May 30, 2008

O Best Beloveds, test results are back and in Dr. W’s word, things are “worse.” Well, wait, let’s start with good news; there is no cancer in my brain or lungs. This has to count for something. There is, however, cancer again in my liver, three spots of particular note, including one that is about 2 by 2 centimeters, or about an inch in diameter, which wins for the biggest lesion thus far.

But it’s only in my liver, right? I asked, ever hopeful. No, no, there’s plenty of cancer in my bones as well, specifically, skull, back, lower back, a femur, sternum and most notably, in my right hip, a spot big enough to be “at risk for breakage.” Oh, now, cut that out! I said. I don’t have a lick of pain, even when I walk and walk and walk, so how can this be? Dr. W. thinks the right hip warning is the test reader “covering their ass,” but even so, he’s ordering an MIR to make sure everything’s sufficiently solid. If it’s not, then I get radiation there to help it heal. This is really dismaying; radiation on my right hip means radiation hitting my abdomen and, remember, long time Maladies readers, how fun radiation to my chest was? (No, really, it was fun. There were no side effects at all apart from a little reddening of the skin. I loved radiation.) Well, that party ends as soon as those rays are directed at organs with digestive functions.

But that’s borrowing trouble, and goodness knows, we’ve got enough trouble as it is. It’s unclear if the rest of the bone activity is similar to how it was a year or so ago–so small that it was like salt and pepper dusting–but the point is that there is more and new involvement in both bone and liver.

So, chemo. The good news–finally! Glass half full! I knew if I looked hard enough it would appear thusly!!–is that he’s going with the Navilbene, which to my mind is the good chemo, because there is no nausea or any other side effect, really. I mean, if you are going to have chemo, that’s the way to do it. He did hedge his bet on hair loss, allowing as how there may be some thinning. That’s better than total hair loss, but then again, I’m already vanity-knocking thin on top. Maybe the chemo will only target the follicles that are already empty and just give up rather than trying to take down any others? I know, I’m reaching here, but a scantily haired girl can hope. Navilbene is once a week, IV-delivered (through my blessed blessed port, that is), two out of three weeks, which means we are back to the whole schedule juggling if Steve and I want to go out of town, and also means that after German most Fridays I have to go have chemo, which does seem like insult to injury, if you ask me. There is a chance that this plan could change; Dr. W’s boss/partner is at that big cancer research convention in Chicago right now, and could come back with a whole brand new nifty treatment for us to try, which is why we aren’t doing anything until next Friday, since he won’t be back until mid-week. This gives the docs a chance to discuss this case and see what else they can cook up. But why the relatively mild chemo, under the circumstances? Because Dr. W. doesn’t treat off the amount of cancer, but rather off what the cancer is doing. And not only am I asymptomatic (no pain or any other distress), but also my liver enzymes are normal which means my liver is functioning normally and has not been adversely affected by this. Also, I’ve had quite a bit of chemo–you think?–and so he doesn’t want to pull out of the big guns until they are absolutely called for.

And how long? Nine to twelve months. Great. And then, assuming that the amount of cancer is considerably reduced, I either get less chemo with longer stretches in between, or he puts me on a different oral chemo, or he tries another hormone therapy.

Believe it or not, I’m not flipped out about this. It probably has to do with my own particular attitude towards life, which is that I prefer definition, decision and knowledge to limbo and liminal states. The news is really not good, but it could be worse, and at least we know and have a plan. I doubt I will feel quite so jolly after a few months of chemo (unless it really isn’t much of anything, which is a distinct possibility), but there’s plenty of time for whining then. Meanwhile, I went off the Wellbutrin a couple of days ago because it seemed to be causing more anxiety than it was curing, and am about to try Celexa, so ideally I will have some little helpers to keep my mood sunny.

Besides: “Look,” I said to Dr. W. “Fay, Nichole and I have a date to get our PhD’s together in May, 2010. Or 2011. Whenever. The point is, I’m booked. So fix this.” “We are going to fix it,” he said, calmly. Good enough.

I did want to have hair for Fay’s wedding though,