Indolent Cancer
7/30/08

That's how Dr. Waisman described it today, O Best Beloveds, which tickled us no end, and, I think you will agree, justly so. The point is this; however much cancer I have now (the amount unknown until I get scanned again, probably next week depending on scheduling), whatever is there isn't doing anything of consequence, yet, anyway. "You aren't yellow," Dr. W. said, ticking off undesirable symptoms, "You aren't in pain, you don't have regular nausea or vomiting, no weight and appetite loss [actually a little of both, but nothing of real note], you aren't overly fatigued, your liver enzymes are normal so your liver is functioning normally." It's just, you know, cancer. So that's what they call it, I guess; indolent cancer.

But it is, you know, cancer. And this meeting was to discuss this, and how the field has changed again. No longer do I have a super responsive cancer, that is easily (okay, with lots of effort and whining) taken down. It's now rather like those insects who survive pesticides and continue to thrive. It's not that Dr. W. (or Steve and I) are giving up; far from it. He's got more chemos in the pipeline (more on this in a few lines) and he is optimistic about the chances of the upcoming one getting me into remission again. But it's that all along, particularly these last almost three years, I've been tootle-ing along, doing my thing, as well as chemo; traveling to Egypt and Estonia, working on a Ph.D., writing books and food porn. That may change, he said; because the cancer, indolent though it may be, is more aggressive, it may take more aggressive treatment to get me back into remission. The party may be, if not coming to an end, severely curtailed.

This, of course, isn't fun news. But then again, I'm the one who spent a year with a full class and international and domestic travel load during two different rigorous chemo combos, so piffle, I say. But the problem isn't emotional (blithely says the girl who has been spending a great deal of time of late grinding her teeth and popping anti-anxiety meds, but pretend with me for a moment, 'kay?), it's physical. My body (yeah, I said "my" body, all you non-dualists out there) can only take so much. It's going to get more tired, it's going to have bad blood counts and react to bad blood counts with more bad blood counts. And so on. And that's not even discussing what happens if this next chemo doesn't work. (More chemos, each with a little less proven of a track record, in case you wondered.)

So Dr. W. said, "And here is where I have to tell you that you are welcome to get a second opinion." Thanks, but no, we said. For one, it's plain exhausting just thinking about doing that. For another--there just isn't anybody better out there. And for third, all anyone else will do is say, for example, Zoloft instead of Celexa, and the rightness of that can't be proven until we try it and all that gets us is where we are now, except with someone we don't know and love and trust.

Meanwhile, I said something along the lines of "But we will have plenty of warning if things are starting to go badly, right? I mean, it's not like it's going to happen over night or anything?" Absolutely, he said, plenty of time. "Great!" I said, thinking about dissertation deadlines and also because I don't know when to shut up, "Like how long?" Months!, he said.

Oh, hi, MONTHS? Like, not YEARS? It could change from indolent to a Protestant work ethic THAT FAST? Forgive the excessive caps use, Beloveds, but jeezum crow. I'm going to be checking my palms against a banana every five minutes from now on. (I remain exceedingly pink at this time, I am relieved to observe.)

Well, that's enough of that. Here's the plan; Doxcil, which as I mentioned before is very well tolerated; no hair loss, no weight gain, controllable nausea, but hand/foot syndrome, though not as bad as on Xeloda. It's only once a month, which is nice and convenient. Unknown how it will effect me over time; as always, he's had patients on the stuff for years with no problems, but whether that's me we can't know until we get there. Plus, of course, I'm going to have to be on it for a long time, probably, because it's a long way from tumor markers of 1043 to normal markers of 32. I was all for just hooking me up and starting today, but we have to wait until after the scans. The scans won't change a thing--he knows there's nothing seriously amiss, no matter how much cancer there is, thanks to above list of non-symptoms, but he wants to know exactly where we stand before we start.

Now, some food porn to relieve the tension. The night before I started Navilbene, we went to a brand new--like only a few days old--restaurant in Echo Park called Lot 1, and had some righteous seared pork belly by way of marking the start of whatever it was we were about to begin. Not to mention marking the start of a fine new local restaurant. Now, less than three months later, the chef is leaving and the menu is changing completely in two days, so we went back and had some righteous braised pork shoulder, tender yet assertive, dappled with sweetly carmelized kumquats, and sitting on a bed of cream of wheat (Yes! It's like white polenta! Only it's...cream of wheat!). I do like my porky symmetry.

Hardly working but trying to work harder than my cancer,

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