Monday, June 7, 2010

Survivor- The Unscripted Reality Show of My Life

My saga with chemotherapy is coming to a close-- for now.  I am getting back some strength finally and hope to go back to work next week after I have the port removed from my abdomen.  So all that is left for now is the quarterly checkups and the ongoing fear that maybe the cancer will come back.

I have said here before that I am a big believer in statistics and even though I understand that statistics do not predict the individual case, I am always taken aback when I see the stats on recovery from ovarian cancer.  In short, the numbers are not all that good.  In the NYT this morning a hopeful headline about a new treatment for ovarian cancer led me to read the article with anticipation.  Unfortunately, my focus when reading the article was not the "hopeful" outcome but instead the median times for the cancer to "worsen" after chemotherapy--a surprisingly short 10+ change months for the control group who, like me, received standard chemo after surgery.  Holy "bleep"!  If I am "average", my cancer will be back in less than a year!  I understand  the arguments why that may not be true in my individual case--I responded well to surgery and chemo, I had stage 3A cancer, not stage 3C or stage 4 where tumors have spread and/or cannot be fully debulked, I am younger and healthier than the average ovarian cancer patient etc.  Still I cannot help flinching at the stats which never cease to surprise me at how bad this particular cancer is.

In another albeit older NYT article I found today, a study found that monitoring CA125 levels every three months did not improve survival rates for ovarian cancer.  Huh?  In fact, the head of my gyn-onc group at Cedars was quoted in the article as saying that the group would reconsider how frequently to test CA 125 levels in light of the study.  Apparently my doctor did not get the memo or new evidence changed their mind because I was told that I had to come back every three months to check CA 125 levels.  The article was also interesting in that some patients apparently want to have their levels checked because it gives them the illusion of control in an inherently unpredictable situation.  I can understand that justification for the test although if it does not matter to chances of survival I could do without the anxiety of the blood test and waiting for the results, thank you very much.

I have faced the issue of stats before when I read a critique of the proposed protocol for my chemo treatment right before I started chemo.  The critique found flaws in the study design that led to the National Cancer Institute recommending IP chemo with cisplatin and taxol for ovarian cancer.  "More study is needed", the critique stated.  I agreed with the critique and then ignored the analysis and underwent the IP delivered chemo protocol anyway.  Why?  Because my doctor thinks it works and he has made his life treating patients like me.  Statistics and study design do not matter when you have put your life in the hands of your oncologist.  You just feel happy when the CA 125 levels keep going down and hopefully stay down.

So as I start my "normal" life again I have all these fears about the future and yet I keep reminding myself that the stats do not matter to me as the individual.  I will survive as long as I am going to survive.

ADDENDUM:  After I published this post I realized that as I close my chemo saga, I still have to get back my hair.  It continues to bug me that I do not have hair but the fact that I did not mention it when I was recalling what was left now to get back to normal after chemo obviously shows that I have shifted my focus a bit.

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