This Monday morning begins, as many have over the past 6 months, at the Dartmouth-Hitchcock Norris Cotton Cancer Center-Kingsbury Pavilion (say that 10 times fast!).

In her ongoing fight against breast cancer, my wife ended four months of chemotherapy with her last treatment back on December 6, 2011. She’s thoroughly enjoyed having several weeks without any kind of treatments. Her hair is very slowly starting to re-appear and she’s been feeling overall pretty good.

Today begins the next course of treatment. She is starting one year of receiving a drug called Herceptin. Her breast cancer tumor was found to be “HER2/neu positive” and the theory goes that the antibody in this drug will help reduce the chances of recurrence of her cancer. Every three weeks for the next year, she’ll be coming in to the cancer center for a couple of hours to get an intravenous infusion.

Herceptin is NOT chemotherapy and the side effects are expected to be minimal. Perhaps just some fatigue for a couple of days. (And, oh, yeah, there are potential cardiac issues that need to be monitored… 🙁 )

And then assuming all goes well, in 3 weeks she will start five years of a daily pill of Tamoxifen an anti-estrogen hormone treatment that will effectively be trying to starve any remaining cancer cells that need estrogen to grow. All sorts of lovely potential side effects to that including many of the effects of menopause (ex. hot flashes, mood changes), memory loss/fuzziness, and even increased risk of other cancers.

Not fun.

As we’ve gone through this process, I admit to feeling that as far as we have come with research into breast cancer (and we HAVE come a long way), we still have such a long way to go.

The treatments we have today are like a series of sledgehammers, each trying to do what it can to beat the cancer cells down. Your treatment seems to be:

• operate on your body to physically remove the tumor
• slam your body with a series of radiation blasts to kill cells that may have been around the tumor (thankfully my wife did NOT have to do this)
• slam your body with truly toxic chemicals (chemotherapy) to try to kill off any remaining cancer cells (and many other good cells in your body)
• slam your body with antibodies to try to block and kill any remaining cancer cells
• slam your body with hormone therapy to try to starve any remaining cancer cells

Wham… wham… wham… wham… blow after blow after blow after blow in an attempt to kill off any cancer cells in the body and reduce the risk of recurrence.

All the while with the frustrating reality that there might not be ANY cancer cells in your body right now!

Now, the treatments are getting better. Instead of big, massive sledgehammers that are applied to every woman, the treatments today are perhaps smaller sledgehammers that can be targeted a bit more. There are tests that can determine whether some treatments are appropriate – or not – for people. (Something I wrote about before.)

Still, though, the treatments seem to be pretty heavy-hitting.

We need the mystical “scanners” of sci-fi shows that can scan a body and confirm the existence of cancer cells to see if any of this is really necessary.

We need even better drug options that can target specific cancer cells more like scalpels instead of sledgehammers.

We need the “nano-machines” of sci-fi that can travel through the blood and find and kill cancer cells.

We need more refined and targeted weapons in this ongoing war on cancer.

And I know we WILL have improved weapons over time…

Meanwhile it’s hard to argue with the odds of using the existing treatments. According to the tests on my wife’s tumor and based on various studies, there was a 60% chance that she’d be cancer-free after 10 years if she did no further treatments beyond the removal of the tumor.

Add chemotherapy… add Herceptin… add Tamoxifen… add all that together and statistically her chance of being cancer-free after 10 years is now up in the 90s percentage-wise. Maybe 92% or 93%.

60% vs 92%

Not a hard decision to make, even with all the side effects.

While I’ve already tweeted, Facebooked and Google+’d about it, I should record here for the sake of completeness that my wife was recently interviewed for what turned out to be an excellent article and photo of her in our local Keene Sentinel newspaper.

The article, titled “KEEPING THE FAITH” by columnist Sherry Hughes, is now available online and was on the front page of the Friday, October 21, 2011, dead-tree edition of the Sentinel as part of a feature on Breast Cancer Awareness Month.

As she will say herself, this was pushing my wife WAY outside of her comfort zone… in stark contrast to me, she is an intensely private person and severely dislikes having her picture taken (even with hair!). She agreed to do the interview when asked by a friend… and then proceeded to do it even after finding out that a photographer would be coming.

It turned out to be an excellent, inspiring and uplifting article (admittedly, I’m intensely biased 🙂 and I thought the photo of her turned out great. I’m extremely inspired, personally, by how open she’s been about it all… “it is what it is”, as she says.

Anyway, that’s the last chapter in our ongoing cancer saga… a bit of unexpected publicity and a chance to tell her story…

Today is my wife’s second (of four) chemotherapy appointments. She is sitting right now at the Norris Cotton Cancer Center at the Cheshire Medical Center here in Keene, NH, with an IV of toxic drugs flowing in to her.

Many friends have contacted us/her wishing her all the best today… hoping it all goes well… relaying that they are thinking/hoping/praying all the best for her.

All of which is VERY much appreciated.

The truth, though, is that today is really not bad.

Today is really just incredibly… well… monotonous.

Boring. Tedious. Whatever word you want to pick.

This has been a fascinating revelation to me who knew nothing about chemotherapy before this all began.

Here is the snapshot of our day…

We arrived at the hospital at 9:30am. A little before 10am we were brought back into the chemo treatment area were she sat down in a comfortable recliner-type chair. A nurse drew some blood samples that were sent off to the lab and then proceeded to get some vital signs and other normal tests… and then we waited for the lab work to come back.

Once the lab results came back fine, they set up the IV with some anti-nausea medicine, some saline, etc, etc, and give that to my wife for a while. There was some other medication my wife had to take an hour before the actual chemotherapy chemicals began, so she had to take that and wait.

Sometime after noon, they administered the first of the two chemicals that make up my wife’s “cocktail”. It ran for over an hour dripping into her bloodstream through the IV line.

After that was all finished, they hooked up the second of the two chemicals… and that will run for 45 minutes. After that she may be done… I don’t quite honestly remember if they did something else. She’ll probably be ready to go home somewhere around 2:30 or 3pm.

But this is what “a day of chemotherapy” is like.

Sitting. Waiting. Sitting. Waiting. Sitting. Waiting.

For hours.

They have individual TVs there, of course. And she and I talk now and then. The anti-nausea medication makes her kind of tired, and so many of the patients, her included, take a nap for a bit… or just don’t feel overly talkative. Friends have stopped by for a visit, which is a nice distraction. You can get (or bring in) food and drinks. A volunteer came by offering Reiki massage. They have free WiFi so you can use the Internet with your computer (which is what usually I do… sitting there doing work while my wife rests).

But overall it’s just a long tedious day of sitting and waiting.

If her experience this time is like the last time – and like what we understand from others in the process – this afternoon/evening she may be a bit tired from the drugs but overall okay. Tomorrow she will probably be fine. Wednesday morning she may be fine.

And then sometime on Wednesday the hell will start.

The chemicals will be doing their deed of killing cells and the body will be reacting. And then will come the pain, the sickness, the fatigue…

… which will pretty much continue straight through the weekend and on into next week…

We’re hopeful with some new medication that this time around it won’t be quite so severe, but time will tell.

Today, though, is all about the monotony of the injection of the drugs.

Sitting. Waiting.

Sitting. Waiting.

Image credit: drhenkenstein on Flickr