The roller coaster ride that is referred to in cancer treatment has peaked and is plummeting on a downward run. While I referred to Tarceva recently as a miracle drug, it may not be working that miracle for me.
We met with the doctor yesterday for review of the scans performed earlier in the week. After earlier signs that were very optimistic, the news this time was not what we had hoped for. While the spots on the brain have remained stable after initially shrinking by half and other spots on the liver and lymph system have disappeared, the primary lung tumor was “showing more activity” and there were new spots on the pelvis. Patients often develop insensitivity to Tarceva, but it is usually after years, not months.
Both Gary and I received this news with shock and dread. I’ve been feeling so good physically and emotionally, it is hard to take in the information that my body has been heading in a different direction. The path I was on felt so positive, I was winning. And then the doctor’s voice pulled me up short and reminded me that we may be in control of a great deal of what comes our way in life, but we are not in control of everything. Is it Fate? Genetics? A test? The Grand Plan? Or maybe just life handing us something that we will need to cope with as best we can.
We do have options; I like to think that we always have options. Chemotherapy can be combined with the Tarceva for a stronger punch. The side effects would be more challenging to manage, but it might slow the disease process. Another option could be entrance into clinical trials for drugs that are in the process of entering the market or are in developmental stages. We focused on this after my oncologist indicated it would be the choice he would make for himself or his mother (I use to ask what the male doctor would choose for his wife, but as doctors become younger … I now substitute “mother.”)
I know very little about clinical trials, but I do know that my insurance does not cover them and none are local. Since they are considered “research,” as opposed to tried and true treatments, any expense would come from my pocket. This not only includes the cost of the actual treatment, but also the associated costs of travel to Boston, where Massachusetts General has a highly respected program or the equally highly esteemed Mayo Clinic. How do you make a decision balancing unknown risk and expense with the potential for greater reward?
We meet again with the oncologist in two weeks to decide on a plan. Today the plan that feels right is to take on the risks and see if I can be accepted into a clinical trial.
There are all kinds of lessons here. I so believe in optimism that the possibility of “Don’t get your hopes up.” offends me to the core. I will continue to hope for the best possible outcome and will expect good things from this life. When faced with challenges, I do think we need to explore the choices we have, sometimes looking long and hard to make sure we don’t miss any options. We need to weigh the pros and cons. We also need to talk with the experts and seek advice from them, but not to blindly accept that advice if it doesn’t fit for us. Search your soul for the right direction.
My next two weeks will be spent in deep soul searching.
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