Saturday, August 2, 2008

A Day Spent on the Interwebs

Wow - lots of info on breast cancer but there sure aren't any answers are there? I've been asked to participate in a trial study (IRB# 06-090; TAC vs. TC for Adjuvant Breast Cancer Treatment). TAC and TC are types of chemo. Adjuvant Treatment is a form of treatment added to the primary treatment to keep the cancer from returning. The primary treatment for breast cancer is the surgery to remove the tumor. Cancer is sneaky though and can return even though the tumor has been removed. There are two types of adjuvant treatments - local and systemic. Local treatments are geared towards the area where the tumor was initially found - in my case since I chose a lumpectomy rather than a mastectomy I will have six weeks of radiation. Unfortunately (it's interesting how often that word is used when reading about cancer treatments) surgery and radiation do not guarantee that the cancer cells were completely removed. Some cells could have been left behind in the surgery area (which hopefully - another word I've seen a bunch - radiation will take care of ) or some may have broken off and traveled to other parts of the body though the blood stream or lymphatic system. These cells can lay dormant for awhile and then start growing again. Systemic treatments will hopefully (there I go again) take care of these. The oncologists looked at all of the results of the tests done on my tumor. I think it was mostly because of the size of the tumor (2.9 cms) that systemic adjuvant therapy was recommended to destroy any cancer cells that may be lurking throughout my body - in this case chemotherapy and hormone medications. Cancer cells are fast growing cells and the chemo drugs find these cells and kill them. Unfortunately (see there it is again) there are also other fast growing cells that are "good" cells in the body. Chemo does not distinguish between the "good" and "bad" cells and will also destroy both of them - such as hair cells and the cells that are found in your mouth. Fortunately (hey we like that word!) the "good" cells don't die off forever and will grow back while hopefully (!) the cancer cells will all be killed for good.

My oncologist asked me on Tuesday if I would be willing to participate in a clinical study of two different types of chemo drugs. TC has been used for awhile now and has been shown to be effective in case such as mine - low grade (II), early stage (II), estrogen/progesterone receptor positive, Her2 negative, etc. etc. etc. TAC is a newer drug that they are testing that has shown much promise. My medical oncologist pointed out that the treatments that are available today for me were tested by the ladies who have come before me. I initially thought that maybe one of the good things that might come out of this is that I could help those that come after me. (Never ending cycle it seems). But, he pointed out that the patients in the study are very regimented. For instance during chemo a shot is given afterwards to help keep the number of white blood cells up to healthy levels. This shot has to be given to a clinical study participant the day after chemo - while if I'm not in the study he would be able to give me the shot the same day of chemo. This would save me another half day missed from work and a three hour round trip drive. It was later pointed out to me that patients on TAC also have an increased risk of heart problems. It's been a tough decision (almost harder than the decision to have chemo) but I've decided not to participate in the trial study. My thanks go out to the ladies who have gone before me and I would love to help those coming after but I really need/enjoy my job and worry I will miss too much work as it is. Also, with the heart disease that runs in my family I worry about that side affect also. sigh.... nothing is easy about this.
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I'm getting to learn all sorts of new words. None of them are much fun - febrile neutropenia (fever and drop in white blood cells), alopecia (hair loss), stomatitis (inflammation of the mucous lining of any of the structures of the mouth), leukocytopenia (low white blood cell counts), skin toxicities (just like it sounds), invasive ductal carcinomas (what I had), dosimetrist (runs the radiation equipment and helps calculate dosages with the oncologists), and I won't even start listing all of the drugs out there. Not really enjoying the new words - none of them sound like fun.
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On another note - watched "Resident Evil: Apocalypse" today. Nothing like a good zombie movie to put things into perspective!

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