Not Good News

punch other way

But not exactly bad news, either. Just not the news we wanted to hear.

Last week, my wife, Loren, who was diagnosed with metastatic breast cancer late last year, received the results of her latest brain scan. It shows many lesions shrinking, which is good, but others starting to grow again. And, most worrisome of all, a new lesion that wasn’t detectable before.

I got the news over the phone, while Loren was away at yoga. Her radiologist asked to speak to Loren, but she was not home, so I asked if she would like to leave a message instead.

She said, “This is Loren’s doctor, and I’m calling with the results of her MRI. Please tell her I’ll call back tomorrow, maybe sometime around noon.”

I said, “This is Loren’s husband, and can you, maybe, give me hint about what they say?”

She paused for a moment. “There’s good news and bad news. The cancer in her spine is gone, completely wiped out. But she has increased activity in parts of her brain. Very small lesions. I’m going to recommend CyberKnife, which she can do at the main campus. It’s more targeted than what I can do down here.”

I took notes and thanked her for the call. I paused. She paused. I said, “Alright.” She said, “Okay.” And I hung up.

Bad news always seems to come this way. First we learn there’s something wrong, then we get more details, more information. After a day or two, we have a vague sense of what’s going on, what’s next, and what it all means. Not the full picture, of course, because the only real question we have is: How much time does Loren have? And how much of that time is going to be good?

Nobody knows. And nobody can know. We can only guess, and look at statistics, and hope and pray that Loren is an outlier on the good side of the curve.

All we can do is get on with our lives. All we can do is spend every moment we have as best we can, together and happy, with family and friends. Just like everyone else. Just like Oprah says.

I just wish it wasn’t so hard.

Copyright 2017. All rights reserved.
#cancer #breastcancer #caregiving #radiation

Chemo+1

IMG_4234That’s how we denote it in Loren’s notebook — Chemo + 1, or C+1 for short. It’s the first day after chemo, and it’s not too bad. It’s an odd combination of energy and fatigue, punchy-ness and resignation.

The Dexamethasone makes Loren’s brain wildly active, and she has a million ideas at once. Some of them, of course, have to do with improvements for the house or her husband, and she rattles off lists of things we need to do — Right now! — and ideas for the future.

But simultaneously, she’s physically slower than usual, with slower movements and speech patterns. She pauses halfway through her thoughts and I wait — and wait — for the conclusion, which sometimes never comes.

When Loren gets going on something we need to fix or do around the house, she sounds so very much like Eeyore from Winnie the Pooh. “House blew down again, oh well.”

We laugh a lot on C+1, which helps with the slows, and Loren generally feels okay, just tired. Which really isn’t all that bad.

Copyright 2017. All rights reserved.
#cancer #breastcancer

Chemo Day

BB34E757-4089-4994-A848-7546B85F0F77Chemo day dawns bright and sunny, and we spend the morning doing dishes and tidying up, eating breakfast and getting ready for our days. My day includes a long day at work, which used to seem like a tough way to start the week.

But compared to Loren’s day, it’s easy. Loren will arrive at the cancer center at 10:00 am, and the first order of business will be a blood test. Then a short wait and a chat with the oncologist before three hours hooked up for the infusion.

Today is Round Five, so we know how this will go. Loren will arrive energized, hopped up a bit on Dexamethasone, and leave tired and flushed. She will be noticeably slower tonight, her movements and speech patterns fatigued by the drugs.

Loren got home about 5:00, sent me a text, and then slept until 7:30. She ate a small dinner, then watched TV and played on the Internet — looking at the stock market — until a little after midnight.

Chemotherapy has become so routine that I dropped Loren off in the morning and she took Uber home, because I was stuck at work. Very different from Round One, when I stayed with her most of the day.

And very different from six months ago, when I never imagined cancer would be a part of our lives.

Copyright 2017. All rights reserved.
#cancer #breastcancer

The Day Before Chemo

tom hills

Walking in the San Jose hills the day before chemo.

The day before chemo is a happy day, full of energy, full of life. But there’s also a shadow, an unknown of what the next round of toxic infusion will bring.

That’s because the effects of chemotherapy are cumulative and somewhat random. What was bad during round one, like nasal issues, is easy in round two, while something new inevitably pops up to take its place. Loren has, fortunately, been almost completely nausea-free, but there’s always the fatigue, which seems to be cumulative.

There’s also a shadow because we are nearing the end of Loren’s first six rounds of treatment. Sometime in March, or maybe April, the docs will take a look with another scan and we’ll see how things are going.

Externally, two things are positive: Loren does not have any coordination issues, though she is developing some minor neuropathy (numbness) in her fingers. And her cough is definitely gone. But we won’t know for sure how her tumors are doing until the MRI compares them with last time.

We are hoping for huge shrinkage. And doing our best to live each moment in the sun, despite the shadows in the future.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

chemo

Loren’s first chemotherapy session at the Stanford South Bay Cancer center.  Election day, 2016.

This is how we fight cancer. With the latest chemotherapy drugs, infused every three weeks in a surprisingly cheery infusion center.

Round one was kinda long. Loren was there all day, receiving each drug slowly, one at a time. The idea is to do it real slow the first time around, in case there are any adverse reactions.

No adverse reactions, we are happy to report. Loren did great and got herceptin, perjeta, and taxotare, as well as a supportive drug aimed at supporting her immune system.

Chemotherapy is a funny game. The goal is to attack the cancer cells directly with the targeted agents, and gently poison all of her fast-growing cells with the taxotare. That’s why the side effects include hair loss — your hair grows quickly — and digestive issues — your gut is lined with tissue that is designed to wear off and regrow quickly.

After chemotherapy, the game is to get the poisons out of your system as quickly and efficiently as possible. So Loren is drinking 2 L of water a day to help flush it all out.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

img_2818

Loren in the Radiator at Stanford Cancer Center South Bay. She says she gets to keep the mask when they’re all done.

We fight with radiation, at least at first.

Loren’s treatment begins with ten days of radiation, administered in ten-minute doses every weekday for two weeks.  The she gets a week or two off before beginning chemotherapy.

She is receiving whole brain radiation to shrink the tumors there.  Each day she receives 300 rads of radiation, for a total exposure of 3,000 rads over two weeks.  So far, the main side effect has been short-term memory loss, which also affects concentration.  Besides that, she’s just a little tired.

Her first round of chemo will be a cocktail of three drugs: taxotare, herceptin, and perjeta.  Taxotare is a general chemo drug, while herceptin and perjeta are Her2-specific drugs, designed to attack that specific form of cancer. Side effects from the taxotare are the usual ones you think of — hair loss, nausea, and fatigue.  Side effects from the others are much milder.

The plan is to punch Loren and her cancer as hard as we can with radiation and chemotherapy, to shrink the tumors in her brain and lungs.

Copyright 2017. All rights reserved.
#cancer #breastcancer

This is How We Fight

IMG_4235We fight it with coffee in bed — every morning — looking out the window and catching up on our messages.  And talking about cancer, if that’s what we need to do today.

I read some dopey self-help article a month or two ago about how to feel less stressed about work.  One of the suggestions was to set aside a little bit of time each day to worry about work.  Just half an hour or so, same time everyday, where you can fret about office gossip and office drama, upcoming meetings and project deadlines. The writer quoted psychologists who said setting aside some time to fret acknowledges the importance of your worry, but doesn’t let it take over your life.  It gives it a time and a place, but only a time and a place.

It’s been surprisingly effective for us.  We talk and worry (though not every morning), and then get on with our day.

I like to call it our Cancer Hour.  It’s not Happy Hour — that comes later in the day — but it gets us going in a pretty good way.

Copyright 2017. All rights reserved.
#cancer #breastcancer