Friday, August 07, 2009

The Rollercoaster of Results

It's been a week of consultations. First with Birgit to check my wound and bullet holes; and then with Chris Atkinson, my lead oncologist,to learn how many 5 year survival percentage points I lost with the latest round of results.

The bullet hole marks are from the post-op drains and are disappointingly small and normal and healing fine. My wound, so beautiful under the white strip tape is hideous with the tape removed. Think shark bite. Think of opening a can of spaghetti when the first flushes of red seep between the lid and the rim.

But, it's healing perfectly too and I am the picture of good health. Except that I have cancer. Except that possibly I don't. And here's where the results rollercoaster begins. Buckle up, if you can be bothered or just make a note in your diary to check to see if I'm alive in 5 years time.

The pathology report following surgery showed that I actually had 5 lumps. 2 were pre-cancerous and 3 were high grade invasive ductal carcinomas measuring from 1cm to 1.2cm. This is good news. A few small cancers are thought to be better than 1 larger one.

The margins around the cancers were deep - this is good news. It means the cancer has not penetrated into my chest wall. 21 non-sentinel lymph nodes were taken out. 1 had cancer in it. This is bad news. It means the cancer has spread and there is a greater risk that it might be elsewhere in my body. Only 1 had cancer in it. This is good news. It could have been present in more nodes which might indicate a more agressive cancer or one that had spread further before we caught it. Getting a sense of the rollercoaster yet?

Cancer cells sometimes have hormone receptors on them. This makes them vulnerable to particular types of treatment and indicates that they are at least trying to behave somewhat normally. Tests are carried out for two types of hormones (oestrogen and progestorone) and wouldn't you know it, my bloody cells haven't got any intention of behaving normally. They are receptor negative. This is bad news. They won't respond to hormone therapy and so this little potential remedy is off the shopping list. Advances in medicine mean that tests are also conducted now to see if HER2 receptors are present. About 20% of breast cancers have HER2 receptors. This indicates a more aggressive form of cancer. Wouldn't you know it, my cells are aggro little shits and are HER2 positive. This is bad news. It is also good news. It means that Herceptin can be used to give the bastards a good old fashioned hiding.

Loathe as I am to get all political - my voting history is as follows:

Labour for David Lange
National, Act (first MMP election)
Green, Legalise Marijuana Party (a social experiment that didn't quite pan out as I'd hoped)
Green for Rod Donald, National
National, National

Despite being mistaken for Ruth Dyson (more on that a.t.l later), I consider myself to be economically conservative and socially liberal BUT I will forever vote National if Health Minister Tony Ryall's decision to fund Herceptin for 12 months rather than the 9 weeks that Pharmac approved under the Labour government is what keeps me alive until I die.

So, the results from this week indicate that my prognosis is a bit worse than I first told you, but there are still really good odds of me being around for the rest of my life - and still absolutely nothing to worry about. Lance Armstrong was WAY WAY WAY WAY more fucked than me before he began his treatment and look at him go now. I might yet make it to the end of Nayland St on my mountain bike!

So do I still have cancer? Maybe. Maybe not. All the treatment I'll have from here on in is designed to kill any invisible cancer cells that are lurking, unknown and undetectable, in other parts of my body and to prevent the return of the original gremlins. Cancer is a numbers game.

In the very first lecture at Law School we were told that 180 places in second year would be given to the best performing students out of the 500 odd that would sit the final exams. "Too easy" I thought. "That's more than 1 in 3. I only have to be better than two total lepers and I'm in." As it turned out, I did slightly better than that and beat a whole bunch of them. Cancer survivor stats are like that.

"Of 100 women in a similar position, who have all the available treatment, x will be alive in 5 years time and have no recurrence, x will be alive with a recurrence and x will be dead from cancer related illnesses. x will be dead from other causes."

Arrogance is my problem. I'm having trouble imagining how they could ever find 100 women similar to me.


glennrewi said...

100 similar woman to you Sacha? hell no, there's only 1 Sacha, the world wouldn't know which way to spin with 2 of you on the planet :)G

Ben said...

Sach, am simply blown away by your blog & the attitude to life that you capture in each post! Hope that all the post-op fun & games are going as well as can be expected and that the family are coping OK? Best wishes 'Sydney' Ben