First things first: I am delighted with my Oncologist. His name is Dr. John Glaspy and I am completely confident in his ability to handle my situation in the best possible way. He is the Chief of Oncology/Hemotology at UCLA and a very published researcher who will know of and have access to the newest and most advanced cancer treatment therapies as they become available over the years. I am fortunate to be in his care.
As we suspected would the case, the game plan has changed now that the cancer has spread. Initially we thought we would attack it hard and cut it out, in hopes that we would kill it all and be done with it. This is no longer an option for me. As Dr. Glaspy explained, if we try to win this war, it will kill me in the process. Short of a miracle cure (which, by the way I am most certainly NOT discounting), I will always have this cancer and I will alway be fighting it.
Now, I must admit, this has taken a little swallowing, this change of mindset. When you have something dangerous and unwelcome growing in your body, every instinct you have is to squash it out and dominate it completely. Instead, I must learn to co-exist peacefully with this. The goal is this: keep me alive as long as possible with the best quality of life possible. Really aggressive treatments are not sustainable over the long haul (and believe me, the long haul is what we want!) so for now we are going with the old adage "slow and steady". It won't win the race but should give us the best combination of results.
Like guerrilla soldiers, we will not attack head-on or draw battle lines. Instead, we will constantly annoy it...drop grenades on it from here and there instead of firing bazookas. As good guerrilla fighters, the first thing we are going to do is cut off the cancer's food supply and watch it flail around for awhile. This should make it good and angry.
My particular cancer, as Dr. Glaspy explained it to me, is addicted to estrogen. It is what it feeds on to grow. If we cut off the estrogen available to it, it should cease growing for now, and may even shrink a bit. This may work for a few years (or much more or much less) and then, when we need to, we will talk about what needs to happen next. All the avenues of chemo treatment are still open to me, but we won't break them out until (and if) the cancer stops responding to this starvation, which is called "hormone therapy".
So, you may ask, how do we cut off the estrogen supply to the cancer? By completely removing it from my body in a very short amount of time. Like the cancer, my body is not going to enjoy this very much. Essentially, I will be passing into complete menopause in a matter of days. Most women find this uncomfortable spread over months as the body adjusts, so he has warned me that I am likely to find it quite uncomfortable for a few weeks. Still, it all sounds better than chemo to me, so it's all relative at this point!
This is the plan: we will begin to shock the estrogen out of my system today with an injection and oral therapy that will continue for 3 months. At the end of 3 months we will re-scan my entire body to see if we have indeed halted the growth of the cancer. If it is working, we will remove my ovaries to make my post-menopausal status permanent and consider whether or not to proceed with the masectomy, depending on how the breast tumor is looking.
Warning: I am apparently going to be intensely crabby and weepy over the next few weeks. (Pray for Jay!) It has been suggested to me that I consider laying off the blog during this time in case I alarm any of you with what are sure to be crazily shifting perspectives on all of this. I may and I may not, but do be forewarned as to the potential instability of my sanity as my body adjusts. By all accounts it will return eventually.
Oh, I almost forgot to mention the really good news in all of this: So far, the spreading cancer has not done much damage to my liver. It is sprinkled all over it like fairy dust, but has not really dug in anywhere and affected its function. So, if we stop this thing where it is I can literally live for decades with it. That's right, decades! This is so much more than we hoped for when we walked into that office yesterday, and hope is such a good thing.
Of course, the less attractive alternative remains that the cancer does not respond to hormone therapy at all and continutes to grow over the next three months, so please pray specifically that it responds (and keep up with that whole complete miracle cure thing too, if you don't mind!).
Thanks again, amazing family and friends. You teach me strength, faith and charity, and humble me with your kindness.