Thursday, August 18, 2016

DO NOT GIVE UP

Just before she died

Now here’s one that’s hard to swallow.  A clinical trial – properly conducted and published – seems to be telling us that secondary therapy for advanced ovarian cancer is futile.  To put this in context, compare Linda’s treatment five years ago.  When first diagnosed she was in stage 3c and her CA125 was over 600 (normal is less than 35).  Her initial treatment was surgical debulking – that is, they cut out as much tumor as they could find.  When she recovered from surgery she underwent eight weeks of intensive and thoroughly unpleasant chemotherapy.  Her chemo was administered intravenously.  Nowadays she might have received her chemo through a hole in her stomach – this is now known to be more effective.  Moreover, she might have had chemo before surgery; “neoadjuvant chemo” is preferable in some cases.

After chemo we settled down to wait.  Each month she had a blood draw for measurement of CA125.  For about a year she remained steadily at CA125=8.  Then one day it crept up to 12.  Then 20.  The damned thing was coming back.  Next she underwent a course of an alternative chemo, which slowed her cancer’s growth and gave her a few months of what you might call quasi-remission , and at the end she was on some other drugs, which didn’t help at all.  After diagnosis she lived about three years.

Well, the study described below seems to be telling us not to monitor the progression of the disease, because this has been shown  to be of no value in terms of ultimate mortality.  That is to say, you are no less likely to die if you combat the resurgent disease than if you simply ignore it.  The recommendation seems to be to simply forget about it and thus save yourself worry, discomfort, and expense.

Well, folks, screw that!!  Life is too precious simply to toss it at the wall to see if it sticks.  If I had ovarian cancer – which, thank God is impossible – I would fight the son of a bitch with every weapon I could lay my hands on, and if I died anyway I would know that I had done my best .  That’s what Linda did.

By the way, it hasn’t been easy to write this blog.  Lots of old scabs were scraped off, and I am crying as I finish.  The older I get, the more I realize how inadequate I really am.

I was married to one of the bravest women in the world.


7 comments:

  1. Well, Myrl, now you've made me cry. Re-living those 3 years is hard for those of us so close to the process. To fight or accept an illness is such a personal response. I was in that living room when Linda made the shift to stop treatment and it was a profound moment that ultimately held a lot of beauty for me. She was effortless grace.

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    1. I am prejudiced, of course, but to me, she was wonderful.

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    2. "Effortless grace", what a beautiful phrase.

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  2. Yes, it's hard to think about such a difficult time. One of the hardest times of my life so far, as well. I have never been in such a situation where something was awful and there was nothing that could be done about it. So frustrating to feel so helpless.

    So they are really saying not to bother trying chemo after surgery? That it doesn't help? But it seems like it did help her at least once, didn't it? She got the level back down for a while? Maybe I am not remembering correctly. Or maybe they are saying you are still going to die, but if you have chemo you will live a little longer. Is there really NO ONE who has been completely cured from ovarian cancer? Interesting.

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    1. Read the article, then tell me what you think they are saying; I’m not sure.
      No, it is possible to survive OVCA, and it is commonplace if the disease hasn’t spread, Even stage 3 and up is survivable, but the frequency is low.

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    2. Here is the other side of the story. I think that the very last paragraph is vital.
      http://www.medscape.com/viewarticle/867650#vp_2

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  3. Crying is healing. Not that I would know. I hate it and avoid it as much as possible. But it's healthy.

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