Postcard From Tucson

So, I'm in Tucson, as many of you know, for one of my twice-yearly checkups with Dr. Livingston, who was my medical oncologist from the time I was first diagnosed back in 1998 until he moved to Arizona more than a year ago.

This is the third time I've come down to see Dr. Livingston, and every time I've felt it was so worth it. Just to see him, and to have him review everything that is going on with me and my treatment, and to tell me what he thinks.

There is a level of trust here that I do not have with any of my other doctors. (In the case of Dr. Lee, my new medical oncologist in Seattle, I think we'll get there, but it's still not the same, much as I like him.)

The News
Last time I saw Dr. L, last May, I was at the point of refusing any more treatment. Let's be honest: I was contemplating suicide. That's how strung out and upset I was--It was a combination of my being totally worn out from treatment, problems Younger Son was having, and frightening problems at the cancer center in Seattle (Swedish) where I was being treated at the time.

He, bless him, proposed a treatment break. That lasted six months, and since then I've had lots of treatment in a short time: two rounds of radiation, three weeks at a time, and I've started a new chemo regimen, which includes Tykerb.

As I've said in earlier posts, my tumor marker dropped like a rock in the last couple of months, putting me in the "no active disease" category, possibly in the "clinical remission" category (although Dr. L and I didn't discuss labels), and I DIDN'T BELIEVE IT.

So, basically, I came to Tucson to have Dr. L tell me to believe these test results. And now I do.

He did say something that I hadn't heard before, which is that the Tykerb, my new oral chemo drug, sensitized the cancer cells so that the radiation worked better than it would have if I had not been on Tykerb at the time. That was cool. Take that, cancer cells.

My mental mantra for cancer cells goes something like this: "Biff. Bang. Bop. Take that! Nuke them back to the future!" I used to do the new-age-y visualization stuff, talking gently to my body and my cells, but now my visualizations are at the level of a violent comic book. Where's my super hero?

I also, being me, had a long list of questions written out, and we went over these carefully, everything from whether or not I should go back on Avastin (no), to possible harm to my thyroid from the last round of radiation, to how often I should get zometa (the ONE DRUG that I am now getting by IV. For most of my history since metastasis hit six years ago, I've gotten three or four drugs every time I went in for treatment).

Zometa damages the kidneys, and I don't want my kidneys to fail--wouldn't that be an irony: To be killed by the cancer treatment rather than the disease. Of course, that happens. We all know it.

And then there's the dip in my chest where my right breast used to be. It's gotten deeper recently, and I didn't worry about it so much as wonder whether or not I SHOULD be worrying about it. I asked one of my doctors in Seattle, and he just kind of dismissed my question without answering it.

Dr. L says that it is atrophy of the tissues because I had radiation to the chest back in 1999, when I had a local recurrence.

Great. Question answered. No more need to wonder. Or worry.

We had a bit of mutual congratulation over the fact that my tumor marker (CEA) has never been this low. Never. Not in six years of treatment for metastatic disease. And I reminded him that he had been taking care of me for more than nine years now, which is also quite a milestone. Typically, women with metastatic breast cancer only live two to three years from the time of the metastases.

There are a growing number of us, though, who are living a lot longer than that, especially women whose mets are only in the bone.

We also talked about my low energy and agreed that once I had the results of the tests of my thyroid function I could go from there with Dr. Lee. But also I need to accept that I'm going to feel like crap for a few more weeks, or possibly a month, because of the radiation.

That is so hard for me. Unbelievably hard. I do not do "feeling like crap" well.

As I write this, I'm still in bed in the hotel in Tucson, haven't gone any further than the bathroom. Monica is here and she brought me coffee and water. It's noon, and I'm contemplating staying in bed all afternoon, because we want to go out tonight to an art thing, a First Friday gallery show at the art museum here.

What I'd really like to do is go for a short hike in the desert, but I don't have the energy. We're going to try that tomorrow morning.

The Horizon Opens Up, Again
So I'll go back to Seattle with a couple of things to check out with my oncologist at home, Dr. Lee, and with incredible peace of mind. The feeling that I have is that the horizon is opening out again.

I asked Dr. L this question: "Given the low tumor marker, and how well I am responding to the Tykerb, I feel like I probably have a year of feeling good ahead of me." And then I stopped and waited for him to answer my question posed as a statement, and he said, "YES."

So. Yes. That means, given the way I live my life, that I will focus on the things I want to do in the next year, because I have some assurance that I will be able to do them: A couple of short trips. The Cancer Bloggers Reunion. The trip to Japan in October.

Then, at home, it's almost time to start thinking about my vegetable garden for the coming summer. Time to start some seeds and know that I will be here to plant them outside, and to eat the fruits and vegetables as they ripen.

Tired as I am, I love my life, and I'm willing to fight for it, for at least a while longer.

Love you all.

A note: If you want to read more about Tykerb, go to the search box in the right column and enter "Tykerb." I've written at least a half dozen posts about this new targeted therapy.

@ Jeanne Sather 2008.

Comments

[Lisa]

JEanne, COngratulations on the good news. Believe it and celebrate it. I hope that you get your walk in the desert.

[jeanne]

Lisa--thanks! I am celebrating, in bed with some pudding and my blog. And I'll get the walk tomorrow.

Missing my dog--what's a hike without a dog? But he's at home.

[Laurie]

WOO HOO! I'm glad to read this news, and it's a joy to hear the positive, kick-butt attitude you're feeling today. Should we go out somewhere to celebrate when you're back in Seattle? A Japanese dinner, perhaps? Happy travels on the way home.

[jeanne]

A Japanese dinner would be wonderful, thanks for thinking of that, especially when I've kept canceling on you lately. Maybe an early dinner on a weekend?

[laurie]

Remission is one of the most beautiful words in the English language. So glad to 'hear' you using it.

[Amorette]

Excellent! Worth it to make the trip...that's how I (usually) feel about my neurosurgeon, too.

I hope you have a year of feeling good ahead...and then another year, and another.

:)

[jeanne]

Oh, yeah, but you know me, Amorette, I'm living on the two-year plan. Refuse to worry or plan anything further than two years out, and generally just a year. Doesn't mean I think it's all going to come crashing down after that--not with the friends I have.

I'll e-mail you tomorrow morning with a request, right now Monica and I are heading out to paint Tucson red (which won't be hard)--we're going to a thing at the art museum, all dressed up.

[Liz J.]

Congratulations, I love your good news.

[amy]

I love this post, I really do. Congratulations!