metastasis would determine what kind of chemo regimen would be called for. In her view, it was better not to use the most powerful chemo agents if there were no bone mets, in order to save them for my arsenal further down the road. Her compromise was to leave the spine alone so as not to screw it up for the later surgery, but to order a biopsy of my ribs.

Then my oncologist came in and said that I should have my spine repaired first, which sounded crazy. Isn't it more important to kill the cancer first, I replied -- it could be months before I'd even get spine surgery booked!

OK, she said, then we'll do the chemo first. I pointed out that her associate recommended doing a biopsy to determine which kind of chemo to pick. But Dr. Lee (I'll call her that because I once called her that in an article I wrote) disagreed; she felt "in her gut" that we should be throwing the toughest possible chemo at me now rather than later. Maybe she feels this in her gut because she didn't throw the tough chemo at me five years ago. In any event, I guess I am going with Dr. Lee's gut instead of a bone biopsy. I have to admit that I think I have cancer in my ribs. I don't know why I think that, but there you go.

I did protest that the clashing opinions were confusing me, but the resident deferred to Dr. Lee, of course. So the upshot of our typically circular conversation is that I'm going to do the tough chemo starting next Tuesday. The combo is called FEC-D, which includes three injections of three drugs (FEC) followed by three injections of one (D):

F = Fluorouracil
E = Epirubicin
C = Cyclophosphamide
D = Docetaxel

I took the F and the C last time, but the other two are new to me, with possibly stronger side effects. I think there is also a certain increased level of deadliness when these drugs are combined.

My patient navigator sent me a pdf of a very good handout from the B.C. Cancer Agency on how this regimen works and what the side effects are.

The injections will be three weeks apart for a total of six mornings in the hospital over four months. After that I may have radiation to my armpit every day for five weeks (something Dr. Lee frowned on last time I saw her but now seems to think is a good idea -- we'll see what the radiation oncologist says tomorrow).

As for my back pain, it has shifted again; the shoulder-blade pressure seems to have decreased (maybe my armpit is starting to loosen up) and the spine pain is worse, along with the pressure on my stomach and the indigestion and heartburn. I feel as though someone has impaled me through the sternum. I've had this gastro stuff on and off since September and it's really bad today; makes it hard to eat. It actually feels much like the gastro symptoms I had during chemo five years ago. So I'm a little worried about going into chemo next week feeling like I'm already on chemo...

Pollyanna moment: Last night a bunch of former coworkers came over; we hadn't all been together in a long time, and it was a riot. The younger men brought me a gorgeous big bunch of pink tulips. We ordered Pakistani food from the place down the street and laughed our heads off, and I was able to sit at the table fairly comfortably.