This has been a very tricky question, which I have chosen to ignore here in my blog until I got more up-to-date data from my doctors. Read on, there’s a long-winded explanation first, but some real encouragement at the end!
From the start, my OBGYN and my three main cancer doctors—my surgeon, my oncologist (chemo man) and my radiologist, have told me we are going for a complete cure. I have better relationships with some of these people (my OBGYN and my oncologist) because I have spent more time with them and like them and feel they are telling me the truth. On the other hand, to be honest, I feel like I have barely met my surgeon yet, and when I did, I felt like I was getting a boilerplate pep talk.
Reporters are taught in journalism school, that, “When your mommy says she loves you, check it out.” So, even if I have up to five learned doctors, counting my family doctor, three of whom I really trust, telling me that I am going to get better, I will check it out.
There is lots of published information out there if you want to look for it. I and several of my friends, who also tend to be investigative-reporter types, independently zeroed in on some published data that has appeared in all the most recent cancer-patient information guides that you can find at bookstores and online. Particularly, there are charts prepared by statistics mavens and actuaries that give odds for people with various cancer scenarios.
Now, I was diagnosed with stage 3-A breast cancer. That means the cancer had spread to “several” lymph nodes, but they could not find it anywhere else, including the other breast. If you take that information and look through the books available today, you will find rough guidelines like this: a woman with “several” lymph nodes involved who gets aggressive treatment will have a 56 percent chance of being cancer-free after five years. Unfortunately, that means a 44 percent chance of not being cancer-free in five years.
This was what I found in my research. My friends who began researching the question independently came to similar numbers. As a result, a subset of my friends started talking to me and trying to prepare me for what we feared might become a rougher, perhaps shorter journey than we had hoped. In a nutshell, I have had in the back of my head this scenario: that, even with really aggressive chemotherapy, surgery, and radiation, we might not be curing me. Instead, we might only be buying me extra time. For an illustration, I thought I might in fact, turn out to be like the case of Elizabeth Edwards, who bought extra time through treatment, but in the end turned out to have cancer that spread to her bones and killed her, ultimately, a few years later.
Emotionally, this got tricky. Most of my friends, relatives, and community-wide amazing support system are with me in my “I’m going to kick cancer’s ass” mode, which I am in, myself, most of the time. But there are a few friends out there who have run the numbers with me, who know this is not a done deal. Consolidating this information in my own brain has been a process. I have personally now gotten to the point where I am not wondering if I will see the bulbs Matthew just planted bloom next year; I will. I am no longer worrying about when if I will make it to 50, a year from this July. I will. But when I stop to wonder if I am going to make it to Julia’s wedding or to hold my first grandchild, I can turn into a weeping mess of Jell-0.
So, I promised you good news if you read to the end of today’s posting. Yesterday, I had my 3rd chemo treatment, which means I am now halfway through! Yay me! In the course of that treatment, I got to have a long consultation with the good Dr. Frederick Smith. He is my oncologist, my chemotherapy guru, and one of the three people in charge of saving my life save my life, along with my surgeon and my radiologist. His is the fine art of poisoning me thoroughly every three weeks, but not quite killing me. After he answered all my lesser questions (“Can I take vitamins?” “Why are my eyes all weepy?” and so forth) I brought out my big one: Are we curing me, or are we buying me time? And do I only have a 56 percent of being cancer-free in five years?
There was kind of a two-part answer. The first good news was from the physical exam he did. He confirmed that the tumors are getting smaller. The drugs are working. I told him I had thought so, too, because they seemed smaller to me and were much less painful. He laughed that I seemed so surprised. “That’s why we’re doing all this to you!” he said. But he was clearly pleased.
The second part was when he explained the numbers my friends and I had found in the literature. He said not to apply them to myself. The 56 percent number was well, well too low, he said, although he did not give me a number with which to replace it. That new number does not yet exist. The data are being generated now.
The data that appears in the books we were reading were correct, he said, but very out of date, at least ten years old. In addition, they refer to the first generation of chemo drugs that was used. We are now using the third generation of chemo drugs, and it is thought that their success rate will be some 20 percent better. In addition, he said, surgery has improved immensely over the last 20 years.
My husband, John, who was sitting there, is a trained actuary and statistician with degrees in the fields from University of Cape Town and Oxford University. He made the point that the numbers also included persons plenty older than me, who may have had other major illnesses such as heart disease and diabetes, whose results would have skewed the whole thing but was not obvious from the way the data were reported.
So I asked Dr. Smith if we were just buying me time, or are we trying for a complete cure?
“Cure,” he said, almost belligerently. “We’re PLANNING on it!”
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