I know you are all anxiously awaiting yesterday’s report. I haven’t really processed this all but here goes.
Dr. Ravi is really nice. And smart. He took time to go into great detail about the science behind my cancer and the science behind the treatment. He showed us the algorithm that all doctors at high volume centers use to determine chemo or no chemo. He let us know, quite nicely, that he doesn’t just use the algorithms, he writes them. The doctor knows the mathematics of cancer. Period. Did I mention he’s smart?
The chemo that is used to treat my type of sarcoma is harsh. The drugs are so harsh they would most likely give me permanent heart and kidney damage and give me a poorer quality of life than trying to manage the cancer if it returns. And on top of all the horrible side effects, the chemo is only 40% effective. In addition to the poor effectiveness, since my cancerous tumor has been removed already there is no way to measure if the chemo is actually working.
The theory behind a harsh chemotherapy treatment is that you try it and if it’s not working (the tumor's not shrinking), you stop the treatment so that it doesn’t damage the body further. This is not an option in my case because the tumor had to be removed to provide a diagnosis. If there was a milder chemo in pill form, he said he would prescribe that. But there's not.
So he worked through the math with us and said that in his opinion, the odds of my cancer returning is only somewhere between 10 – 20%. Not bad odds, I think, considering I was told they were 50/50 or 60/40 in January.
He said if it were his family he were treating, he would recommend no chemo. Too risky.
I’m not sure what I was looking for yesterday because I cried throughout the appointment. I cried all afternoon afterwards and I just wasn’t sure it was the “good news” everybody thought it was. I think I was hoping the doc would say that there’s this magic little white pill that will cure me and give me the greatest odds of surviving with minimal side effects. I really want assurance that I’ll come out of this fire unscathed. But for now, today, I cling to God’s promise to me that I’ll be okay. I choose to trust Him when my only other choice is to worry in fear. I choose to trust.
It was simply just reiterated that there is no cure for sarcoma. This will be with me for the rest of my life. The team will reconvene later this week to discuss radiation therapy. I’m supposed to find out Thursday. (I suspect that means I may know by next week but I’m not holding my breath.) But I’m hoping for none. I’m hoping that I hear what I heard yesterday. We’ve done all we can at this point. Those were not the words I was looking for yesterday but they are good words and today I am making friends with them. I will take them.
I think what I discovered yesterday is that there is a point in cancer when you sit in a doctor’s office and he says that there is no further medical treatment for your cancer. Sometimes people who hear that are really sick and have already tried lots of medical intervention. Sometimes they are just like me, doing pretty well and wanting to make sure they’ve done everything medically possible to fight their cancer. So even when it seems like I haven’t done much, I have to believe we’ve done all we can. Dr. Ravi reassured me that even if I went through chemo, we would be sitting in his office having the same conversation in six months. I am at the point where most patients want to be already.
He reassured me that the most important things I did to live the longest life possible free from cancer were to self-diagnose my lump, get to the doctor early and get the best surgeon possible. Surgery is a valid treatment for cancer and getting the best surgeon you can who knows the most about your cancer can be life-saving. It was for me. Had I waited another month or two to discover the lump, see the doctor or have the surgery, or even if the surgeon had left cancer behind, chemo wouldn’t be optional. Chemo would be my reality. Decreased heart function and kidney damage would be staring me in the face. Early detection saved my life. And the best news is I don’t even need more surgery. I had nothing removed but the cancer!
Dr. Ravi shared wise words with me. He told me he can treat cancer, he can manage any recurrence and he can give me the best quality of life possible but it's up to me to learn to manage the uncertainty and he can't take that away. Ever. Cancer brings uncertainty to the surface and medicine can't take it away. At all.
So for now, I’m hoping to return to MDA every three months for clear scans and get outside the two-year window. Then three, then four, then five. Once I get outside the five-year window my odds drop even lower of it ever returning. I will have annual scans for the rest of my life.
And, yes, we have a contract on our current home. We have inspections today so say a prayer they go smoothly. We are negotiating out our new home in Conroe. It will work, we are just ironing out the details right now. May 13 everything closes. Whew! Four months have changed everything! Almost.
Waiting is my new way of life. Deciding what to do in the wait will be how I live. I’m ready for marathons, moves and whatever else life throws at me!
So today I continue to live just as I have for the last three months. Only better.
“Wait for the LORD; be strong and take heart and wait for the LORD.” Psalm 27:14
“We're depending on God; he's everything we need.” Psalm 33:20