Once A Cancer Patient, Always A Cancer Patient

I recently read a blog post from one of my favorite bloggers and author, Nancy Stordahl.  She discusses the fact that seven years after her diagnosis she still needs her Oncologist.  After reading this post and the comments left by other women, I decided I wanted to continue that discussion here.

After a cancer diagnosis, finding the right medical team is not always as easy as it may sound.  Of course you start with whoever is in your area, any local cancer center, and who accepts your insurance.  One thing you have to consider is that you will be working with this team for a very long time, especially the Oncologist.  Once treated for the disease, you will still continue to have regular visits for blood tests and exams for years to come.

For instance, my treatment was over at the end of 2013, and here it is May of 2017 and I am still seeing my Oncologist every 3 months for blood tests and physical exams.

The doctor/patient relationship must be a solid one if you are both going to deal with each other this long.  According to Nancy's blog, finding the right doctor has not been easy for many patients.  You must decide what things are important to you in your medical team. 

Does the doctor listen to you and answer your questions? Does he or she treat you kindly or are they stern and overbearing?  How much experience do they have treating this disease? Do they discuss all the many different treatments for cancer and help you make the tough decisions?  Do they welcome all of your questions and do their best to find you answers? 

These are all good questions to consider when forming this relationship. Having to change doctors in the midst of treatment can be very stressful and difficult with so many emotional issues going on at that time.  

Nancy went thru 5 doctors before finding the right match. 5! That is nuts!  Her 5th choice was a woman who had extensive experience with BRCA+ patients so that was a good match for her.  That relationship turned out to be a disaster, so she went back to choice #4 and developed a relationship of mutual respect.  However, to hear her tell it, this doctor is warm and cordial, yet they do not chit chat much. There are no hugs, only handshakes, and they usually stay on topic when discussing her case.

If that sort of relationship works for you then that is great. For me, I got so lucky I still thank the universe every day! My Oncologist is a leader in his field here in Southern California, and one of the happiest, funniest guys I have ever met! He is the lead Oncologist at my local cancer center which is literally only 15 minutes from my house.  The only snag I ran into is that no one at this center accepted my insurance. Because my general physician worked with all of these folks at our local hospital he went to bat for me and my team decided to take me on despite my insurance!

This man tells me jokes, hugs me every single time I walk in, kisses me on the forehead and tells me I am beautiful even when I feel like the ugliest duckling.  I have always felt safe in his care and his entire team. His nurses are knowledgeable, caring, and also full of personality.  His team of radiologists and surgeons were also great people that all made my journey uplifting and actually a bit fun! Even the nurses in the infusion room for chemotherapy had me laughing and chatting so the time would fly by.

There are several other reasons why I adore this team and this cancer center. One big reason is that I have online access to my medical records so I can see all my test results as they are posted. This also means my general physician can also follow my treatment and test results, so discussing anything between my Oncologist and regular doctor is so easy, and they can communicate with each other as well!

I realize now after reading Nancy's blog post that I am the exception to the rule and I feel so bad for people who are having a tough time with their medical staff.  

One women commented that her doctor does not have the time for her list of questions at her visits. Another women commented that an intern used the word "cure" when discussing chemotherapy with her and this made her lose confidence in their experience. Another woman said she went the way of a naturopath instead of the traditional Oncologist and that seemed to be working for her.  

The one recurring theme I see is that all these women discussed that their relationship with their doctor was a bit too impersonal and cold.  So many people are getting cancer today, and these doctors can be overbooked, overworked, and we all become just a number a to them.  If this is not the sort of relationship you want, my advice is to just keep looking.  If I had to visit a doctor every 3 months that did not listen to me, or had a cold personality, I would go mad!

I still have another year or more to go with my doctor and while the visit itself can be stressful, I look forward to seeing him.  He knows I am on pins and needles waiting for each blood test result, yet always has a joke or a hug or a smile for me. My biggest fear right now is that he is close to retirement and I may have to begin the search for a new Oncologist if he leaves. You can bet I will judge every doctor to come by my current one!


Image provided by Pixabay.com 

And Now For The Good News!

During this 2017 Relay For Life season - amidst all the fundraising, walks, and painting the town purple - I would like to talk about some good news!  All of that research we are raising funds for is actually working!! 

The most amazing new research is on a nanoparticle that can shrink breast cancer tumors while also preventing any recurrance of the disease! Can you imagine? 

It sounds very sci-fi, but researchers at the Mayo Clinic have developed this nanoparticle and have tested it on mice.  70% to 80% of the mice tested showed a reduction in tumor size, but even more amazing is that they showed a resistance to any new tumors recurring, even when exposed to cancer cells approximately one month later!

Test results showed that it was producing an immune response to HER2-positive breast cancers.  Basically it is causing the body to create memory in the immune system! To read further about this study you can check out the Nature Nanotechnology online publication.

For women like myself, diagnosed with estrogen receptor-positive (ER-positive) breast cancer, there is also some good news!  In the headlines earlier this year was an announcement about a new chemotherapy drug called Abraxane.  

One of the drugs used in my chemotherapy, Taxol, is very hard on the body and causes many side effects including severe allergic reaction.  Because Taxol does not dissolve in water, it has to be put into solvents along with steroids and antihistamines when delivered to the body.  This meant I had to be in that infusion chair for upwards of 4 hours.  The biggest issue with this particular drug is how we acquire it. It comes from the bark of a Himalayan yew tree which is now facing extinction.

Abraxane does not have this problem, which means no more solvent or added medications, which in turn reduces the infusion time for chemotherapy from 4-5 hours down to roughly a half hour!!  Testing also showed that women receiving this drug had almost double the response rate.  It seems it is all about the delivery!

At this time the FDA has only approved this drug for women with recurring or metastasized breast cancer, but it is only a matter of time!

Another recent development is a new aromatase inhibitor hormone therapy that seems to perform better than Tamoxifen.  This means, for post-menopausal women, they reduce the risk of late recurrance in ER-positive cancers even better! Testing is still ongoing.

Lastly, on the radiation front, a new accelerated course of treatment is being researched that could reduce the current 6 1/2 week treatment down to about half of that! This can be a huge quality of life issue for some women, where going in for radiation 5 days a week for 6 1/2 weeks can really be a challenge.

For myself, not only were my issues about travel and parking fees, which I was thankfully validated for, but also it meant that after treatment each day I was wiped out!  Because I have very sensitive skin it really did a number on me.

Rutgers Cancer Institute of New Jersey is currently testing this targeted radiation and trials are showing positive results.

So while you walk around those tracks and raise money for your RFL teams, remember, what you are doing is really working in the real world for real people! It may not be a cure yet, but this new research will provide women suffering from breast cancer and the side effects of treatment a better quality of life!


Image provided by Pixabay.com

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This brought me to tears. She and I share the same fear and the same concern about the direction our country is headed. I urge the Senate to rethink this act of murder!