Friday, May 30, 2008

Second Opinions

Hard to believe it's been 3 weeks, almost 4, since I last wrote. Work has actually picked up finally and I'm way behind, which is really a good thing since the first few months of this year were so slow we almost went belly-up. And of course Little League has been consuming almost every non-working moment. What little time that leaves I have tried to devote to Cathy, "the baseball widow", as she refers to herself. When I do sit down at the computer to write, I've been trying to catch up my Little League team's website. It's a very cool thing, which I love doing for the kids, but it is time consuming. There's a link here somewhere, on the right side I think.
Cathy spent the last 2 days in Durham (NC, not Conn) at Duke University seeing the doctor who was her oncologist when she was first diagnosed as having cancer. Our friend Chris took her down there and they stayed with a couple who are his "other" best friends. Chris is our closest friend. He lost his father this past January, after losing his mother a few months earlier. I wrote about his father in a January post entitled "Getting Old". Chris stays with this couple who live near Durham quite a bit, though not as much now that he's retired and not travelling all over the state all week. Seems backwards, doesn't it? We know them ourselves, through Chris, and have been to their place a few times in the past, but this is the first time either of us have been to their new home. It's on a lake, and very nice, I understand. When the doctor asked Cathy to stay another day for some more tests, Chris just said "hey, I get to go fishing another day". He's the best.
The real story is that Cathy is seeking answers to her questions about her treatment. The doctor she sees now uses a test that tracks "cancer markers" in the cells. I'm not medically literate, but essentially it measures a particular chemical level in the body which will tend to rise when cancerous cells are present. Apparently it gives you very early warning about these cells, but some believe it gives TOO early of a warning. Doctors such as the woman Cathy saw at Duke believe these markers only show the possibility of cancer, not necessarily the presence. Therefore, in their opinion, one could be getting treatment for a non-existent condition, treatment that is extremely destructive to one's quality of life. She believes in treatment only when a biopsy shows a definite cancer presence.
The other side is that we deeply respect the doctor she is seeing now at Forsyth Memorial's Cancer Center. He is a long-time Little League acquaintance. That alone, of course, is not reason enough to trust him with one's life, but we've known him long enough to know that he's a straight shooter, he's completely honest with us, and he's very in tune with the cutting edge of cancer treatment. He believes the markers he tracks are very reliable indicators of tumor growth, or at least of impending tumor growth, and by treating when those numbers go up he is running interference on the spread of the disease. Stopping it before it gets started.
That is a wonderful thought, never let the damn thing get going and you can live indefinitely, right? But the truth is chemo is hard. Cathy has no energy while she's on it, and until the staff infection forced them to remove her portacath, she was getting chemo almost constantly. After several straight months of treatment the numbers would get down to a level that our Dr. was OK with. She would get a break just for a few weeks, then the numbers would start to rise and she was right back at it. It's been weeks now since she's had treatment, and she's feeling better than she has in a very long time. The garden is looking better than it has in several years. I'm doing most of the heavy work there, but she's out there directing me, showing what to plant where, telling me what's a weed and what I'd better not touch, pulling weeds herself, spreading mulch, stuff she hasn't done in a very long time.
So it seems to all come back to the "quality of life" question. But now there's indication from her former doctor, whom she trusts very much and really, really likes, that maybe the treatments aren't even necessary at this point. Maybe we're not gaining any time together by constantly going through the hardship of chemo. Maybe we can go on as normal until we see a definitive tumor presence in a biopsy and then treat it and still have just as much time. Two doctors, two different views. Who can know? How does a simple lay-person decide?
Of course, Cathy is no simple lay-person. She is an RN, and was in oncology when she worked at the hospital. She also spent a few years working with Hospice, which gave her even more experience with cancer, from a different perspective. So she is on-line a lot, looking up reports, reading up on new medicines and treatments, and checking out the medicines they are giving her already. This has proved very valuable a few times as she has caught symptons she was having and tied them to one of her meds.
Eventually she will make her own decision and I will support it regardless of what she decides. I do feel like we are going through this together, but the truth is there is no way I can feel what she is feeling, physically or mentally, and while I certainly can help her talk it out if she wants, I think this is one decision that she has the only vote on.
Kinda like our president, I guess. :)

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