Saturday, June 25, 2011

Diagnosis Cancer: An Unexpected Life Journey

No one wakes up hoping that today will be the day they hear “You have cancer!”  It happens. It’s all part of the journey we call life. And, cancer itself is a journey. It is up to you to determine just how you will handle the journey. Will you be someone who immediately hears “You’re dying!” Or will you step up and realize that even with a “life sentence” of cancer, you can still live a long and healthy life.
I heard the words “You have cancer” on December 4, 2000. Breast cancer, stage one and fully contained. That was the initial diagnosis. I had a lumpectomy followed a month later by sentinel node surgery. At that time, they removed six lymph nodes, all of which were biopsied and determined to be benign. So, although I now had joined the ranks of cancer survivors, my immediate prognosis was excellent. 
My medical oncologist, Dr. Nikita Shah, M.D., is on staff at MD Anderson Cancer Center Orlando. For information about either Dr. Shah or Dr. Kahky, go to: She is a renowned expert on breast cancer and even at my first session with her, I felt at ease. Dr. Shah is a petite woman but despite her physical statute, she is larger than life when it comes to her expertise in oncology/hematology.  We spoke at great lengths about my options following the lumpectomy and sentinel node surgery, both of which were done by Dr. Michael Kahky, M.D., a highly respected oncology surgeon. Since my tumors (one benign and the other malignant) were both found when relatively small, and my lymph nodes were all benign, I now had several alternatives as I looked towards future treatment. I went home with volumes of reading material. I’m talking about a huge assortment of papers all dealing with chemotherapy.  Needless to say, I was already overwhelmed.
My choices were... go with chemotherapy and then when that course of treatment was completed, start on Tamoxifen, an oral anti-estrogen drug while also doing radiation treatments or go with radiation treatments while also taking Tamoxifen. The first, of course, not only meant going with months of chemo and all the side effects that would come along with it, but then, I would still have to begin taking medication afterwards plus deal with radiation treatments down the road. So many things to consider including all the side effects from chemo as well as radiation. It was daunting. The second option meant going right into radiation treatments and taking the Tamoxifen. I would not have to have the chemo if I went with option number two. So, what was the best choice for me?
I spoke with Dr. Shah and Ellen Borowicz, RN, the oncology nurse. We talked for what seemed like hours, reviewing all my alternatives. We discussed the pros and cons of each choice, although it really did not help me make my choice. Again, it was completely overwhelming to think that this decision was life changing. I also spoke with my husband, Edward Feldman and our two children, Brian and Adrienne. Phone discussions were held with my mom, Henrietta Wattman (a survivor of both breast and thyroid cancers) as well as my brothers, Gary and Michael Wattman, my mother-in-law, Leah Feldman, and numerous friends and family members. I read through the material, trying to fully comprehend all the information before me. Fortunately, I had a fairly good background for understanding medical material. I had worked for years in hospital public relations and for health care non-profits including the American Cancer Society. Being able to digest and breakdown medical information was not beyond my ability, but now, considering this was my life, it was a bit more difficult than anticipated. While I read and attempted to understand my choices, the time clock was running out. I needed to make my decision so that we could begin whatever treatment I selected. It was by far one of the most difficult decision I have ever had to make in my life. Ultimately, even with everyone’s loving advice and even perhaps wisdom, I still had to make that decision myself. It was “all about me” and it was my life on the line. If you have never understood true fear, this was my moment to face it -- and to deal with it. 
I finally made the decision. I would undergo radiation treatments concurrently while taking Tamoxifen. I factored in all the reasons, both pro and con, for both choices. I also looked at the percentages, which one offered me the greatest benefits. In other words, which one would be the best option... the one that would keep the cancer from returning. Quite frankly, the percentages were identical. No matter which choice I went with, there was an extremely small chance of the cancer returning. So, when all was considered, I went with the option least likely to cause the greatest number of side effects. Chemo was obviously going to radically affect my life for months and years to come. While with radiation only, I would not have to deal with the side affects of chemo. There would be less affect overall on my life and my ability to live a quality life at the time. So, my decision was made. Preparation was underway for me to start radiation treatments. A whole new experience was about to begin. 

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