Preparing for chemo

Short version: I’m feeling good. I have reduced (but better than “normal”) range of motion in two directions for which I have started exercise therapy. I will start chemo this Thursday. I will have a treatment every 2 weeks for 16 weeks. I expect to lose my hair, and may experience a range of side effects that vary, sometimes significantly, from one patient to another. I’m going to keep working.

Long version: We had a very informative meeting with the oncologist last Thursday, I’m glad to report. He spent over 1 1/4 hours with us. He reviewed the salient characteristics of my cancer, then logged on to a tool for medical practitioners called Adjuvant Online, where he entered the key data elements. The model predicted the probability of no recurrence within 10 years given selected treatments or combinations of treatments based on a large volume of case data. It is unfortunate that the model does not include like data on the benefits of naturopathic or alternative therapies. (It also predicted probability of being alive after 10 years, but we didn’t spend a lot of time on that.)

The probability of no recurrence over 10 years with no additional treatment (except radiation, which is assumed, given that I had a lumpectomy) was 39%. Adding chemo only, it goes up to 61%. Adding hormone therapy (Tamoxifen or aromatase inhibitor) only, it goes up to 64%. And adding both chemo and hormone therapy, it goes up to 78%. Jerry and I had done homework in preparation for the discussion and asked lots of questions, but as much as I don’t like the idea of chemo, the numbers were too compelling to ignore. I opted to do chemo. The drug combination that I will receive is called ACT or TAC. I’ll have four biweekly treatments of Adriamycin+Cytoxan followed by four biweekly treatments of Taxol over 16 weeks. All of my treatment will be done at the Navy hospital. After the ACT is complete, I’ll have a radiation treatments 5 days a week for 5-7 weeks. Then I’ll start a 5+-year program of hormone therapy.

There is a lengthy list of potential side effects (not unlike the list on about any prescription medication) which I won’t recite but many of you will have some idea of. I’m told that no two folks react the same, so I’ll have to see for myself which ones I experience. Yes, I will lose my hair. I’m assured by many that there are great anti-nausea drugs now! I’m hoping my otherwise good health will hold side effects to a minimum.

Tomorrow morning, I will have a test that will establish part of the baseline for monitoring as chemo progresses. Thursday morning, I will have a port inserted through which blood will be drawn and chemo administered and that will remain in place until the chemo part of the treatment is completed. (I’m very glad that they won’t be probing for a vein every two weeks, as that is always a hit or miss thing with me — usually miss.) And following insertion of the port, I will go straight to oncology for my first dose of chemo. Wow. My plan is to have treatments on Thursdays to minimize impact to my work schedule.

On an entirely positive note, we also met with the physical therapist on Thursday. She measured my range of motion. Three measurements were already normal. The other two need work, but are ahead of the usual curve at only 4 weeks after surgery. I’m doing exercises at home and will continue to consult the therapist and increase my exercise until I return to full range of motion — and golf! Yea!!!!!

I’ll keep you posted on developments.

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