Let's Go!

Let's go! This is what I imagine my dog, Zeke, saying to me after several hours of televisits from home most Monday afternoons. He will give me a look as if to say "Come.On!" 

I have felt the same kind of restless energy over the two months since I called the radiology scheduling line to set up more testing for a lump that I had started to feel. The dual antibody treatment for my stage 2a breast cancer actually rhymes with "Let's go!" and today is the day to start that treatment. 

The end of last week was incredibly challenging. One day the plan was to start with surgery, and the next day the plan was to go with 12 weeks of antibody treatment and weekly chemotherapy before surgery. The uncertainty was crushing in, and I had by this time brought core staff members into the awareness of potential schedule changes. They have been an incredible support, the best core staff we have ever had at Green Spring Internal Medicine. 

Now, at least we have about four months of lead time before surgery takes me out of commission for a month. Meanwhile, it is our busiest time of year with very little room to reduce my schedule. The need for patient care is only increasing at the practice, so we are going to try to hire another physician. 

My weekly administrative session has gotten eaten up with doctor visits and upcoming treatments. My day off has recently been the day my feelings have caught up with me. The past two weekends dragged on for so long in the waiting, trying to inform people, trying to manage my emotions. 

Having a plan has been mentally therapeutic: antibody injections every three weeks for 5 rounds, chemotherapy every week for 12 rounds, having to get a haircut in the next couple of weeks, seeing the dentist, 12 lab draws the day before chemotherapy, 12 IV sticks to allow the treatment to be delivered, taking stock of the premedication regimen that could cause me some lost sleep, looking up all the research. 

Though I am actively trying to submit to the medical authority of the expert specialists, I find myself again challenging the treatment plan. I do not want to take dexamethasone. I have severe osteoporosis already. Of course I don't want a hypersensitivity regimen to the paclitaxel, but I have already taken this drug 15 years ago and tolerated it. As it happens, there is research supporting at least lower doses of difficult dexamethasone and also research supporting stopping its use after the first 2 treatments. I am hoping this middle ground will be acceptable to the oncology team. 

Today is the day to go! I am grateful for the scientific advances in the biology of this particular type of cancer which have improved survival tremendously. Historically, even for early stage disease, 1 in 4 patients with this experienced distant metastasis later in life. How hard to have cancer hanging over one's head with those kinds of odds! After this treatment is over and surgery is done, there will be a one week waiting period to see if the cancer is entirely gone. This is called pathological complete remission or pCR. Please pray for this! If this be the case, then the chances of cure are very high, and it's possible that no more chemotherapy would be needed. I will have to continue one of the antibody treatments, though, for the next whole year. If we can just stay on track and on time, I might be through with this before Thanksgiving 2025.