Thursday, June 29, 2006

to Chemo or Not Chemo?

I have been racking my fucking brain over this tedious mind-fucking decision. My body is totally ready to quit. I have chemo brain already, only after a few cycles, 1 month of treatment, with 5 to go.

I have good intution, I knew something terrible was going to happen to my health before I found out I had cancer in February, I knew in November something terrible was going to happen, I just didn't know what part of my health would be affected, but I knew it was something. I have been called jokingly a prophet because my intution is usually that fucking good. However, it's null and void when it comes to lotto numbers, I play 217 it comes out 297, etc., I am 1/2 and 1/2 on this one. I don't know whether or not to do or not to do. I dont' know what keeps me going, I guess the fear, and possible guilt that I would have knowing a year from now it came back and I didn't do anything about it. Anything about it, is harsh, I've had my entire large intestine and appendix removed for this, I've gone through 1.5 cycles of chemo, 2nd was a reaction and stopped early. So it's not like I haven't done anything. My tumor was only 3.2 cm and I had the rest of my colon removed prophaylitically so that I would be okay. I keep have these reappearing masses on my ovaries every other month, that appear to be cysts, they're larger than 6 cm, and I have a 60% chance of endometrial cancer, so I guess I should just throw in the towel and say hello hysterectomy?

I hate being in the midst of this, I hate not knowing, I hate having to make this decision, that not only affects me, but Dawn. I wish things were easier, hell, doesn't everybody?

I got in a sort of altercation with the lady at the bean building today. I went in for my pelvic sono, that seemed to simulate a Vaginal War and the tranducer (wand they stick inside of you-very phallic like) is Darth Sidius or something. I had the sono done she told me the right ovary is now clear, the left has a mass. I was worried instantly, wondering, thinking, pondering, jumping to conclusions, is it another cyst, why are they becoming so prominient now, is this a message from my body to demand further follow-up? I go out and ask the lady at the receptionist desk if she can check for me to see if my ct results are back, the abd/pelvic ct that I had done yesterday, she says I have to see my doctor for that. I told her that HIPAA law allows me to request my medical records, regardless of doctor verification at anytime, and they have to produce them for me, she stated that wasn't THEIR policy, I told her that HIPAA policy supercedes THEIRS or they will be in violation of HIPAA, that HIPAA is federal law. Then I proceeded to tell her that they found something on my ultrasound and I wasn't trying to be a bitch, but if she was a cancer patient she would understand. She looked, and said nothing was back yet. She told me Monday would probably be the earliest. I will wait until then, I won't wallow in self pitty and go up there tomorrow like I was, hell I've only had 3 appointments this week and I have another one tomorrow.

Okay I will stop ranting for now, tune in next time as we continue the CHEMO discussion on cdcafe.


Anonymous Anonymous said...

Abstract No: 3519
Citation: Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings Part I. Vol 24, No. 18S (June 20 Supplement), 2006: 3519
Author(s): P. G. Johnston, K. Mulligan, E. Kay, J. Black, S. Moore, U. Mc Dermott, R. Wilson, D. Harkin
Abstract: Background: We have developed the first disease specific microarray for colorectal cancer using a transcriptome-based approach. This unique tool has been specially designed and optimised for analysis of gene expression profiles from formalin fixed paraffin embedded tissues (FFPE). To evaluate this tool we are conducting a study in patients with Dukes B (stage II) colorectal cancer (CRC) using FFPE tissues to determine a prognostic genetic signature predicting disease recurrence. Methods: The colorectal array was developed using a high-throughput transcriptome-based approach and encodes over 52,500 transcripts expressed in normal and diseased colorectal tissue. To date, tumours from 32 patients have been selected (mean FFPE tissue block age - 10.4 years) from the stage II CRC cohort of a phase III randomized trial comparing 5-FU/Leucovorin versus no adjuvant treatment (NI240). The patients were from the observation alone arm;19 of whom were disease-free for 5 years post-randomisation, while 13 suffered relapse prior to 3 years. Results: RNA was extracted from all 32 FFPE tissue samples, amplified, labelled and hybridised to the colorectal cancer disease specific array. Raw data was normalised using scalar, median-polish and z-score strategies and scalar was selected as the best strategy in relation to predictive error. Within this data set genes selected by correlation using ANOVA performed best in both KNN and support vector machine algorithms (supervised). Using this approach a gene signature containing 48 genes demonstrated 100% accuracy in the prediction of relapse in stage II CRC (p<0.001). This signature was also able to separate samples at the meta-node level using unsupervised hierarchical clustering. Conclusion: We have developed the first colorectal cancer disease specific microarray and demonstrated its use using FFPE tissues. Using this approach we have derived a gene signature that predicts for a high likelihood of early relapse in stage II CRC.

7/11/2006 8:20 PM  

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