I am pondering some hard decisions regarding my future treatments. I haven't reported much lately because I really don't know what to say. At first, I thought with the stage of 1 Breast cancer and clear margins and no lymph nodes positive meant I was in the clear -- no chemotherapy necessary. More test results have shown strong indications that chemotherapy would be advantageous for my type of cancer. I have a very aggressive form of breast cancer (LCIS with ICS). They did catch it in its early stage. When you combine all laboratory pathology, genetic testing, and future predicting breast cancer testing all the numbers point to adjuvant chemotherapy along with hormone therapy for lower reoccurrence rates. When combined together the numbers significantly go down as far as the likelihood of reoccurrence over the next 9 years. The hardest part is the doctor is just giving me all this information and wants me to decide what I would like to do. I can just do the hormone therapy alone, or I can do both chemotherapy and hormone therapy. The easiest way to explain it is like this: Based on a huge study (TailorX) the data can be applied to my situation like this, out of 100 women 12 are more likely to have a reoccurrence. So 88% chance it is not coming back. If I add in the hormone therapy it increases that percentage to about 94%. If I add in the chemotherapy regiment, it adds another 2-3%, at about 96%. This is a prediction. Not a guarantee. I could do nothing more and take my chances that I am not one of the twelve. I could do all of the above and still have something come back in the next few years. The choice is mine. No pressure. Now you see why I want an easy button. I've been here before. Having to face chemotherapy before is not something anyone wants to undergo. I have had conversations with God about this all ready being on the "not to do ever again bucket list," and here we are again on the doorstep of staring at the beast of chemotherapy. This is not on my bucket list, again! So the decision has to be made on what direction to go for treatment. I choose to seek medical treatment at the Siteman Cancer Center because it is one of the best cancer treatment facilities in the US and maybe the world. I wanted expert minds to review and advise what is best in my situation. I have prayed. I have waited and waited. I am wrestling with my scientific self who says, yeah do the chemotherapy for that extra 2-3% decrease in reoccurrence over the next 9 years. But my heart is just not in it. Is it worth the stress my body will have to endure? Is it worth the rearrangement of my schedule? My husband's schedule? My kid's schedule? What about the side effects both short-term and long-term? It is well known that some chemotherapy drugs do in fact cause or lead to other types of cancer. We all know that the purpose of undergoing chemotherapy is to kill cancer cells. The problem is the chemo drugs can't distinguish which cells are possibly cancerous and which ones are healthy.
My oncologist doctor is recommending Cylcophoshamide, trade name Cytoxan, and Docetaxel, trade name Taxotere. This would require 4 treatments over a 12-week period. It is an aggressive dose in a short amount of time.
Technical Information (From Chemocare.com):
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in the division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis). Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, the rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles. Unfortunately, chemotherapy does not know the difference between cancerous cells and normal cells. Chemotherapy will kill all cells that are rapidly dividing. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, are the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body. Cyclophosphamide is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell-cycle non-specific. There are several types of alkylating agents.
Docetaxel belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division. Antimicrotubule agents (such as docetaxel), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.
During chemotherapy, the idea is to rid the body of the cancer cells and try to keep you going. It is horrible. The chemotherapy cocktail is specific for each cancer patient. There are medications given to help alleviate and make unpleasant symptoms milder and easier to manage. I remember it like yesterday. Every time I brush my teeth it reminds me of chemotherapy. I had a big issue personally with how my mouth tasted during chemo last time. I wanted to brush my teeth all the time. The only problem was it made me gag. I know maybe that is TMI! But seriously the struggle was real, daily.
I'm going for a walk again. Time to get to the bottom of this and make a decision. I appreciate your prayers and words of encouragement. I know this was a lot of information. It is for my brain and my heart. I have cried a lot. I am so torn. I do not have peace in my heart. I am asking God to give me clarity, wisdom, and the courage to walk boldly in the direction I am to go. I will continue to wrestle this out like Jacob. All through the night, Jacob wrestled a man. He wouldn't let the man go. He wanted a blessing. He wanted to know His name. He knew enough to give the man a name himself after not being able to win the battle all night long. Peniel-meaning I have seen God face to face. And the man touched Jacob's hip socket. This took Jacob's ability to run away, physically and literally. No more running. He changed Jacob's name to Israel. Meaning he contended with God. He went from Jacob, meaning laughter to fighter or contender. I want in on what Jacob learned that night. God is in the business of not letting go. He wants to bless us. I'm a fighter a contender. What about you? Nothing easy about it.
Kari Jobe with Elevation Worship -- The Blessing
If you are local here in Missouri there will be a benefit event on my behalf on Saturday, June 11th at New Hope Baptist Church in Peace Valley (7908 CR 1790 WP 65775). It is from 3 pm to 7 pm. There will be food and a silent auction. If you are unable to attend and want to help out privately message me and I'll get you the information.
