Not Down Or Out

It could be worse. I might not be laughing.

Tag: cervical cancer

Cancer Comes Calling

Yesterday a former student contacted me to tell me that her cancer has returned.  I felt my pulse start to race when she shared the news. I had to force myself not to let my head drop into my hands because it was not my cancer and she needed to feel confident that this time her doctor would find a treatment that would end this nightmare for her. But it felt, in that instant, like my nightmare had returned. I was scared, too. My eyes teared up. I tasted bile at the back of my throat. I had to resist the trembling that began in my fingers and started to radiate up my arms toward my torso.

She is only twenty-six years old. She has cervical cancer. She just got engaged to a man who longs to start a family after they are married. She has numerous other complicating interpersonal situations to handle while she decides how to next treat this disease.

It is her health situation and her personal situation, but I can think of little else today. It is awful that someone so young has to face this disease twice in the same year. When she was first diagnosed, she elected a very limited treatment. She had the affected cells of her cervix frozen to remove them. She declined to have a hysterectomy or undergo radiation or chemotherapy because she wants to have children. I understand her courage in turning down treatments that would deprive her of a dream that a twenty-six-year-old woman does not want to throw away.

When I was twenty-six I did not think that I would ever need a contingency plan for cancer. I imagined that I would live a very long life. I counted on it.

I did not imagine I could have cancer until it no longer required any imagination to contemplate it. I had cancer. All I could think was, get it out of me. I had it in an organ that I could survive having removed. Everyone is not that “lucky.” You can have cancer in your blood. There are organs we can survive having removed, but life never returns to what it was after some of these organs have been removed. I read today that Sheryl Crow recently announced she has a benign brain tumor that may have developed as a result of radiation therapy she received to treat her breast cancer. Some sources say that there probably is no link between the tumor and the cancer treatment. No one knows what caused her condition. But I can tell you what caused my concern that my radiation may have planted the seed for another cancer–speculation published in the news. Should I stop reading altogether?

I picked up a novel, hoping to distract myself from my obsession with cancer news. I did not get far into the plot of Eleanor Brown’s The Weird Sisters (Berkley Books 2011) before I learned that the sisters in question were gathering to help their mother through treatment for breast cancer. Nowhere to run, nowhere to hide.

I have spent so many of the last six months wondering if my own approach to cancer was too conservative or conservative enough. I underwent chemotherapy and external radiation and have declined internal radiation because the radiation I did undergo has caused serious injury to my previously healthy bladder. I have asked myself if I did enough as often as I have wondered if I was hasty in agreeing to the treatment I underwent. There are no answers to these questions. The science itself is inexact.

All that any of us ever know is that cancer is a daunting opponent. It can reside inside us. It can feed off of any number of things that we do in life that give us pleasure or save us time. Yesterday I waited in a drive-thru lane to buy a bottle of water and asked the cashier at window 1 to suggest to his supervisors that they post a sign in the drive-thru lanes saying, “Thank you for not smoking while we serve you.”

He thought it was a great idea. But I’m guessing that people who wait in fast food lanes are not all that keen on making healthy choices. Moreover, even if the others waiting in the drive-thru lanes were to spare me their secondhand smoke, I’d be breathing the exhaust from their tailpipes, wouldn’t I? I could stop for water at the store, but there are folks standing outside of it puffing cigarettes, too. I could bring water from home, but it gets warm so fast even when I stick it in the thermal bag I bought for that purpose. I carried warm water for awhile in reusable plastic bottles until I read that they might be allowing toxins to leach into the water before I drank it.

The local 5 p.m. news program always offers the latest in health news. One day the reporter told me that dark chocolate is good for me. The next day the same reporter told me that the additional fat in even small quantities of dark chocolate consumed daily could make the difference in my battle against high cholesterol–a negative difference.

This week The New York Times published a commentary on the case against consumption of salt. Salt has been on medicine’s “hit list” for some time, but the author of this new article explained that the scientific evidence does not support the warnings against consumption of salt. It may be that reduction in salt consumption causes more health problems for some Americans than it averts. Eggs also faced condemnation and now return to the table as science vindicates them. However, this week I read a report on the conditions of hens caged for the production of eggs that made me wonder whether I might do better to give up eating eggs altogether.

I have no idea what is the right choice any longer. The truth is that none of us get out of this existence alive. All I know for sure is that the return of cancer scares me. It leads me into a maze that has more twists and turns than a roller coaster and offers no warning of the hazards that lie ahead until it is too late to avert them.

So I had to say to my former student that I was going to pray for her. And I urged her to speak with her parents and her fiance as soon as possible about the cancer threat so that she could receive their love and support as she faces new choices about dealing with an old enemy. I acknowledged that the return of cancer might mean the end of her dreams of having children and of having her fiance’s love. At that point I could no longer hold back my tears because the one thing I could share with this young woman was an appreciation of the threat that cancer represents in any life. It never comes at a good time. Its treatment never comes at a price you can manage without suffering. It has the capacity to take from you everything you hold dear. It forces you to make choices that you have to live with or die for having made. It is bigger than you can imagine, more insidious, more scarring, more scary than you want to imagine. You never get to see it or reason with it. It is the danger that lies within that scares the worst. What is more scary than a call from the police telling you that the call you received in which your life was threatened has been traced to a room in the home in which you are hiding? Once the evil hides within, no place ever feels safe again.

At the end of our conversation I feared that I had let this young woman down because I could not maintain the message that she could win this battle. I was only able to say that she was tough enough to handle whatever will happen next. Today I am forgiving myself because no one has been able to convince me either that I will win this battle. That’s not a gift anyone can give at this time, but, oh, how I wish I could. How I wish I could.

The Urologist Has Spoken

As many of you know, one of my chief physical complaints following radiation and chemotherapy has been the painfulness of my bladder. The radiation has caused it to bleed, sometimes with large clots that are painful to pass. There is pain the many times a day that I eliminate–not a twinge or a twang. This is pain that makes me bite my lips and shudder to keep from crying out, often without success.

I recently underwent a procedure during which a urologist inserted a camera into the bladder and looked around. Then he filled the bladder with water, which water he withdrew for testing. The test revealed no abnormalities consistent with finding cancer there.

I have been trying to speak with the urologist ever since he left me a message to that effect. I wanted to know when I could expect the pain to abate. I continued to bleed and wondered when I could expect the bleeding to stop.

We finally spoke this morning and the news was not happy.

I have what I now understand to be a permanent condition called radiation cystitis. In layman’s terms, the bladder has been fried. In time, pain may abate for periods of time. However, it can and, more likely than not, will return. Pain and bleeding are commonplace. My pain management options–the orange pills that I found made my condition impossibly more painful in December or the astonishingly expensive and unhelpful Vesicare that we tried in January or the always recommended ibuprofen–are the treatments. That orange medicine was a pernicious little “poison.” When the pharmacist saw that I was to take it for a month, he was stunned. Perhaps not familiar with cancer treatment, he said the drug usually was not administered for more than a couple of days. The Vesicare’s sticker price caused sticker shock. The ibuprofen is not suited to addressing episodic pain.

There is a 60% chance of reducing bleeding if I take about 30 treatments in a hyperbaric chamber. No such chamber is available at my hospital, and I would have to pay for it myself. It would not address pain. (Paul has made the very gallant offer to help me pay for that treatment if I want it. Dear Lord, thank you for the friends you have sent me. I do not intend to accept his offer, but I am moved deeply by his impulse and his caring.) There is a 30% chance of some improvement if some formations in the bladder are “shaved” off during an invasive procedure some find painful, which would not be offered at this stage in my recovery even if I fancied another invasive procedure, which I do not.

Live with it, is the best advice for now.

I inquired as to whether internal radiation, which I currently am resisting, could make this worse. The radiation oncologist would have to answer that question and dosing could affect his judgment. The urologist could only speculate that the frying (my word choice) has been so thorough that it might make no difference at all. I see the oncologist, Dr. H, on February 27th. I have not gone to see the radiation oncologist since his department sent me to the ER in late December. That is the doctor who used hand gestures to explain the consequences of radiation. When I looked confused at his pointing to his crotch and hips, he explained he was not used to patients with my level of education.

I will be discussing this with my naturapath first. Rather than do nothing, I would like to think that I might find some way to manage my pain, short of daily medication, if not cure my condition. This was not happy news, but, as my doctors so frequently maintain, the alternative to action is cancer. That argument has induced me to do many things that may yet prevent a return of cancer. With time has come much wisdom. I think daily of the statement my father used (comedically) when we whined as kids: “Come over here, and I’ll give you something to cry about!”

Who seeks a steaming hot mustard plaster to address a bad cold any longer? How about a good bloodletting to address anemia? The field of medicine has come far, but, at its edges, it remains a field like world exploration before the discovery of the Americas. You set sail with hope and courage, but, in the back of your mind, there is a possibility that the world will prove flat and you will neither arrive at your intended destination nor return home. We set sail anyway, don’t we?

The nature of man can be to risk all to succeed. I pray that I have done so and not undergone so much pain and injury for naught. Speaking of prayers, anyone so inclined is welcome to pray for the abatement of pain. I already have begun yet another entreaty for spiritual intervention. So far, God has heard your many prayers and helped me through some very tough times. I pray now for the strength to “take” the medicine I asked for and doctors prescribed.

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