Thirst for knowledge
A little bit of information is a dangerous thing. I’ve always been of the opinion that a thirst for knowledge is a wonderful attribute. But when it comes to cancer I’m not so sure. A few minutes on my laptop with a search engine and a question I want positive answers to can really do some damage to my positive mental attitude.
Today I had my tumour and lymph node scanned again. They feel a lot smaller to me and the scan confirmed they had indeed shrunk (from 1.7 to 1.1 and 1.8 to 1.2 for the stats buffs amongst you). ‘Great news!’ you’d think. Not so for my mind, as I have my heart set on them melting away completely before surgery and to be told it was a ‘reasonable’ response was not what I wanted to hear. ‘Damned by faint praise’ as my Dad would have said.
Pathologic Complete Response
You see there’s this medical term called a ‘Pathologic Complete Response’ which means when they go in and do the surgery and take the tumour out, the chemo has gone all Terminator on it and smashed it to smithereens. No cancer cells left. It’s apparently associated with better long term outcomes and less chance of it coming back. Sounds good, yes? I've got it in my head I need this pCR but it doesn’t look like it’s shrinking quickly enough for that to happen. But the silly thing is I don’t even know that, it still could. It’s just another example of how little control I have in this situation and that is THE most frustrating thing about cancer.
A simple Google search in the hour I had to burn between my scan and chemo this morning threw up all sorts of new ammo for the negative voices in my head. ‘When during chemo do tumours shrink?’ I blithely asked my computer. In less than a second I had a page full of scholarly articles about related issues. I knew I shouldn’t have clicked on any of them but like an addict I couldn’t stop myself. Suddenly I was reading all about ki67 – this is a marker of how many cells in the tumour are dividing and multiplying. Mine is quite high – 59% - and means the cancer is quite aggressive. A quick glance over research paper written in medi-speak I couldn’t possibly hope to understand and the one ‘fact’ that leapt of the page was that the higher the ki67 the more likely the chance of a recurrence. Bugger.
Doctor knows best
A chat with my oncologist helped to put my mind at rest a little. There is more chance of the cancer NOT coming back than there is of it returning. She told me the Pathologic Complete Response only adds a few more percent onto an already good survival rate. And she pointed out (and as I’d already thought myself but forgotten in the googling frenzy) the ultrasound scan only provides a 2-D image. Those measurements could easily include scar tissue from the biopsy and tumour marker being put in and none of us will know exactly what’s in there until my surgeon goes in and takes it out in May.
So, I’m trying now to forget what I’ve read and focus on the fact that today marked a third of the way into my 9 weekly rounds of my second and final chemo drug and two thirds of the way through my chemo as a whole. We are getting somewhere!
I’ve just got to focus on the here and now, not look back in anger or orward with fear to the future. I’m here, I feel good, I have the support of a beautiful family around me.
I need to become less Oracle and more Ostrich. It’s time Dr Google is struck off!