...Lace Up Your Gloves...

We left Dr. Cavalcant's office yesterday around lunchtime, and got into the car. I turned to Greg in a bit of disbelief and said, "So, what just happened there?"

With tears in his eyes (that were potentially from hunger at that point) he quietly said, "Victory."

VICTORY.

Round one belongs to ME.

We went to see Dr. Cavalcant yesterday - armed with the knowledge from the pathology report and what Chairman Mao told Greg he saw while he was in there last Thursday. The first piece of good news came when I did the dreaded weigh-in, blood pressure, and heart rate. But wait - since the last time I had been in there on December 29 with the edema, I had successfully dropped 18 (yes EIGHTEEN) lbs of water, tumor, and junk and was back to my fighting weight. This surprised me, particularly since I've been eating like a normal person again now that I can taste things. I suppose I'm misguided by the abdominal swelling that is still present. I'm ready to be done with that part... yesterday. Then, the blood pressure and heart rate. NORMAL??? Holy crap.

And then, back to The Waiting Place, now disguised as an examining room.

He finally came in, and said he had seen the pathology report, and we recounted what Chairman Mao and all other doctors of note had said. I think that was the first of three times he shook our hands during that particular visit, in congratulations. He expressed his relief that it was not all "socked in" and that the cancer had not spread anywhere outside the ovaries. We briefly discussed the ascites, and our relief that it came back with no malignant cells. Most of all, he was relieved that we decided to remove the offending ovaries. As a side note, even though we haven't expressly discussed this benefit with him, it seems to me that removing the ovaries also removes my primary source of estrogen, and being that my breast cancer happens to be ER/PR+, removal of the source can be nothing but good.

So, then what.

Well, he told me that he wouldn't put me back on Taxotere because the truth is, it would just beat the crap out of me again. He then told us about Abraxane - another taxane, but one bound by a protein instead that doesn't require steroid pre-meds, and somehow gets into even more nooks and crannies than the other taxanes. The side effects, albeit milder, are not that different than the other taxanes. Ugh. So, the Abraxane would be given weekly for 3 months over 30 minutes per session, with the Herceptin.

He then told us that it wasn't our only option. In his words, treating a cancer is very cookbook at the beginning diagnosis, but when it gets to a certain point (read: Stage IV, chronic illness) things become less cut and dried and there are more paths to take to get to the same end point. He then gave us Option B, based on the pathology report and the surgery findings. Herceptin alone.

Wait, was I hearing correctly? Was there even a faint possibility of NO MO' CHEMO???

So, we asked questions and more questions. Questions about if he felt OK with this option. Questions about "what next". Questions about why, when, and how. And we got these answers, in no uncertain terms...

More isn't always better. The fact that I am young, strong, motivated, and in great (by his estimation, "relatively good" by mine) shape gives me an edge. Right now, the cancer is either gone, or stable, and what we're trying to do, is keep it that way for as long as possible. The thing, is there is more than one way to get there, and toxicity isn't always necessary. He's going to watch this like a hawk - scan often and thoroughly - and be conscious that all involved keep on top of the progression (or non-progression) of the disease. Sometimes people (myself included until the chemo started to beat the shit out of me) think that the best way to get to the end result is to hit it as hard as possible as soon as possible. The thing is, the nature of this says that there's a good chance it will come back eventually. However, the coming back part might not happen for many, many years. That being said, quality of life is an important component to factor in to the equation. As strong and as healthy and as motivated as I am, I'm still made of blood and organs, and if I don't give my physical self a break and push too hard for too long, it's not going to do me any good in the big picture. Or now. Option B. Ride the wave that I'm on as long as possible with the least amount of toxicity. At this point, neither option necessarily guarantees a better long-term outcome and he reassured us he wouldn't present it as an option if he wasn't comfortable with it. I never thought to dream that Option B was an option when we walked in the door...

It's too early to re-scan at this point, as the PET would be all screwed up and inaccurate due to the post-surgery internal trauma, but in 8 weeks, we should be able to get an accurate scan done. So, the way we figured it, WORST case scenario something shows up on the PET when I get re-scanned and I can start the Abraxane, if necessary. By that time? I will have had the pleasure of living chemo-free for three months.

I think the world heard our collective sighs of relief as we realized what Option B meant...
Option B will get me into the Canyon when the Clouds come in March.
It will allow me to continue to taste and enjoy and savor.
It will allow me to continue to regain my energy and once I am recovered from this surgery, allow me to rebuild my muscles and continue to get stronger.
It will allow me to start to hike again. Maybe even to run.
It will allow me to actively work on my hair growing project. GOD, how I can't wait to bitch about my hair...
Option B will allow me to reap the healing of my soul as my body heals and relish in the love and laughter around me.
It will hopefully mean that my eyes will stop tearing eventually and I won't have this nagging eyelash-envy of others.
It will mean that for now, whatever that means, whether it's 8 weeks or 8 years, I can start to live again.

We left the office with the literature on Abraxane, and the knowledge that in two weeks I'd be back to see him, and armed with a decision. By the time we had gotten to Paradise Bakery (or potentially the second the words left the doctor's mouth) the decision seemed clear.

I wrote it back in August:
"I'm going to win, you know."

Victory. Even for a little while...