THE GREY AREA

I recovered very quickly. Of course I was sore but I healed with no complications. When I returned for my post surgery check-up, I found out that my actual cancer was only 1.1 cm and the borders were clean. I was very excited and assumed that meant we could go straight to radiation and that I had dodged the chemo bullet. My doctor unfortunately burst my bubble by informing me I was in the “grey area”. This foul sounding term is for those whose cancer is between 1-2 cm, hormone positive, and her-2 negative. I was told the unhappy fact that microscopic cancer cells can escape the lymph nodes and find a new home somewhere in the body. She said it was the oncologist who would know best whether to recommend it or not based on statistics. The sad fact is there is no blood test that exists that can verify whether there are cells wondering or not.

I met a couple of weeks later with my oncologist. I was very nervous as I thought about unruly cancer cells trying to set up shop somewhere inside of me. It gave me the creeps! On the other hand chemo sounded so dreadful too. What a spot to be in, no black or white solution. He sat down and showed me this nifty graph. It takes my tumor facts and spits out my chances of being clean and alive in 10 years. I found out my cancer was a grade 3 (aggressive) which increases the odds of re-occurrence. The bottom line was if I added on hormone therapy (taking a pill called Tomaxifin for 5 years), it increased my chances of survival to 77%. If I then add chemotherapy, it bumps me up to 84%. So the magical number was 7%. Is chemo worth it? Well, both the doctor and I agreed that it was. But, he cried, they have a brand new test called the Oncotype Test created just for people like me.

What this test does is it looks at the specific genetic markings of the tumor and runs my markers against thousands of others and matches mine with those people with similar markings. Then they will rank my tumor into 3 categories of low risk (1-18), intermediate risk (18-32), or high risk (32-50) of re-occurrence. For me this was a hard decision because it is new and once more based on statistics. It is a very unnerving notion that one is putting one’s future life on the line based on statistics. There was also the problem of insurance. Not all insurance companies are onboard with the price tag of $3,500 - $4,000! I was told that our company had been coming through with paying for this test for the past few months. Well, my husband and I decided the more info the better to help me decide whether to do the chemo or not.

So, I had another two week wait in front of me and I admit I was very nervous again. I suppose I hoped that the number was either very high or very low so the decision would be easier. I decided the best thing I could do was pray and pray some more that when I got the results back, I would know what to do. Well, when I got the numbers I was not too thrilled. I was a “20” which was the low end of “intermediate risk”. Basically what that meant was with the hormone therapy it boosts my chances of being alive and healthy in 10 years to 87% and with chemo added it went up to 90%. So the new magical number became 3%. My doctor recommended that I not do the chemo. He felt that the chemicals as we all know are hard on the body and that it was not worth the side affects. But on the other hand, I was still in the intermediate risk category, so if I chose to go forward with it, he would support me and get the ball rolling.

Well, all the way home I was grinning from ear to ear. I decided right then and there that I was not going to do the chemo. I figured I would start to eat more healthily, exercise more faithfully, and let the Tomaxifin kill all of those renegade cells. No puking, no hair loss, no mouth sores, and not being tired all the time. Suddenly the holiday season coming up was looking much brighter. So I told my husband, kids and a couple of friends what I had decided. On the other hand this was a very important decision and I had fasted and prayed that day. I asked my husband for a blessing for guidance and confirmation and in the blessing he said that I would know what the right thing for me would be. So I went for a long walk in the quiet dark around my neighborhood thinking through all of the facts weighing all of the pros and cons. I sill came back to the same answer – no chemo, why put my body through that sort of trauma for a measly 3%.

Still I had to remind myself that this test was new and based on statistics. So the last thing I did before I went to sleep that night was to say my prayers asking if I had chosen wisely for me. Well, I woke up in the middle of the night with a huge “stupor of thought”. I felt very strongly that I had made the wrong decision. When I got up the next morning I spent the whole day seriously restudying everything the doctor had told me or given to me to read. I reread parts from my library books. I had a doctor friend download all kinds of info that pertained to my unique “grey” area. It was a long day. Everything concurred with the advice from my doctor and with my decision, yet it did not feel right at all. That evening while I was at work putting books away in the library I finally quit thinking so much. I had confided to one of my friends at work showing her all of the graphs and stats, all she did was look at me and say, “Just remember, what ever decision you make, you have to live with it. You can’t change your mind later.” I finally had to admit to myself that for some reason I was supposed to do the chemo and when I did, I felt all of the turmoil go away and a complete peace filled me. Suddenly it was okay to go through this scary process, hair loss and all.