Somehow, we know what we know...

I was at an offsite meeting in Stamford for a few days, and my attempt at posting via email apparently failed miserably, so some updates are due. First, Dr. Megibow confirmed that the lesions on the hip & spine are indeed metastases. I knew that already. I did have those brief moments of hope that we were dealing with "just" the liver, but inside I knew that it was not real. Because of that, when Beth was telling me this on the phone, we had a conversation about my first course of treatment in 2006. I told Beth that I wasn't blaming anyone or even criticising, but that looking backwards, when I was diagnosed with atypical medullary breast cancer, we all seized on the "medullary" part and not the "atypical" part. Medullarys are associated with good outcomes (ie 94% 5 year survival rate - although I don't know how fresh that data is), atypical medullarys have a prognosis more like invasive ductal (64%). Again, looking back, the cell division rate was high, and the tumor wasn't tiny. So probably, Taxol would have been a good idea. Would it have changed where we are now? No way to know. But, my point was that this time, optimism is not a strategy. Hope is not a strategy. Our strategy has to be realistic and we have to bring everything we have to bear on this disease.
So I had the last chemo of this cycle on Tuesday, and it went just great. Got to watch all but the last 10 minutes of Roman Holiday on her portable dvd player. My blood work showed that the liver enzymes are getting better, and that the neupogen is keeping my white blood cells in good shape.
Albert and I met with Dr. Stella Lymberis yesterday to talk about a protocol for radiation to the hip & spine. She showed us the lesions on the CT scan, which was helpful, and her recommendation is that we give the chemo & avastin a couple of weeks to do their thing, have another CT scan in 3 weeks, then see what's what. If the tumors are stable or have shrunk, then we will not radiate yet. If there is any progression of these 2 tumors, we will radiate, because in both cases they are close enough to nerves or the spinal column to worry about. We both liked Dr. Lymberis, her approach was both very rational and reassuring. I had the same conversation with her that I had with Beth, because it's important that the doctors know how I feel about treating my disease.
Hair is falling out but not yet in clumps, so no bald patches yet. At the offsite, I wore a beige wool jacket that just collected EVERY hair, and I was extremely self conscious all day Thursday. Today I am going to get my hair cut pretty short so it's not so noticable when I shed, and I expect by next weekend to have to buzz it and start with the wigs.