day 136 – decision point FAC: ultrasound of my breast cancer in treatment

I am writing this while waiting for my ultrasound exam, which will tell us whether the tumor is responding to FAC. 

If you recall, back on day 110 I described how my oncologist and I decided to move from taxol to FAC one week early, because the ultrasound at that time showed if anything slight growth of the tumor. I was pretty disappointed that day, to be sure. After 11 weeks of chemo I had wanted to see some result. It was also the first time that I would learn whether the therapy I was undergoing had an impact. Now I am facing a similar result, but with a little more mixed feeling.

My favorite outcome would be, of course, to see that the tumor was really getting it in the teeth. Subjectively, to me, it feels smaller and a little harder, as if it were being reduced to a little lump of evil. I have a hard time actually feeling it, because as time has gone on the visceral urge to have the damn thing out is growing. Even if I imagine it as dying, it doesn’t change the feeling that it is time to be rid of it. So I really hope to learn today that it is smaller, that we are having impact with FAC and that completing two more cycles will bring further benefit, particularly on the cells we can’t see, which are all over my body.

But, I have to admit that my not-so-far-behind second choice would be stop the FAC. It really isn’t all that bad, and I can imagine much worse, but it is not a walk in the park either. In the first two cycle it basically shut down my digestive system for about 5 days, and lays down a solid layer of fatigue. I could easily imagine not doing it again 🙂 I am very conscious of catching the smallest glimpse of why people call a halt to therapy at some point, which I have not even approached remotely, but which I can now imagine much better. 

When I have these thoughts I think of my father, who had surgery for his head and neck cancer, followed by radiation and then dealt with the after effects for a couple of years. I also think of my step father, who just started his first round of chemo yesterday, after battling prostate cancer with surgeries and radiation for a decade. He in particular has a fight on his hands, meeting this therapy at a different stage in his life, and after many prior battles. I wish him all the best.

One of the reasons I wouldn’t be totally devastated to part ways with FAC a little early, is that my oncologist, and several other breast medical oncologists I have hallway conversations with assure me that most effective part of my therapy comes at the end – tamoxifen. Male breast cancers arehighly hormone   dependent, and so when all is said and done, that is going to be great. So let’s get there as soon as we can (after surgery, and after radiation). That’s how I feel today. 

But when I think of how I might feel tomorrow, or more precisely on a day when I have to face recurrence, if it ever comes I have to concede that I would have wanted to have done everything I could at this stage. That future me would tell the me of today to buck up, and complete the FAC. 

PS The measurements showed a slight reduction in size for both tumor and the major axillary node. The tumor looked more lumpy to me, and as if it had less blood flow on the interior. The decision awaits discussion with my oncologist tomorrow.

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