How Much is Too Much?

Last Thursday I had my first appointment with an oncologist. I went in thinking I would get a treatment plan, and I had decided to spend the weekend researching the drugs and making a plan of my own for managing the effects my treatment would have on my daily life: how to prevent getting sick while my immune system is compromised from chemo, figuring out how to keep up with the housework if I'm too tired to do it myself, finding what I would wear when my hair falls out, looking for support resources for Walker if this whole thing gets overwhelming for him, dealing with my job....

I didn't get a treatment plan.

Dr N, the oncologist, first went over my treatment options. There are three choices on the buffet: radiation, chemotherapy, and hormone therapy. In my case, there will be a combo meal of at least two, radiation and hormones, but I'm still in the holding tank on the chemo. A test has been developed that looks at 21 factors of a tumor to determine the risk of cancer recurrence. The tissue excised during my quadrectomy is used for this test. The results take one to three weeks to come back. The lower I score, the less likely it is that chemotherapy is warranted.

Some women take the chemo regardless. They want to use every available weapon in their fight and no doubt, chemo is a powerful weapon. Some women absolutely refuse chemo, taking their chances with just the other therapies. And for many, that works out fine.

For me, well, some days I feel like my brain is a puddle of mush, incapable of making a decision. I don't know if it's stress, or fear, or information overload. Right now, without the information from the 21 point test, Dr N rates my risk of recurrence at 30%. Radiation lowers it to about 20%. Hormone therapy will lower it further, as much as down to 10% but more likely somewhere in the 12% range. Now, there is never a 0% chance of recurrence, unless you're dead. Chemo would knock a few more points off that risk rating, but it's pretty hard on your body. Some side effects can be permanent. So I ask myself, how much risk is too much? Is going through chemo worth a 5% drop in risk? What about a 3% drop? Every woman in America has nearly a 13% risk of developing breast cancer in their lifetime. Radiation and hormones put me right about at that same spot. Do I really need to go through chemo?

I'm trying not to form any opinions or make a decision until the test results come back. It's hard, though. For a person like me, who needs an action plan, sitting around waiting is the worst part of this whole thing. I just want to get on with it.

Click here to read a more clinical explanation of the test and treatment options.