Choices

Being diagnosed with cancer brings all sorts of choices into your life.

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The first choices are what to do for "treatment". I guess one choice would be to do nothing. Or another would be to avoid mainstream doctors and do non-traditional treatments. Or do both conventional and holistic treatments. One thing you learn fast as you try to choose what to do is that there are very few "if then" statements in cancer "treatment". It would be great if a doctor could say "if you do this then you will be OK" instead you get a lot of "if maybe then" statements "if you do chemo, maybe then you will be OK". I've been reading a couple of the breast cancer message boards since I was diagnosed and women really agonize over their treatment choices. Once you hear the words "it's cancerous" your choices are many and all of them suck.

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Once you decide to go with mainstream treatments, your first choice is what type of surgery you want, lumpectomy or mastectomy. With a lumpectomy comes radiation also. My doctor told me that my survival rate with both is about the same. I'm not a big fan of hospitals or doctors or pain so I naturally leaned towards the lumpectomy choice. It is less invasive with no extra reconstruction surgeries needed. I also was pretty sure it would be cheaper which when your life is on the line seems like a stupid reason to not do something but I'm guessing money plays a big role in a large percent of treatment decisions in the US. Christina Applegate on the other hand chose to have a double mastectomy based on her family history and results of DNA tests she took. I'm sure many other things went into her decision also that she hasn't shared with the general public. Now did either of us make the right choice for ourselves? We will never know. Even if we have a recurrence or if we don't have a recurrence, who is to say it would or wouldn't have happened anyway.

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Now if the cancer is caught early, there is no sign of it having spread, and test results come back favorably then the surgery / radiation choice might be about it for treatment decisions. Then there are all sorts of post cancer lifestyle decisions to make but that's a whole other topic. Hopefully I'll get to that point and we can all have a discussion about my aversion to veggies.

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But for me and for many like me, we are given the choice of undergoing chemo. While in the end this wasn't a hard choice for me, it was an agonizing choice. The list of possible side effects to chemo is really really long and has nothing good on it. In fact when you start chemo they have you sign a release that has the line "I understand that it is not possible to anticipate all side effects." It then goes on to a list of the worst side effects it can cause up to and including death. It also says "I understand that no guarantee or assurance has been made as to the results of chemotherapy and that it may not cure, control or improve this condition". So, not only can the treatment kill me, it might not even help me with the cancer thing at all. What kind of choice is that? Angel Nurse Nancy told me before the first meeting with my oncologist that he would be giving me a rate of survival percentage if I do chemo. She said that I needed to decide at what percent I would or would not do the treatment. Well, when you haven't had chemo before and have only heard about how hard it is plus knowing it might not help at all, it's hard to make that decision. I tried to decide at what percent I would not do chemo. 20%, 15%, 10%, 1%, .1%? It's your life you are deciding upon. Well, I love my life (but really so does everyone else so I'm not saying if you chose not to do chemo that you don't love your life but that's how I saw it for my decision) and I having not been in chemo before I couldn't imagine it would be worse than dying so I made the personal choice that unless he said chemo would not help me at all I was going to do it. Well, my percent came out at around 10%. If I was to undergo chemo treatments my odds of having the cancer return would be cut by 10%. That number seemed huge to me - of course I would take 12 weeks of chemo over increasing my chances of a recurrence by 10%. But that was me. For the pain, cost, time, and all the other bad things with it 10% might seem like a small percent to others in my position. Now that I am half (!!!) way through chemo would I make the same choice? You Betcha!! Six weeks from now or if the cancer does come back, will I still say that? I don't know. I've read about many many women who have had a higher percent than that and not do chemo and I've read about many many women who have had lower percents and did do chemo. Once again will any of us ever know if we made the right decision? Nope.

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Is any decision that we truly believe is right for us the right one? Yep, I believe that is true. I though have been (I hate to use the word lucky or blessed when it comes to my cancer so I just say) I have had it better than some women in that my decisions have been pretty clear cut to me so I haven't spent much time second guessing my choices and if I stay healthy I won't ever have to but so many cancer patients out there have many more gray areas in the treatment choices. I would think it would be very hard to not sometimes think "maybe I should have...........". Once again when it's a choice that has to potential to be life or death - yikes - no one wants to be in that position.

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One "if then" statement I have heard from a doctor is "if you get chemotherapy, then you will lose your hair". Yep - as you can see by the picture I've lost my hair. Another choice that is discussed on the message boards is how to deal with this. It seems like wearing wigs or scarves has been the first choice of many. I've seen many women - especially the younger ones - go with my choice though, just going around bald. I just hate having things on my head but I hate looking like this. In the end I went for comfort instead of vanity. Most of the time when I am out around strangers I have worn a scarf or hat but today I just went to town au naturel. Heck it's Breast Cancer Awareness Month and what says breast cancer better then a pink ribbon? Yep - a bald "cancer girl" walking around. I'll scare women into doing self exams or getting a mammogram. Pink ribbons make breast cancer seem pretty and feminine - I've learned it is more like putrid green, pain, and swelling. So, I'm just a walking public service announcement for early detection. Side note and another possible blog topic - why is there so much focus on early detection and a cure but hardly even talk of prevention?

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There is one choice I have to make daily though - it's a hard one and it's a very important one that effects my entire life. When I first wake up cancer is not the first thing I think of - I usually have a few seconds of being my old "normal" self. When I do remember it still takes my breath away and not in a good way. I think if I was standing up when I remember, it would take me to my knees. It's that unnatural and disturbing to me, it still deosn't seem real. Right then when it hits I have to make the daily choice. How am I going to handle having cancer today? I could crawl up in bed and not leave it and be all "woe is me". I could be angry / anguished and all "why me?" and take it out on all those around me. I could try to ignore it and shut down, not letting anyone in or showing any emotion. I could be full of dispair and think that I am going to die from cancer. Or I could chose to live life as fully as I can within the physical restraints I have right now; laughing as much as I can, not letting the little things get to me, enjoying the people around me, being thankful for the support I am getting, smiling at my bald self when I catch a glimpse in a mirror, loving my dog, enjoying the sound of the wind through the trees, chasing the ravens out of my yard, having some steaky goodness, reading good books, and just trying really hard to find the positive in the situation I find myself in. OK - so it's not really that hard of a decision for me but I can see how others in a similar physical situation but in a different life situation would choose one of the other choices. Who knows as I get further into my new life with cancer I might pick another view on my day / life and that would be OK but I hope I don't.

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We all make the choices that we think are right for us and we hope we get the chance to live with them.

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PS - one more item for my "Thank You For" list. Thank you for making fun of my baldness (Charliiieeee). I appreciate everyone who says I look good bald. I know though that you are just trying to be nice. Which is nice but I know better and it was great to have someone finally tease me about it. It's the little things...........

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PS again - I just got fabulous news! I hear there's going to be a new baby in the family! WooHoo. I am so so so happy for you two! Now my hair will have to grown back. It's bad enough I scare stranger's kids with my Uncle Fester look, I can't be scaring my cousin's child. Yet another way that Life is Great!