Monday, July 11, 2011

Big Adult Thought


Good Morning Chemo 13:

This could be a good/interesting/disappointing week for us – We’ll have to see. Regardless it is going to require me to, as Kathleen Andersen used to like to say – put my Lt. Col on.

I start block four next Monday and that is the halfway point in the prescribed course of treatment. Before beginning this block I am supposed to get a body scan of some type to determine progress we’ve made thus far. To me this progress peek can also be a decision point.

·      Obviously if the scan shows no movement/reduction in my cancer I’ll be devastated – truly. Even so there is no decision to make; I drive on with the treatment as outlined and get some mental health counseling.
·      If the scan shows a reduction, but not elimination, then obviously we are the right track and I drive on with the treatment – skating away on the thin ice of a new day as it were.
·      But and it is a big one – if as I believe – the cancer is gone, then what? Do I stop chemo early? Do I continue? How far do I go? I need data to decide. Here are some of my thoughts.
o   I have reviewed some research from the University of Texas that suggests adult males with Burkitt’s-type lymphoma have 90 + cure rate after four blocks of treatment. I need ensure my definitions match theirs and the data is in synch.
o   Is there a cure scale somewhere that shows success rates compared to blocks completed. For example, if my scan says I am cancer free and I take six blocks of chemo in lieu of the prescribed eight is there a drop in my short/long-term projections, if so how much of drop? A couple of percentage points? On the flip side, is there a corresponding drop in potential for developing secondary cancers?
o   Where is the point where accepting risk becomes gambling. I am not willing to gamble.
o   Most of the data I see starts with a person starting with stage four and not stage two like me. What sway does that have in all the data analysis?

These are not small considerations and I have to be intellectually and psychically honest as I go through all this. Am I merely suffering from chemo fatigue and looking for an out? Are other considerations driving this than just the cool methodic approach I’d expect from any big decision? If pressed, can/will my doctor prepare a briefing for me with this level of detail in order for me to make a good decision about next steps? If not, what next?

 Love to all, 
Bill

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