Wednesday January 5th 2011. I have been dreading this day since I was diagnosed in November. It felt as though I had to cram in as much of life as I could. Today I met with my oncologist team at Princess Margaret. I did not sleep at all last night. I knew that the results of the genetic testing would ultimately determine my treatment course and my chance at a semi-normal life. Going back to the hospital today makes it real. It means I really do have cancer. Shit.
8:30 am: Waaaaaayyy to early to be doing anything, let alone be sitting in the waiting room of my neurosurgeon's office. Because that's exactly where I wanna be right?! Lots of windows though, so that's a nice touch. I'm waiting to hear the results of my post-op MRI on Dec 29th. Can I just also add that follow-up MRI scans are hell. If I've said it once, I'll say it again: MRI scans cause sheer emotional turmoil. When I finally see my neurosurgeon, he tells me I look good (well obvs!), and reads the radiologist's report: the tumour has been completely resected, and there are still signs of lingering inflammation around the surgical cavity. There are also signs of low-grade cancer cells around the tumour bed - "cancer/abnormal activity". He also told me that the surgical cavity has filled with some sort of fluid, which he explained was perfectly normal and was not at all concerned. Bottomline: the post-op MRI is as good as it can be. Finally, some good news! Point for Sarah.
1:30 pm: Blood work. Story of my life. I have people in every blood lab in the GTA. How awesome is that? I should get a t-shirt made or something.
3:30pm: Pulling out the big guns now. In comes one of my oncologists. I'm a nervous wreck. This is it. Pull it together. Before I get to the details, let me give some background on the importance of this day. My cancer cells can have a specific genetic make-up: a 1p19q loss of heterozygosity. The co-deletion of both 1p19q renders the cancer cells more sensitive to chemotherapy. The 1p deletion is particularly significant. I've been anxiously waiting the results of this genetic test for over a month. Am I looking at chemo? Chemo and radiation? Or radiation? I was hoping to avoid radiation all together. I didn't really want to go down to the hospital 5 days a week, every day for my sessions. Plus, radiating my poor brain cannot be good. And I think everyone knows the side effects of conventional cancer treatment. So, deep breath. My oncologist said I have a good prognosis and he would recommend chemotherapy at this time. I had to ask him a second time. I have the co-deletion of both 1p and 19q?????!!!! I know it sounds ridiculous, but I was excited. I mean if you're going to have cancer right?! Given the results of the genetic testing and my post-op MRI, he prescribed temozolomide for 12 months. Chemo for one year: 1 pill for 5 days once month, which is all my body can handle. This drug is generally well-tolerated, although nausea and vomiting can be an issue. Never mind, they'e got good drugs out there for that shit. It also crosses the blood brain barrier, and has been effective in treating aggressive brain tumours. I need to see my oncologist every month for follow-up and blood work, since chemo is destroying all my rapidly dividing cells. We'll do a scan three months from now to see what's going on, and that will determine what happens next. This means that if the tumour were to ever come back, I have radiation in my back pocket. More arsenal to fight FigNewton the III. Bastard. So I feel like a dodged a major hurdle today and I'm crossing my fingers that I respond to chemo. My oncology team fully expects that my scan in 3 months will be stable.
So that's my update. I'd have to say I'm relieved. Finally, some good news. Finally things are turning up Sarah. I feel confident that I can and will beat this. However, I also know the race, the battle is not yet won. It's still a long road, and even though the news today is a step in the right direction, cancer is an unpredictable bitch, and I gotta stay on high alert. I start chemo tomorrow. Sarah vs. Cancer Round 1. Let's box.
