Tuesday, April 7, 2009

..and sometimes I just cry

Hello everyone
Hard to write this morning.  As positive as I might sound, some days I just get caught up in the 
prognosis. I guess I really have never been given one, if one really exists.
For an oncologist to say I have an excellent prognosis, now what does excellent mean to an oncologist, and what is it compared to?
I guess the only time in my life that I have been acutely aware of my own mortality was on a Horizon flight into North Bend.  Apart from that I really had never planned to get old, ....or die.
However here I am, with a stage of cancer with a 51 percent 3 year survival rate, and a message from the cancer clinic that it is much better than that.

Today I finally got onto the OHSU library, which is available to rural physicians. I found out that
the 51% survival rate was for Stage 3c endometrial cancer with no further treatment(only surgery).  It sounds like they have been going back and forth in the studies for quite some time trying to figure which is better, chemo, or radiation for this disease.  For awhile they have used whole abdomen radiation, and this was extremely toxic.  (in studies if you lose more patients to the therapy than to the cancer that is no good either)
When they only used  external beam radiation (not whole abdomen), they improved prognosis up to 65%  3 year survival, however those who developed recurrences developed them outside the field of the radiation.
Patients who were treated with just chemo had improved survival rates again up into the mid 60s,  however those that recurred did so in the vaginal area.
(I am receiving chemo, internal radiation and external beam radiation, cannot find data on that.)

I have found studies where recurrences were higher amungst obese women, and those over 65.
In all of this,  I struggle to find out what MY number is, what colour is my balloon?  And then....what number would make me comfortable right now?
My mother was told that there was a 5% chance that she would have a stroke from an angiogram, and she did.  ..... she said afterwards that she did not really even pay attention to that.  She would have needed the angiogram anyways though.  So even when the chances are low they still happen. I guess this works both ways though.

I guess all of this is my way of explaining why I cannot just be totally strong and confident each and every day. I guess I thought it would be an artificial blog not to include the negative bits.

Love and peace
janet bates

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