The Oncology Appointment

10 July 09

We met with Dr. Markus today. This was our second appt. with him. He is part of the Rocky Mountain Cancer Center practice, which itself is a satellite of a center up in Denver. We're very happy with the arrangement and as for Markus himself? Kind of an egghead. And I'm pretty sure that's how he'd describe himself.

He's a really, really, really smart guy--MD and PhD--and as he talks about cancer and oncology, I can see that he is. . .on fire about it. He likes his subject. And he really knows his subject. He is a man of science, and not too interested in a personal connection. That said, let's be realistic about what kind of doctors the field of oncology is likely to attract. Are these doctors supposed to "people people"? No. They're supposed to be eggheaded scientists constantly striving to identify and deliver the latest and greatest advancement. At least, that's who I want on my team.

And all that said, Markus himself has a talent for explaining his mega-wat knowledge in exactly the terms that makes sense to me and Bryan. He answers our questions very well and completely and he's very likeable. Just when I was thinking to myself, "I guess it's OK that I'm just another cancer case to this guy" he commented on the philosophy of treatment we should be taking: "Let's just beat you up now with everything we have because then you'll be dancing one day at your child's wedding." To his great credit, he teared up as he said it.

I am a sucker for doctors who nearly cry.

So, yeah, we believe we are hooked up with the right guy. Not a single reservation about him. Of note is that his first name is Maurice. I am hard-pressed to name more than 5 American pop songs that include a man's name. "Maurice" is on the list.

Do you care about any of this or should I just get to the treatment portion of the post?

Chemo shall begin 2 weeks from now. We have two options in front of us. Tests demonstrate that they have the same outcome. But this doesn't mean that there is not a right choice for us.

With the surgery vs. chemo first choice, research shows the same statistical result. Yet it was very clear to us that we were to do one and not the other.

With this choice, there seems right now to be no big distinction. Option 1 is Old School. It includes getting "A," which is the "poster child" poison of chemo from the beginning. And it also includes starting "H" at the end of the protocol. The advantage is that "A" attacks cancer cells. There's a reason it's a classic.

"H" is a protein that's only a few years on the scene. Mine is a really aggressive, nasty sort of cancer that multiplies quickly. "H" is a protein that stops its growth. "H" is not for every type of breast cancer, but it is for mine. (Before "H" came along, the prognosis for my type of cancer was a little on the dim side, just because it is so dang aggressive. Amid everything else I'm feeling, I am deeply thankful to all the women who came before me and offered up their treatment to clinical trial.)

Option 2 does not include "A," but it starts "H" at the very beginning of the protocol. The advantage is that we'd be starting "H"--the cancer-growth inhibitor--right away instead of later.

And it's not a simple "A" vs. "H" kind of choice--it's not like that's the only difference. The two protocols themselves are different chemical approaches. I've just broken out the theoretical difference for you as Markus explained it to us.

As far as side effects, both protocols are identical. Except that "A" is the primo cause of nausea, and as I'm prone to nausea (e.g. motion sickness, car sickness, trampoline sickness) I'd likely become nauseous. They give drugs to counter-act this, of course. But then, that's just more drugs for my system to absorb.

This is what we need to think about and pray about in the coming week. We hope to give him a decision by next Friday.

Both protocols last for about 4 months. The chemo goes in once every 3 weeks. And either way, I'll go in once a week for an entire year to get the "H." (With Option 2, I'd start going weekly from the beginning because the "H" starts immediately.)


In terms of the statistics, it's a coin toss, as Markus says. He is very good about sharing which way he leans/where his preference lies, but also pointing to the science and admitting that it's just that: a preference. (And his preference is Option 2.)

So, coin toss, yes. But, again, this doesn't mean there's not a definite path before us. Please pray for our discernment.