Donna in Hollywoodland

The Oncologist

I was really hard on The Oncologist.
And he knew it too.

Just walking into the Cancer Center was hard enough. I saw a woman leave with a scarf wrapped around her bald head, and it my emotions took a nose-dive.
I had to use the toilet, and I was so frightened and frazzled I flushed it twice before I sat down.
Everywhere I looked, there were reminders of something I don't want to do.

The one thing I told myself as I was driving was "Maybe the Oncologist will say something that will make me want to have chemo."

He did the exact opposite. He made me Not want to get it even more.

He said we would talk, he would get my medical history, and they he would give me my Options.
I was excited to hear the word Options, with an "S".

He explained to me everything I already knew.
Right now, as it stands - I no longer have Cancer. They removed it when they took out the tumor in my left breast, and the lymph node that had the cancer in it.
So it is gone.

But .... they don't know if any Cancer Cells made their way into my system or into my blood stream.
Because it was in my one lymph node, and because it was an Invasive breast cancer - meaning it spread outside the milk duct and into the surrounding tissue - they are assuming that I have Cancer Cells somewhere in my body - But Maybe, Maybe Not.
With all the modern technology that exists, there is no test available to check and find Cancer Cells that are floating around.
The only way they would ever know for sure, is if a Cancer Cell landed somewhere and started to build a cancerous tumor sometime in the future.
But for now it is a guessing game, so they are going to Assume that there are cancer cells.

A funny saying came to my mind as he was talking. I forget where I had heard it before.
"When you ASSUME, you make and ASS out of U and Me."

But with all the modern medicine available, we still have to Assume when it comes to Cancer Cells.

He recommended Chemotherapy. 4 and a half months.
Taxotere, Adriamycin and Cytoxan - were the Chemo drugs he would give me.
I wrote the names down and told him "I am going to go home and research these all on the internet."
Of course, He said.
I replied "Also, everything you do, I will need a xerox copy of it. You have to expect me to be 100% involved in the treatment that you are giving to me. I will ask alot of questions."
He nodded, Thats Fine.
But he looked alittle perturbed that I was taking notes.

Unfortunately, - Surprise, Surprise - my tumor was not Estrogen sensitive. If it had been, they could have just given me and drug and put me into menopause and we'd be done with it. But no such luck.

Then he went over the possible side effects. He started with the obvious. Hair Falling Out. Nausea.
I said "I don't care about my Hair Falling Out, or being nauseous. Those will go away. I want to know what this will do to my internal organs."
He said One drug can possibly cause heart failure. Another drug can possibly cause blood in the urine because of problems with the bladder.

Wait, Wait, Wait ... Heart Failure ?
Did you see on my CT scan, it showed some abnormalities with my heart. I can't risk Heart Failure !
(All my rough years of being too heavy-set and partying alittle to much, seems to have given me a borderline enlarged heart.)
He said, We'll have to do an echo-cardiogram on you to test your heart, to see if it can handle the drug.

Then I asked "What about my kidney? I only have one kidney."
(They removed one when I was 9 years old, because it was dead since birth.)
Yes, he replied, the chemotherapy can make you so dehydrated that you can have renal failure.
"No" I said "I will NOT risk losing my kidney. I will NOT end up on a kidney dialysis machine."

I asked him .... What chance do I have of getting cancer again ?
As it is now, with just the surgery .... The general population has a 30% chance of getting cancer somewhere in their body.
Then I asked him... If I get the Chemo, what then are my chances ?
He tried to make it sound good.... but it didn't work.
He said the Chemo would reduce the 30%, by 25% or a quarter. He said that was 12%.
But I work in an accounting office... half of 30 is 15... half of 15 is 7.5

For all this risk to my internal organs ... Heart Failure with a semi-damaged heart, Kidney Failure with only one kidney ..
You are only giving me a 7.5 % deduction ? From 30 % down to 22.5 %. ?
"Thats not enough" I told him "I don't see how the risk evens out with the 7.5%. It doesn't equal to me."
Especially when I currently don't have Cancer, and we are Assuming about the Cancer Cells....

He refused to discuss Experimental Drugs, or Clinical Studies - saying that they were far more dangerous than the drugs that he would give me, because there was so little known about them.
So there was no "Options" with an "S" - it was singular, just one option available - Chemotherapy.

We were getting into a pretty heated discussion, when the nurse broke down the door.
"Doctor, So-and-So is having a bad reaction to her Chemo Drug."
The doctor jumped up, and dashed out without a word.

Okay... you forgot to mention that. I could have a bad reaction to the Drug.
Jot down one more possible side effect.

He came back in, and we continued our heated discussion.
"If you said you could completely cure me of getting this cancer again, then maybe it would be worth risking these possible side effects", I told him.
No one can guarantee that, he replied.
I said again I don't see how this small reduction is worth the risk.
He said something about getting into your car and driving on the freeway is a Risk too, but you do it.
Oh, no... wait, I thought to myself - that comparison does not make sense.

I stated again, and with more force "If my kidney fails during Chemo, I will not go on a dialysis machine."
"Now you are getting overly emotional", was his reply.
Gee, such a pat answer. Just poo-poo my concerns, Doc, I thought to myself.

The Nurse barged in again. Another problem with a patient.
The doctor dashed out.
Ok, these emergency interruptions are showing me something here.

The Doctor came back in. He looked completely exasperated by me and my opinions.
He said "Aren't you afraid of getting cancer again?"
I replied "No - I am afraid you are going to damage my internal organs, when I am not even sick."
He said "Look, you have to have faith in your Doctors."
I looked at him "Its not you that I don't have faith in. I don't have any faith in the procedure you are recommending."

I said "Lets do this. Run the blood tests. And lets do the Echo-cardiogram. That way we will have the results. Then I guess you will want an answer in a certain amount of time too".
He said "Two weeks."
I said "Okay, good, I will come back in two weeks, after you have the test results."

I made all the appointments for the follow-up tests. The information is good for me to know. And I am sure the Radiologist needs the info when he is ready to do Radiation to my Breast.

But I could tell by the look on the Doctors face, that he pretty much had figured out that I was planning on not getting the Chemo - or at least Not getting the Chemo with him doing it.