Treatment Update!

Well, today was a big day in terms of continuing cancer treatment fun. A very big day!

I finally went back up the mountain to Paradise, to the Cancer Center at Feather River Hospital. It's somewhat fitting, since this is where is I started this whole journey, heading up to Paradise to get myself enrolled in the BCCTP plan that is covering so much of this whole mess.

It's a gorgeous campus, with big trees, a "healing garden" and a gigantic fish tank in the lobby of the cancer center.


The healing garden was lovely in August. I'm not sure if it's even more beautiful now, covered in snow. Yes, boys and girls, I got to stomp around in the SNOW today!! I'm looking foward to going up there 5 days a week for 5 weeks.........ok, I'm NOT looking forward to doing it for so many trips, but I am looking forward to the drive for the first few drives, and I am really looking forward to the fact that it will be snowy for at least some of of the time. It's a good thing I have 4WD, huh?!

Ok, so now for the part I'm stalling over, because many of you are going to have very strong opinions about it.

Here is the gist, and I will follow with explanations:

• I am having external beam radiation treatments, 15 minutes per treatment, 5 days per week, for five consecutive weeks, starting on January 5. (If all goes as planned.)
• I will be having chemotherapy, a medication called cisplatin, one dose of 40 mgs per week, given concurrently with the radiation therapy.
• After external beam radiation is over, I will have internal brachytherapy, which (as I understand it so far, which is only a little) seems to involve a little plastic cylinder placed in the vaginal canal, and the radioactive "seeds" or rods are fed through some sort of tube up into the cylinder. Those are left in place for some period of time, which might be a hour, or might be two days, and I have no idea yet. That will be done down in Chico, and is an entirely different set of doctors at a different facility, so I'll learn more about that soon.

NOW, on to the thing everyone wants to know: WHY am I having chemo?

Ok...The doctor today, Dr. Barclay, who is the radiation oncologist, tried to explain it to me, and I will try to explain it to you all, but bear with me, because this is all new to me too!

First of all, it seems that I definitely didn't understand some things about how all of this works. For one, at this point, there isn't a question of X% vs. Y%. As I understand it now, by having the radiation therapy I decrease my recurrence rate from 15% to 10%--we knew that. What I didn't know before, was that (again, as I understand it now) at this point, when they do the radiation; when you make that choice to have the radiation and try and decrease that percentage, you have to do the chemo at the same time. It's a package deal.

The drug in question, cisplatin, is a relatively "mild" form of chemo--as chemo goes. Yes, there are still nasty side effects, and YES, I will be losing my hair. BUT, it apparently does what is referred to as potentiation of the radiation induced cell-killing.

Potentiation:

1. The ability of a substance to increase the toxic effect(s) of another compound.
2. an increase in activity or effectiveness; an interaction between drugs that results in a synergistic effect.
3. The action of a substance, at a dose that does not itself have an adverse action, in enhancing the harm done by another substance

Alrighty then. I had to look that one up. The cisplatin seems to have a biochemical effect on the cellular components that inhibits recovery of radiation-induced damage. Several studies I was checking out online show a dramatic increase in survival rates (30-50%) when post-surgical treatment includes cisplatin along with radiation.

So, to sort of restate it, as I understand things, there is very little point in doing the radiation if you don't do the cisplatin--the radiation doesn't give you enough of a benefit without the addition of the cisplatin to really bother with the whole mess in the first place.

Now comes the part where a lot of people email me or leave comments here asking me why in the world I'm willing to go through with the chemo for what might seem like a small increase in my odds.

There is no easy answer to that, and I'm not sure I can explain my reasons yet. I am working on that, and it may take me a little time to be able to articulate it, but I have said from day one that I will do whatever it takes to beat this evil little nastiness and so far, it seems like the right decision. All three of my doctors, Dr. Pisani (the surgical oncologist), Dr. Barclay (the radiation oncologist) and Dr. Mazj (the medical/chemo oncologist) are in agreement that this is what I need to do. And, Dr. Mazj is supposed to be "the" best chemo guy north of the Bay Area, and does not take new patients. However, Dr. Barclay walked upstairs and had a chat with him, and Mazj said to get me on his schedule immediately.

So that is where I am right now, this minute, at 9:08 pm. I have had a hellish day, with my stomach acting up very badly, to the point where when we arrived in Paradise, and the snow was falling, I was too busy barfing into a bucket to watch it. Yeah, one of those days.

On Wednesday morning, I am to be back at the center for a simulation and positioning appointment. This involves finding me a comfortable position, building some sort of Mythbuster-esque vacuum-formed mold of my legs and lower portions to hold me in precisely the right position for treatment, a CT scan, and of course, the positioning tattoos so that they know where to aim the beams.

I asked, the tattoos will be tiny dots, and they cannot do stars, hearts or tiny flowers. Bummer.

So, there will be more on all of this when I feel a hell of a lot better. All I want to do is sleep right now.

I have a LOT of reading to do on this course of treatment. They sent me home with a pile of goodies to read, and I want to do some more research online. I have a lot to learn, but I feel that I've made the right decision for me, although I realize some of you may disagree. You can certainly disagree, but you also have to respect my decision and where I'm at right now and disagree politely, please.

I have very little time to get my lots of reading done, and somehow have to get an entire family's worth of presents wrapped too. It's going to be a busy week....

Treatment starts the first week of January.