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A New Battle, an Old Foe

She knew breast cancer could come back, but it still surprised her. This time, she had a different weapon.

September 09, 2002|By Mary Susan Herczog | Special to The Times

It was a typical day at the new house, which meant I was busy dealing with, variously, Carpenter Guy, Plumber Guy, Handyman Guy and, for a change of pace, Computer Guy, when Dr. James Waisman, otherwise known as Oncologist Guy, called.

"Your tumor markers came back high," he said, referring to a blood test, taken a few days before, that detects a protein made by cancer cells.

"Oh yeah?" I responded, absently juggling the phone while writing checks and pointing. "And high is what?"

"Normal is 0-40. Yours are 252."

"Dear me, that is high," I said, attention having been seized. "And that means what now?"

"It's back."

Yes, gentle reader, it, and I, are back. "It" would be the breast cancer I had diagnosed (I forgo the verb "battled" since, to my way of thinking, all I did was lie back and let stuff be done to me) in 1997 and thought banished forever by July 1998, chronicled right here in a monthly series called "brave and inspirational" by some and "obliviously and freakishly cheerful" by others.

Though my doctors, Waisman and Melvin Silverstein (both once at the Van Nuys-based Breast Center, now still together fighting the good fight at USC Norris' Lee Breast Center) had thought it entirely likely I had seen the back of cancer for good, they had also warned me there were chances of a recurrence. So I'd like to say this wasn't entirely unexpected. But that would be a lie. It was completely unexpected, as was the initial breast cancer.

And I certainly didn't expect Waisman to say what he did--that not only was it back, but it was actually not in the breast but elsewhere--and thus much more difficult to treat.

But after a number of tests--CT, PET (positron emission tomography), bone scan and then way too many needle biopsies under only local anesthetic--it was confirmed; the cancer had returned, and set up shop in my liver. Fortunately, the tumor was tiny, and most of it was blood and not cancer cells, but still. Stage 4 metastasized cancer, they call it (there is no stage 5). All sorts of four-letter words, I call it.

Quickly, let's clear up a misconception: Having breast cancer in your liver means you still have breast cancer, not suddenly liver cancer. Breast cancer is not life threatening while in the breast--breasts are not vital organs except in relation to matters like Pamela Anderson's career. But have it spread to your liver and you learn that 85% of patients die within five years of diagnosis and the rest don't live much longer.

OK, said Waisman upon the confirmation, we are going to go for the home run here--total cure. He thought this possible because of new drugs (and new combinations of drugs), all of which had come into play since I was last treated, and because my cancer seemed confined to a solitary site. And a triple would be what? "We get rid of it, it comes back in five or six years and by then we have the Magic Bullet."

Fine, said my husband, Steve, and I, so what's the plan? A relatively new protocol, combining two different chemos every three weeks.

Day 1 delivers, via IV, Taxotere, a newish chemo that seems to pack a serious wallop but without massive side effects. Starting also that day will be two weeks of oral chemo Xeloda, which also doesn't cause too many problems. A week off, and then repeat, for a total of six rounds.

Hey, that sounds great! we said. Except, he continued, when you combine the two chemos, the results are super-ultra toxic.

Well, of course they are. And that means? Body aches, bad ones. Mouth sores. Fatigue. "But no nausea?" I said, having priorities. No, it doesn't seem to affect the GI tract. Swollen, tingling, peeling hands and feet. But no nausea!

I can do that, I said.

Oh, and uh, just out of curiosity, what if we did nothing? I asked. What are we talking here? "About a year and a half."

Righteo! Here I go! Off to do something! You betcha!

So I did what anybody would do--I dyed my hair platinum. After all, it would fall out before I would have to deal with roots.

Waisman warned me at the outset, this stuff will--and this is the scientific term here--"kick your butt."

Nonsense, I sniffed, not my butt. Nothing kicks my butt. And indeed, I felt rather spiffy for a long time. The regimen didn't seem like much at first. Chemo day passed in an amnesiac blur thanks to the medicinal cocktail that went along with it, as would the following day. Day 3 brought the predicted body aches; think flu aches, only sharper. No matter, my new best friend Vicodin (good enough for certain celebrities, good enough for me) wiped those out.

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