Posted by: cg00n | November 28, 2011

Chemo on the horizon

On Friday I went to see Dr. G.  This was essentially a followup visit.  We talked about all the lumps removed during the last year and he examined my latest scars.  In the process he found another new lump more or less in the middle of the cluster of previously excised ones.  Much to my surprise he suggested that we talk to Dr. D about starting a course of chemotherapy.  Further discussion convinced P and I that this is probably a sensible move but his suggestion has certainly rattled my cage.

Why chemo?  Why now?

As I mentioned in an earlier posting, I’m running out of skin in some parts of my leg.  Taking out the new lump may well involve a small skin graft and, as Dr. G pointed out, if we can find a lump now it is very likely that there will be more that we have yet to find.  Trying chemotherapy now, while it is not urgent, serves two purposes:

  1. it may prevent unnecessary surgery
  2. we find out whether or not I respond to the drug.

“The drug”, in this case, is likely to be dacarbazine which is quite an old treatment for melanoma.  It is well-understood, well-tolerated and effective in about 18% of  patients.  Here in Canada the health care system won’t consider giving me any of the newer drugs until the older (cheaper) ones have been shown to be ineffective.  However, until the new drugs got regulatory approval here the only way to get the newer drugs was to enroll in a clinical trial and using dacarbazine would  likely render one ineligible for the trial.   So now is probably a good time to try the experiment.  If it works, I win.  If it doesn’t we can still cut the lump out and graft over the wound and we will be able to move right onto the newer drugs when it becomes necessary.

All sounds very sensible, doesn’t it?

What’s not to like?

It is amazing what I can get used to.   Finding a new cancerous lump on my leg, having it cut out and stitched up, caring for the wound for a couple of weeks and then having the stitches out are all just part of my ongoing existence.  Three years ago I would have been horrified at the thought of having to go through all this on a regular basis but now, no problem.  I could keep this up until they’d whittled my leg down to a peg.

Chemotherapy sounds like kicking the whole game up a notch.  It isn’t really, as any rational person can tell instantly.  Regrettably I am not as rational as all that.  At least, parts of me are not.  I haven’t actually suffered an anxiety attack but I have certainly been feeling a bit tense, my heart rate is occasionally higher that usual for no apparent reason, my mouth is a bit dry and the butterflies in my stomach take flight from time to time.  That’s the worst of it.

This minor mental meltdown has the positive effect of getting me to do more work on myself.  Having my cage rattled is probably a good thing from time to time lest complacency sets in and I start taking the good times for granted.  This last few days I’ve been re-reading my notes from the course I took late last year, listening to a bunch of talks about mindful ways to cope and really working on my meditation practice.  It’s all good stuff.

Two realizations hit me in the middle of all this.  The first (call it a failure of imagination if you like, but…) I can’t think of any future diagnosis that would hit me as hard as the one that put this whole show on the road.   The first few days after that were just awful.  That’s a comforting thought:  I have probably dealt with the worst part of my illness already.  Unless you count dying, I suppose.

The second is that I think of myself as a fixer:  it’s what I do, it’s who I am.  I fix things.  Unfortunately, the disease I’m dealing with is not fixable, certainly not by me.  I believe this is one of the reasons I have so much angst.  In order to stop suffering, in Buddhist terms, what I need to do is to let go of this part of my self-definition.  Easier said that done but at least it is something else to try.

News.

Not worth calling this a roundup since there’s only one noteworthy item.

Ms. S.L of Calgary pointed out ACT, another mindfulness-based approach to mental well being.  P is reading a book called The Happiness Trap which is an introduction to the therapy.  It contains much that we have both come across but also some new information and a whole new way of talking about the subject.  It is, in P’s opinion, a good book, well worth looking at if you’re interested in mindfulness.  From my perspective the timing could hardly be better!

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Responses

  1. I’m sure you already know this but it bears repeating, I think. My thoughts are with you.

  2. As much as the new step is causing stress, I think you should give yourself major kudos for being able to say “I could keep this up until they’d whittled my leg down to a peg.” That’s massive growth (well perhaps not for the leg). And given some time to process the new world that may involve Chemo, I think you’ll be able to process it into a new norm too. 🙂 Thinking good feelings your way as well. ❤

  3. This morning I was talking to a nurse and PhD candidate who works with cancer patients. Their caseload is significantly larger than ever before because so many of their patients are “living well” past their “best before” date! But they still have the disease. Your oncologist and people like Ian might be the best people to give you advice. Ian has been in that place where taking one meant being disqualified for another. Previously I was not as aware that this was part of the crazy making of cancer treatments. Of course the researchers have to set and follow strict criteria for each trial. Those with cancer just want their best shot at health and wellness. They want the buffet of drugs to be available when needed. I agree it is remarkable that the melanoma is staying in one limb and I’d go for chemotherapy if it gives you almost a 20% chance of total remission.

    Like your other friends I think that you are handling all this remarkably well and I am learning from you. Thank you for letting me join you (virtually) on this journey.

    You are in my thoughts often and I pray for you every day. I believe in miracles even if they are drug induced 😉


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