Prevalence

Just today (not kidding!) I was 
thinking about how sick I am of 
seeing signs that say "artisan ---"
Then I saw this sign at 
the Farmer's Market...

Twelve million people in this country have cancer, according to the American Cancer Society. Around five million of those have breast or prostate cancer. Two or three of them have the kind of cancer that I was diagnosed with in December: cancer of the vagina. It took me a while to be able to say that. It sounds like a cruel joke.

But that's gone now, and I hope the cancer in my lungs responds as well to treatment as my vagina/ bladder/ pelvic bones did. And I hope chemotherapy doesn't end up being the gift that keeps on giving - in terms of insomnia, dead nerves, and a loose canon where there used to be bowels.

I got some more info yesterday - nothing about prognosis of course - about how things will progress, and some more info about how Dr. Nelson thinks about it all. I spoke with her for more than an hour. The main thing is, she complimented my eyebrows.

My cancer staging has changed to "Metastatic Stage 4," upgraded from "Stage 4b" (because now it involves only one organ, the lungs). My blood counts were better. I haven't been able to look at them because I can't log on for some reason. But something went from 2.5 to 2.9. *

Twin Peaks, sans fog

Statistically, the odds that the cancer is, or will, appear elsewhere is high. That is to say, the chances of wiping out every single cancer cell is low. That's why they think of advanced stage cancer as a chronic illness, or rather, a chronic recurrence. It is not expected to go away, and in many cases it doesn't, or it comes back. However, Dr. Nelson said she wouldn't be surprised if mine did go away. She also said my lung nodules are so small, they could have waited on the chemo, but doing it now might mean a long remission.

I asked her what the factors were in assessing how someone is doing. She said:

1. Changes in blood labs, for example, 'tumor marker' (or CEA meaning Carcinoembryonic antigen) elevations. The main tumor marker for ovarian cancer (and my type as well) is CA-125. 
2. Scan results
3. Physical exam
4. How the patient feels

Wires in the sky

She said if someone's scan showed tumor growth and they felt energetic and were eating well, etc., she wouldn't necessarily recommend chemotherapy. She seemed very tuned in to quality of life issues, which was a comfort to me. She cut the intravenous dexamethasone (steroid) I get before the chemo drugs in half. Yay! Maybe I'll be able to sleep tomorrow night before 4 am... 

I have an appointment with her on October 22, so some time before then I will get a CT scan of my lungs, which will be able to determine if there are still tumors in my lungs, and if so, whether they have grown or shrunk or stayed the same. In about four months, a full PET scan, which looks for cancer of any size, anywhere, rather than determining size/change in a particular place. If everything stays clear, I will get scans (not sure which kind) every three to four months for a year or two. 

I have chemo tomorrow, which in one sense is too bad because my feet have come back to life, and my digestion seems to be working normally, and my face isn't numb anymore! I'm fairly energetic, too. Dr. Nelson advised me to take preemptive meds (Colace or Docusate Sodium) against constipation, a word which means something very different to me than it did a year ago. That is, formerly an inconvenience to feeling like your body has mostly shut down in a torturous way. Despite the name of this blog, I don't really like talking about shit (or lack of it), but it's part of my experience now, so there it is.

Will tomorrow be my last chemo ever?

*The 2.9 was the white blood cell count. Normal range for white blood cells starts at 3.1. That is, normal for people who are not on chemotherapy. Abs. Neutrophils up to 2.0 from 1.4 last time. Normal range starts at 2.1, and below 1.5 is considered dangerous). Hemocrit, hemoglobin, red blood cell count, are slightly low. Everything else is within normal range, including.