Push Down, Turn: Phases of Treatment for Cancer

Last year at this time, I was getting ready to start a new cancer drug that would hopefully prevent “cross talk” between any hibernating cancer cells that might be in my body waiting for intel on how to spread, like stealthy double agents. I had many conversations with friends and doctors about my fears, knowing the risks and the lifestyle alterations taking this new targeted cancer drug would pose. The side effects were many. Getting approved for the drug was akin to running a mud run in February wearing nothing but a 100-pound weighted vest. But I opted to try it. The alternative was an increased risk of an aggressive cancer returning somewhere other than my long-gone breasts. That possibility scared me more than living a year on newly approved, strong drug.

Fear based decisions are tough, even when they are logical. I cried a lot in the month leading up to the first doses. I had gone through chemo and a year of infused targeted drugs. I had had my ovaries removed and started another cancer drug to block estrogen binding, which I’ll be on for years. I’d recovered from multiple surgeries.

This new drug would cause months of stomach problems. The pharmacy handed me a bagful of free Imodium (loperamide) – like a pound of it. The makers of the drug called repeatedly to check on me. They offered me a peer mentor to talk with if I wanted to help get me through the treatment. I didn’t opt for the buddy system, but the offer was telling. I knew it would be a tough year. But frankly, I will try anything approved by science that could prevent the cancer I’ve been dealing with from taking up residence in my brain, lungs, liver, bones or any other hospitable environment.

I dealt with the stomach issues and honestly, it was bad. There were luncheons I attended where I didn’t eat, exercise classes I didn’t teach, articles that didn’t get written, dinners I cooked for my kids I did not eat and birthday cakes I made for them I did not share. There were constant mouth sores and careful planning of when and where to take my daily dose. There was no way I could have worked outside of my home during the first months on the drug. Then, once my stomach calmed, my liver enzymes shot up. They were high enough and I was exhausted enough that my doctors reduced the dose to accommodate my fickle liver. I panicked about the efficacy of the lowered dose. But my doctors are confident, competent people. So, I stayed the course.

I will take my last dose of that drug today. I should be ecstatic on this strange anniversary. I should be excited about the possibility of getting rid of these mouth sores, being able to think less about what I eat, hopefully having fewer unrelenting muscle spasms and regaining the energy to stay up past 9 p.m.

Yet, I’m terrified.

I will still be taking one other cancer drug for a fistful of years to prevent the less aggressive type of cancer cells that might be hibernating from replicating. But I am currently holding the last of the pills that have provided some insurance against the reprisal of the more aggressive cancer cells that might have survived. There are no tests to detect trace amounts of the type of cancer I have been facing. There are no scans to detect anything smaller than full-on tumors.

Cancer marks you in more ways than one. It is not just that society looks at you differently. Some see your fragility and deal with it by distancing themselves. Others want to wrap “survivorship” up in a bow and party with you and move on – when you feel like you are a lone survivor fighting a stereotypical slap of freezing waves while clawing at the hull of a capsized ship while the mournful eye of a beluga passively regards your struggle.

I know there are opinions about all aspects of cancer and the decisions patients make. I know people tell themselves all sorts of things to set them apart from patients with cancer – extolling the virtues of what they do to safeguard themselves from getting cancer and becoming one of us. I know there is judgment cloaked as well-intentioned factoids about what you should eat, feel and be to “beat cancer.” I know there are whispers, especially about breast cancer. It is intimate. But I also know there are, likely, occasional eye rolls and that it can be exhausting when a patient with cancer once again steers an unrelated conversation back to the topic of cancer. How can a conversation about my sons not involve a discussion about the collateral damage of cancer?

I know it is not fun.

It is circular and inescapable and intrudes on every aspect of life it enters, especially the most mundane moments.

I have pushed down,

turned,

see the translucent brown bottom of a bottle

that was once filled with tiny orange promising pills.

Ambivalence rattles my swallow.

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