Raising the Stakes

by NotDownOrOut

On October 27th I went to the hospital to discuss my treatment with oncologists. Barb went with me for support. We met my new doctor, Dr. H, a general oncologist who has worked with my surgeon back before he became one of the first gynecologists to specialize in oncology. It was surprising to see how little of my medical file was sent to the new surgeon–just the pathology report prepared after my operation.

Dr. H had two residents following her. They bent over her shoulder to study her moves, filled in info on pages while she wrote on the same page, and ran to get things. Dr. Z must be the more senior resident. He was the only one that she introduced. It fell to him to hover as they tried to find my pathology report. Dr. H could find no record of me except the source of referral. Barb and I were looking at each other with wide eyes.  If we had come for no reason . . . . Ahh, it turned up in the file with someone else’s patient info glued on the front of it. Barb was about to go to the fax room to shake it out of them when everything turned to smiles again.

Then the doctors stared at the report, speaking aloud, discussing me at great length. There are two types of uterine cancer. Mine was the less serious, not a sarcoma, and mine was fed by estrogen. But there were two tumors. The original one was buried deep in the muscle wall of the uterus. This is a factor that makes my prognosis more high risk as it means the cancer was close to breaking through to the abdomen. The cancer had spread to the right fallopian tube. That affected the stage of my cancer. There was cancer going close to the cervix. This also affected the stage. There are lymph nodes in the area that lead to the aorta. If the cancer spreads that far there is risk it will spread via the bloodstream. Had the nodes been removed and tested? No. Dr. H called the surgeon. He was out. She eventually got his senior resident on the phone. No, the nodes were not visible and the decision was made not to hunt for them at the time of surgery. The decision ended up having serious effects on my treatment.

I have a hernia. I’m guessing it blocked the surgeon from exploring further. Much discussion ensued. I had been told after surgery that my cancer was grade one (nonaggressive) and stage three (not terminal but advanced). I had researched this and seen on the Internet that the chance of survival for five years was 58-47%, depending on sub-classification within stage three. I thought my case sounded like the best case under stage three, but my survival rate could drop down toward 45%. But Dr. H dismissed those ratings as outdated even though they were the only ones I had found after much reading. Under the FIGO staging system I was only stage IB. This category has a 91% survival rate after five years!

Barb and I looked at each other and there were tears of happiness because this was a much better prognosis than we had expected. Of course, there were still the unknown factors affecting staging due to the possible involvement of the unexamined lymph nodes, but I was already a high risk case within my stage. So we turned to treatment.

The doctor has a patient at my stage who is pursuing radiation alone and is satisfied. The doctor said she rarely treats people of my education level so she was not going to tell me what I had to do but would lay out my options. She went through the most current protocols. I could have radiation alone or radiation and chemotherapy. She started to pull up study results. She phoned a friend with a study ongoing. She brought in a member of a clinical trial team to discuss their study with me. She read the study results to me. She gave me my pathology report so that Barb and I could read it ourselves.

We decided against the clinical trial because only one of the options involved full pelvic radiation. The other focused only on the cervix. I would be assigned randomly to an option so could not be sure of getting treatment that would attack the nodes no one had seen.

The doctor was frank. It was not possible to determine what was under- or over-treatment. I decided to pursue the most aggressive treatment. So I’ll be having a weekly dose of chemo for six weeks and will simultaneously have five sessions of full pelvic radiation per week for six weeks. It does not sound like I will weather this without considerable suffering, but they are six weeks that improve my chance of making five years and more. She asked if I could take going bald. I told Barb that if my hair was that important I would not have had the same hairstyle for fifty-four years.

Barb agreed that I could handle anything for six weeks. I, of course, pray that this will kill any cancer cells roaming about. I had some blood work done to check for cancer markers in my blood and to establish baselines for the kidney and liver, which are affected by the two chemo drugs I will take.

I feel very good about this course of treatment. I am making a great recovery from surgery. This can be done by about Christmas. I have a week off for Christmas so the last treatment will mean I can take a little break before spring classes gear up.

I guess this counts as a setback. I prefer to think that, by agreeing to pursue this aggressive treatment plan, I have raised the stakes. I am setting my sights on long-term survival. Five years might not be enough living for me. I’m going to give myself the best possible shot at a long life.

Perhaps Susan is right and everyone in my situation has setbacks. What should that mean? Is it any excuse for sidelining me? I don’t think so. Life is filled with setbacks that don’t result in people being “benched for the rest of a season.”

Adversity is a part of life. We should do our best to overcome it rather than knuckle under it. This cancer has come as a surprise to me, but I am strong. I have tried to do things that were difficult before. I cannot say that I have won every battle, but I have done well.

Before I was married in 1981 I had been working three jobs at the same time. I had a job from 11 p.m.-7 a.m. then I taught public speaking from 9 a.m.-11 a.m. Then I went home to sleep. I woke when my sister and fiance’ came by after work. On weekends I traveled with the debate team, sometimes being awake for twenty-four hours straight.

My marriage ended after my first year of law school. Nothing else has ever hurt me as much. It also was a financial hardship to finish law school while my husband and I were separated. He moved out after we had given our landlord notice that we were moving and before we had committed to a new place. He did not want to pay for two homes. I had co-signed school loans for him and suddenly found myself without a co-signer for my school loans. There was a semester when I did not have enough money to enroll. The law school let me attend classes while I scrambled to find funds. I did not have a winter coat one year. My car broke down so many times in tough neighborhoods that I began to live on adrenaline. When my car gave out I waited for buses on dark roads and swore to myself that I would never let a friend go home that way if I could drive her. I finished law school having been first in my class for all three years. I was editor-in-chief of the law review. I won many honors. I also worked two or more part-time jobs for two of the years that I was in law school.

I have watched family members die. Between 1986 and 1996 I lost my Grandpa K, my Grandpa F, my dad, my Grandma F, and then my Grandma K. There were times when my heart ached with such intense pain that I thought I could not handle another setback. The year my dad died I changed jobs, moved from D.C. to Chicago, helped manage a family business while my brother finished his electrician’s apprenticeship, passed the Illinois bar exam, and moved in with my mom. There were so many stress factors to handle that year. I can recall that there always seemed to be a band of tense muscle running across my shoulders that first year after my dad died. But I handled the stress and grief. My family worked together as a team to keep my dad’s business going while my brother finished his apprenticeship. Each of us was under tremendous pressure, but we did not give up.

The year my Grandma K died I spent part of every day of the last couple months of her life with her at her nursing home. I went to work at 3 a.m. so I could leave at about 3 p.m. to drive out to McHenry. Losing her was like losing the only child I’ll ever have. She was so important to my daily life that, when I learned she was dead, I thought life had finally found something that could sever me in two. I still miss our Saturday afternoons we spent together for the four plus years after my dad died and I moved to Chicago. But I survived that loss and made partner that year after having been at a new job for only a year.

In recent years I have worked multiple jobs for multiple universities on multiple campuses. I have had as many as three new “preparations” in a semester. I have also managed to get an article published. There have been days when I was so busy I considered giving up teaching to do something that paid better for less work, but teaching is my passion. I stuck it out.

Lots of people are finding life tough and are not giving up. They accept overtime assignments, take a second job, volunteer, or pitch in to help a family member or friend. Many of them suffer from medical conditions that make them tired or add to other burdens. Isn’t this what life is all about? We survive. We adjust to unexpected demands. We adapt to new conditions. We accommodate the needs of people who depend on us. We stretch to take on new challenges. We don’t quit because life is tough.

That’s the prescription I mean to follow as I face this new challenge. I will survive cancer. I will find a way to adjust to a new schedule of radiation and chemotherapy. I will juggle my various jobs because they pay my bills and feed my soul. I will call on friends for help but still be open to help them. I will stretch the fabric of my life to absorb the new challenges I face. I won’t quit because life is tough.

After Barb dropped me off at my car I sat at the wheel for a few minutes. I closed my eyes and took a deep breath. I cleared my mind of the buzzing that had consumed me all day. I imagined an existence without stress in it. No family, no friends, no love, no work, no obligations, no fears. If you visualize a thing long enough some people think you can attract it to you. Have I drawn conflict and struggle into my life? Can I dispel them by ignoring them? It’s an interesting idea.

My problem with it is that my life is worth experiencing the conflict and struggle because these challenges have brought rewards, too. If I did not have cancer I probably would miss the lessons in humility and acceptance that I have already been learning. If I did not face financial pressures I probably would miss the opportunities I have had to teach different classes and meet so many different people. If I did not face discrimination I might never explore the nature of my own commitment to the society in which I live. If I did not try my hand at overcoming adversity I might know peace, but I would miss the opportunity to make a difference for others.

You can pick your battles, but a battle you do not fight is a battle lost. Now that the stakes are higher than they have ever been before I have to give my best effort to win. I can do anything for six weeks.