7 months (or the natural history of breast cancer)

Cancer, chemo, and chocolate chip cookies

I read something interesting this morning.  I was searching for a chart I had seen a while ago and came across an article that included data I hadn't seen before about the "natural history of untreated breast cancer," which, at least in this context, means what happens if you just leave the cancer to do what it does and don't try and stop it.  I guess I don't really need to tell you, but, as it turns out, things don't go well when you do that.

For very obvious reasons, the patients studied for this were diagnosed between 1805 and 1933.  It basically looks at women who had breast cancer before there were treatments for breast cancer.

(On a related note, be aware that the article itself is over 10 years old and a lot has changed in the treatment of metastatic breast cancer in the intervening decade, so I wouldn't actually recommend reading too much into the facts and figures quoted in the rest of the article any more than I would recommend going right now to Blockbusters so you can rent that great new movie Moulin Rouge! on VHS to keep you busy while waiting for book 5 of the Harry Potter series to come out.  Especially because the stats reported on in the article were from a time when Tupac was alive and Friends was a new show on TV.)

But anyway, I had read some time ago that untreated breast cancer patients had a median survival of about 2.5 years from the time the lump was discovered to eventual death.  Turns out it's actually 2.7 years and this article reports some more figures I didn't know before, including that women with untreated grade 3 breast cancer (the faster growing kind that mine is) lived a median of 22 months--that is, half of them died in less time and half of them survived past that point.  Also, not one of the untreated grade 3 patients was alive 5 years later.

So, I am very happy to report that 22 months from finding the lumps, for me, was last February and, I can assure you, I am still alive.  Go science.  Better living--and just plain being alive--through chemistry is at work in my life.

February, you know, was winter, spring, summer, and newly fall crisp days ago.  Also 41 blog posts of varying degrees of stress, hope, resignation, and silver-lining-searching ago (wouldn't you know it, exactly, to the very day, 22 months after my first biopsy that confirmed my stage III grade 3 cancer, I posted this stressed out little post about my impending stage IV diagnosis.  Which, quite frankly, while a difficult and unpleasant time, was still better than being the day I died.)  And, it was also lots of nice, normal, going about life days ago--which is kind of a miracle given what would have been going on (or not going on) had I been born roughly 80 years before I was.

I have more scans coming up next month that will give us a better idea of what's happening now, but at the moment I feel really good.  And happy.  And definitely not 7 months in the grave.  And for that, and every single anything I've done over the past 7 months (including the stupid things like mopping the floors and playing Plants vs. Zombies, and also the fun things like vacation days, birthday parties, and dying parts of my daughter's and her friend's hair blue, because it all works together to make up a life), I need to thank my surgeons, oncologists, and all the people who brought us some really spiffy advancements in chemotherapy, radiation therapy, and hormonal therapy.

What have you done in the past 7 months that you're glad you didn't miss?

Choices

I've been writing a lot over the past couple of days.  I'm writing, rewriting, editing, and writing again, and I'm still having trouble sorting out my thoughts here.

I read the other day about a woman who died of breast cancer.  Or, I should say, another woman who died of breast cancer.  Unlike most women, this particular person didn't use tested medical interventions after surgery.  Her cancer was stage III and also HER2+, so it was fast moving and had already gone to the lymph nodes before her surgery.  She chose to forgo chemo, Herceptin, radiation, hormone therapy in favor of "alternative therapies."

She was a total stranger who had been a regular poster on a cancer forum.  It was in one of her threads back when I was first diagnosed that I first heard of people willingly choosing to do something besides standard treatment.

To be completely honest, when I read her post a year and a half ago I was astonished.  I was only more astonished to read on and see that there were a number of people cheering her on.  I had no idea there were people who believed chemo was more dangerous than cancer.

Later I discovered there is actually a big industry of alternative providers, herb supplement makers and sellers, naturopaths, and people with little or no health background telling people how to save their own lives, usually basing their advice solely on their own thoughts about their illness and nothing more.  There's even some redneck kid who had surgery for his cancer but "knows" it was his healthy eating and multiple supplements that cured him.  Not sure how to be just like him?  No fear, he'll be happy coach you on his method for a low, low price of just $100 an hour or 2 hours for $175 (I wish I was making this up).

I speak of this in general terms, but to be clear, I have no idea who she turned to for treatment and advice or which of the 1000's of alternative options she tried.

A death brings out a lot of emotion and opinions, even in a internet forum.  People discussing the role the treatment choices made.  People who are making similar choices defend those choices, sometimes criticizing people who wonder because, supposedly, you're not allowed to wonder about choices if someone has passed away.

For the record, I disagree that talking about the choices when someone's died is inherently wrong or disrespectful.  I've been thinking about this and why I feel that way.  I think it's because, to me not talking about choices because of death seems like it tries to deny the humanity involved in that life.  We all make good and bad choices because we're human.  To deny that is to deny the truth about being human in this world.  Although of course there is a time and a place.

I'm struggling with that time and place thing.  I would never post these thoughts on the forum she frequented, nor would I engage her family and friends in a discussion about it.  But ever since I read her post about her path I've been thinking about alternative cancer treatment and people who choose it, and I'm thinking a lot about her in particular and all the issues surrounding this.  I think my own blog is a reasonable place to put down a little bit about what I'm thinking and feeling.  I hope so. 

As I go about my day, making supper, baking muffins, talking to my daughter about today's practice and what's left of her homework, I'm also thinking about the choices we each make every day.  Some we know are momentous--getting married, having children, buying a house.  Some are minor--beans or broccoli?  the black sweater or the green blouse?  Some are clearly and obviously disastrous--driving drunk, armed robbery, beating your children.  And many more choices are in that uncharted area between good and bad, choices that may be far more momentous than you could ever know at the time.  Or may not be.  These are the choices that could put you in the path of a speeding car or cause you to walk down a street and meet your future husband.  Or allow you to brush your hand against a lump in your breast you didn't realize you had.

I wonder which kind of choice her treatment decisions seemed like at the time.   In her posts she was adamant and vocal about the wisdom of her choices, certain that she had done her research and understood more than the doubters, that she was on to something ahead of the curve.  I assume those posts reflected her true feelings, but life is complicated and people are, too.

I hope she maintained that belief through to the end.  Leaving this world early is tragic, and with regrets would be only more so.  I am praying for her family and friends and wishing her joy in the hereafter.  And, like this fallen sister, I'm fervently wishing and hoping for an end to cancer.

I feel like I've only barely begun to sort out my thoughts on this.  I don't know if I'll post more on this later or not.  But I'm certain it will be on my mind for a long time.