The Magic Number

     I recently watched a cancer movie on Lifetime or Oprah Network or one of those saccharine sissy channels. I was not going to watch this movie in the beginning.  I did not want to watch this stupid movie about cancer, directed and acted by women who probably don't have cancer. I did not want to watch another maudlin funeral scene of guests mourning their loss, ignoring that the cancer patient has the biggest loss of all of them. I did not want to watch a rerun of my own life. I did not feel strong enough. I go to support and therapy twice a week, every week, to learn how to be myself again. I have made some hard won progress these past 4 months. Watching a stupid cancer movie could send me sobbingly back into the dark cave from which I had fought so hard to emerge. But I was feeling strong that day. I watched that stupid movie anyway.

     I am so glad that I watched that stupid cancer movie called "Five". It's five different vignettes about five different women who are diagnosed with cancer, hence the title. Speaking from the viewpoint of the afflicted, I found these five women's stories strangely uplifting. It wasn't that they all survive, because they don't. It's that their stories offer me something that is not always readily apparent in my life. Their stories offer Hope. The directors did not forget that part of their audience was bound to be actual cancer patients. The stories were authentic. I was moved.

     I am going to share a little acknowledged fact of life for cancer patients. Many of us stop counting birthdays and start counting anniversaries. We count the years of survival after diagnosis. The magic number is five. The significance of five years is reckoned by the science of fighting cancer. Many studies measure success of treatments by looking at the "five-year-survival rate", the percentage of women still alive five years after diagnosis. Ovarian cancer (my cancer) has a five-year-survival rate of about 30%. That means 70% of ovarian cancer patients die within five years after diagnosis. That is 7 out of 10. That statistic weighs heavy in my head. Many studies do not follow patients after those five years, nor do those studies take into account the quality of life during those five years. It can be a false benchmark. On the other hand, if you can attain remission and maintain that status for five years, the medical community will unofficially consider you cured! They should be measuring Progression Free Survival (PFS). If five years of PFS can mean that I am "cured", come on, five!! Five! Five!! Five!!!

     I am not sure how old I am, but I can tell you that I have survived 18 months since my diagnosis. I am counting in much the same manner that small children count their birthdays. I am 1&1/2 years out. I am also counting my PFS. My tumor markers dropped into the normal range 5 months after diagnosis, but my oncologist maintained chemotherapy for 8 more months. My oncology team then declared me "disease free". I have maintained PFS for 5 months, almost 6 months now. I have made no concrete plans with my life yet. I tell people to ask me in five years. I will address any remaining critical issues at that point. After five years.

     The women who made "Five" somehow touched on all this. I am not sure if they knew at the time or if it was a serendipitous accident. The women in the movie have a ritual for that five year anniversary. They all get to "kiss the wall" in a ceremony and leave their lip prints on display. Four of the five women survive. 4/5 is a believable survival rate. The magic of the moment of marking your survival is powerful. It reinforces hope. Hope against odds and statistics. Hope against common sense and reality. My oncologist reminds me that there is no reason why I can't be in the survival group, but we have to wait five years to see if it works out that way. Someone has to survive, it might as well be me. In the meantime I am still counting. I will let you know in 4&1/2 years.

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The Aftermath of Chemotherapy

     Nobody said that going through chemo would be easy. I approached my treatment as a battle plan. I would have an infusion of carboplatin and paclitaxel every 21 days. I would have blood drawn every Monday to track my white blood cells (WBC), platelets and other blood chemistry. I would meet with my oncologist every 21 days, the day before my next infusion, to evaluate my progress. In the meantime, I would be hypervigilant against germs because my chemo drugs suppressed my immunity. I would be extra careful in preparing my own food. I would avoid any uncooked food. I would avoid large crowds and sick people. I would not floss (floss can cut your gums and introduce bacteria). I would not get any manicures or pedicures for 6 months (the tools used can abrade your skin and introduce bacteria). I would always flush twice (the toxic chemo drugs are eliminated through the kidneys). I would wash my hands more frequently. I ultimately became a germ ninja. This gave me great focus. This also served to distract me from the real issue, I had ovarian cancer.

     I attacked my cancer by faithfully following the battle plan. I would have the 6 months of treatment with carboplatin and paclitaxel. I would then have another surgery to reverse my ileostomy, implant an intraperitoneal port (a catheter to allow infusion of chemo directly into my abdomen) and to allow my oncologist a "second-look" into my abdominal cavity. He would look for any signs of tumor growth and take biopsies. After they found "microscopic evidence of disease", I would be scheduled for another 6 months of chemo, this time with cisplatin (a more potent platinum based drug) and paclitaxel. I would have an IV infusion of paclitaxel every 21 days, an overnight IP infusion of cisplatin every 21 days and an overnight IP infusion of paclitaxel every 21 days. I would still get blood drawn every Monday and meet with my oncologist every 21 days. I would occasionally need to have an infusion of electrolytes or whole blood. I would deal with the side effects as needed. I would take medication to prevent the nausea and vomiting. I would massage my numb hands and feet. I would rest on those days when I was too fatigued to do anything else.  And of course I would continue my campaign against germs. All this tactical warfare propelled me through the next year.

     One day at my oncologist's office, 14 months after my diagnosis, he told me that there was "no evidence of cancer." The battle plan had worked! I am victorious! I am invincible! The cancer is gone! He says that he doesn't need to see me for 3 months! No weekly blood draws or anything! Wahoo! I should wait a few months before any manicures, tattoos, acupuncture, vaccinations or dental work because I am still immuno-compromised, but otherwise, I am free to go.

     Wait a minute. Free to go and do what? For 14 months, my life has revolved around my treatment. I have forgotten how to do anything else. I still see the specter of cancer waiting at the end of the driveway. I still have neuropathy in my feet and hands. I have developed a balance issue and need to use a walker. My bowels still argue with me occassionally. I am still dropping weight even though I eat like a pig. I still need electrolyte infusions, even 4 months post treatment. I am still pissed off that all this crap happened to me. What am I supposed to do now?

     I am supposed to find a way to clean up this mess from all the ravages of chemo. Not only the physical challenges, but also the taxations on the spirit. This is harder than dealing with the actual cancer. Cancer cells in my body are tangible and treatable. Cancer thoughts in my head have tenacity. I look for distractions. I am learning to crochet. I am sewing. I am cooking. I am taking photos. I go to support group. I go to therapy, both physical and psychological. I need more distractions. I need a battle plan. I am floundering in the aftermath of treatment. I still google all the latest research on ovarian cancer. I am obsessing that my balance issue is a tumor metastasis to my brain. I cannot escape from the stranglehold of cancer. There may be "no evidence of disease", but it's not gone. It's never gone. The fight is not over. It will never be over.