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Hollye Harrington Jacobs

Hollye Harrington Jacobs

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Breast Cancer Chemotherapy: Decisions, Decisions

Posted: 03/ 6/11 12:18 PM ET

Now that surgery is behind us (however, the incessant pain from said surgery continues to follow me with me wherever I go), it's time to move to the next phase of FBC (F-Bomb Breast Cancer) extermination: Chemotherapy.

One of the many challenges of navigating the health care world is that there are a trillion, no, make that a gazillion decisions to make, informed by millions of people with trillions of opinions. So much, coming from so many directions is really, really tough to manage, mentally, physically and emotionally.

Medicine is often equal parts science and art, which makes it an incredibly challenging universe to navigate. Add to that the personalities, experiences, training (and sometimes biases) of the health care team, the result is an incredible (often overwhelming) amount of data that needs to be analyzed by the patient and health care team.

While there are certain specific algorithmic treatment modalities for certain types of cancers and other diseases, many considerations go into coming up with an individual treatment plan.

The majority of the considerations come from the pathophysiology of the disease. Pathology reports are done both at the time of the original biopsy and (hopefully!) at the time of surgery (to ensure a corroborative diagnosis).

So, in preparing for our interviews with Oncologists (remember: patients hire their doctors), we came up with a list of questions prior to our discussion. By the way, it is always a good idea to have a list of questions when meeting with your physician (or any health care provider, for that matter). Why? Well, because the disease and its treatment make it all too easy to forget what you want to discuss when you are in the actual meeting.

Notice I said "we"...as a reminder it is always best to go to an appointment as important as this with someone. During the meeting, take boatloads of notes! Clearly I learned my lesson the first time, when I went to my diagnosis alone.

Now where was I? Oh, yes, my list of questions:

  1. What type of chemotherapy?
  2. How many drugs? 2? 3?
  3. What is the timing for medication delivery? Every week? Every two weeks? Every three weeks?
  4. Will I get Radiation?
  5. How can I incorporate integrative (i.e., alternative) medicine (very important to me!)?
  6. Will I get a port-a-cath? A port-a-cath is a small medical appliance that is installed beneath the skin (usually in the chest, sometimes in the arm). A catheter is a tube that is inserted into a vessel to allow the administration drugs, among other uses. A port-a-cath is designed to permit repeated access to the venous system for the delivery of medications and for the sampling of blood. I think Port-a-cath's are great for a number of reasons:

  • Chemotherapy is toxic, and can damage skin and muscle tissue; therefore it is best to not be delivered directly through veins (though some Oncologists disagree). Port-a-caths provide a great solution by delivering drugs quickly and efficiently while preserving skin and muscle tissue.

  • Good aesthetics and intact body image. Vanity is clearly not an issue for me at this point; however, if I could avoid looking like poor Penny at Sunnyside Day Care in "Toy Story 3," then I'm all for it.

  • Patients can resume regular activities, including swimming, exercise and sports (contact sports, however, should be avoided). Too bad that I'll have to miss out on the annual Brookside Full Contact croquet.

  • Prior to every chemotherapy dose, blood is drawn to ensure that your body is up to the chemo challenge du jour. Blood can be drawn through the port-a-cath, which is soooooo much better than drawing blood directly from already weak veins.

So, this week The Husband and I hit the open road of Oncology meetings. The fourth Oncologist with whom we met (and hired) had the following sign above his desk.

"Every Journey Brings Blessings" - Anonymous

What a SL way to start the chemotherapy journey. I appreciate and adore this phrase because it talks about every journey. All journeys. Which we are all on, by the way.

After several intelligent, kind, sensitive, patient, and personal dialogues with Oncologists, we have come up with a pretty solid plan. I will now answer the questions posed above:

  1. What type of chemotherapy? TAC, which encompasses: Docetaxel, which is commonly known as Taxotere + Doxorubicin, which was originally called Adriamycin + Cyclophosphamide. This is the narley, balding, hardcore chemo combo. I have to take this because FBC was found in one of my lymph nodes.
  2. How many drugs? Three (as described above)
  3. How many cycles? Six cycles
  4. What is the timing for medication delivery? Every three weeks
  5. Will I get Radiation? There is a very, very strong likelihood that I will Not have to have radiation. Yipppppeeeeee-dooo! SL!!!!
    1. Will I get a port-a-cath? A resounding Yes! Phew. What a SL relief!

  6. How can I incorporate integrative medicine? Every possible way I can, including:

  • Acupuncture

  • Chinese herbs

  • Reflexology

  • Moxibustion

  • Diet

  • Supplements

  • Yoga (OK, OK...I'll try it. In the past, I have never been able to do it because I would always thing of 8 million other things I'd rather be doing other than being stuck on that mat in contortionist positions to which my body rebelled; However, since I'm in a different place in my life, I'm completely willing to commit to try it!)

  • Meditation (zen-ly refer to above on the same yoga mentality)

  • Music Therapy

  • Reiki

  • Aromatherapy

  • Physical Therapy

  • Hypnosis


My Oncologist told The Husband and me that we need to approach treatment as a long-term project. A marathon. This is an analogy that I can wrap my brain around because I love to run!

It is much better, he said, to wait long enough to start chemotherapy so that when I do start it, I'll be well enough to continue. He went on to say that staying on schedule is more important than starting earlier. Because I've had so many pain complications after my surgery, delaying chemotherapy until my mind and body are strong enough for round two of the FBC extermination makes the most sense.

Below is a Silver Lined quote that inspires and motivates me. Hope it does the same with you!

"A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty." - Winston Churchill

Wishing you all a day overflowing with Silver Linings!

Next week, I will be talking about discussing chemotherapy with children.

To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, Brookside Buzz (www.brooksidebuzz.com). You may email her at hollye@brooksidebuzz.com.

 

Follow Hollye Harrington Jacobs on Twitter: www.twitter.com/hollyejacobs

Now that surgery is behind us (however, the incessant pain from said surgery continues to follow me with me wherever I go), it's time to move to the next phase of FBC (F-Bomb Breast Cancer) exterminat...
Now that surgery is behind us (however, the incessant pain from said surgery continues to follow me with me wherever I go), it's time to move to the next phase of FBC (F-Bomb Breast Cancer) exterminat...
 
 
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02:14 PM on 03/14/2011
You have about the same chance of being alive 10 yrs after a breast cancer diagnosis whether or not you get chemotherapy.Cancer treatment is a trillion dollar business and most of it is worthless.
05:47 PM on 03/16/2011
Evidence? References?
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HUFFPOST SUPER USER
Ljilja
http://graciouslivingdaybyday.com/
03:36 PM on 03/10/2011
I went through breast cancer treatments five years ago - surgery, chemo and radiation.

I was also advised to look at the entire process as a long term project, one day at a time. I am not a runner, but I love to walk. And I did, one step after another.

Best of luck to you!

http://graciouslivingdaybyday.com/
03:47 PM on 03/10/2011
Thanks so much for your note! I'm so happy to hear that you are five years out. One step at a time. Absolutely! All the best wishes to you!
HUFFPOST SUPER USER
traceymarie
the President is black, deal with it
06:33 PM on 03/07/2011
Wishing you well with your choice of treatments.
07:24 PM on 03/07/2011
Thanks so much. I really appreciate it!
This comment has been removed due to violations of our [Guidelines]
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farmilyman
everything is illusion
01:55 AM on 03/07/2011
Mainstream cancer treatment is barbaric but very profitable.
OverseasVet
stuck in a 3rd world country called texas
09:05 AM on 03/07/2011
Not to mention it has a basis in reality and is scientifically proven to increase both life span and life quality.
07:26 PM on 03/07/2011
Thank so much for your input. I couldn't agree more!
07:50 AM on 03/08/2011
I am still here 6 year after chemo, so it appears to work. The only thing I would recommend is to correct any vitamin d deficiency, as a shortage has been shown to be a disadvantage with cancer treatment. Vitamin d is used by part of the innate immune system and so helps to avoid infections. A shortage also seems to stop cells under going programmed cell death.
02:28 AM on 03/08/2011
Let me correct this for you

Mainstream cancer treatment is barbaric but necessary.
HUFFPOST SUPER USER
yougg
just a citizen
09:55 PM on 03/06/2011
In any kind of cancer is is essential that you get a second or even third opinion. 20% of cancers are misdianosed. I went through a breast cancer bout in 2002. The orginal doctor was going to blast me with everything. My husband and neighbor talked me into sending out the pathology to other cancer centers for review. The orginal dianosis was wrong. I did not need chemo at all. I opted for larger margins at the surgery site and radiation. Go to a cancer center or teaching hospital. That gives you the best result.
07:26 PM on 03/07/2011
I couldn't agree more about second opinions (obviously)! Hope you are doing great since your surgery and radiation. Thanks for your comment!
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
06:01 PM on 03/06/2011
Puzzled 500: I'm not putting my cat thru chemo right now. She just saw an oncologist last week (yep, they have those for cats and dogs). I may do a lose dose oral drug, which is supposed to keep blood from feeding any new tumor. I also am going to start a supportive natural liquid therapy. I'm thinking about extending her quality of life without traumatizing her. The doxorubicin and surgery might be effective, but both are costly and traumatic. The range for cat survival from this mammary cancer ranges from a few months to 4+ years with the avg., treated cat being 14 months. I don't think the 14 month avg is worth the trauma to the animal or the cost.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
06:23 PM on 03/06/2011
For those who think it's soooo terrible I brought up my cat, I related to this blog BECAUSE of the type of cancer being written about AND the difficulty in the decision-making process. One of the chemo drugs for ppl is exactly the same one given to cats -- doxorubicin, too.
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f0rTyLeGz
Everything is falling.
05:30 PM on 03/06/2011
My 2¢'s... is that I had Stage 4 non-Hodgkin's lymphoma in 2006. And even though I am a cyclist and a big fan of Lance Armstrong, I decided to just do what my doctor told me to do, and not become familiar with all the treatments, and medicines, and possibilities. I just trusted them and became like a puppy in their hands. I have a very active Little Professor kind of personality, and I guess I knew it would just make me a pain in the doctor's and nurse's behinds if I had to know EVERYTHING, and everything had to be explained to me. It worked out for me just following directions, and not being informed. I concentrated on eating well, exercising, and enjoying others around me, and not letting my problems be the center of everything. I'm wishing you well.
07:33 PM on 03/07/2011
Everyone has their own journey on this roller coaster that is cancer. I'm so glad that you willingly chose yours and that you were able to focus on eating well, exercise and your support system. Sending you all the best wishes!
05:10 PM on 03/06/2011
I applause you for documenting your journey! I'm sure your daughter will be happy you did as well - looking back at her involvement when you are both healthy and older! I lost my mother to cancer when I was a teenager and only understood a few years ago it had to do with her diet. So I'm glad to hear you are addressing nutrition as well.

I'm working as a cooking instructor for the Cancer Project. They have a lot of good recipes on their site. http://cancerproject.org/

Looking forward to reading more about your healing process. Good luck to you!
07:47 PM on 03/07/2011
Thanks very much for your comment and directing me to the website. I couldn't agree more that diet plays a very important role both during treatment as well as building health and strength after the treatment. Thank you,again!
04:54 PM on 03/06/2011
Hollye Jacobs is one of the most beautiful, brave and brilliant women that I have ever known!
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03:07 PM on 03/06/2011
When it was my turn, I discussed chemo with my onco. I was not thrilled about it and in fact told him that I considered it poison. He was not too happy about that as he is a big believer of chemicals. He also was not too happy that I ditched Tamoxafix and then later Arimidex cuz the side effects weere so bad.

Going on 4 years now, only natural methods plus changing my diet and checkup 2 weeks ago confirmed cancer free. I have not been back to my Onco since that discussion mentioned above.

My choice for my life. Everyone has to choose what is right for them and whatever method, traditional or non-traditional , they are comforatable with.
04:11 PM on 03/06/2011
I think your story is amazing. Do you mind if I ask what stage your cancer was at? I often wonder about this. When does turn to chemo, natural, or both?
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06:50 PM on 03/06/2011
Thanks but its not all that amazing, there are lots of people that have found the natural path way before me and they were my inspiration. I was lucky…stage 1, found early by mistake.

Chemo versus natural, in my opinion, is not determined by stage but by personal choice and what you believe. If someone is more comfortable with a doctor’s usual methods, then that’s fine, its their life and their choice; they are doing what they think best for them. It took months at first but I devoured every piece of information on herbs, foods, etc. (I bugged lots of people too who graciously shared their knowledge of herbs with me..in fact see other huffpo article on turmeric/curcimen-its one that I take) and now I am quite comfortable with my routine.

I feel that the medical profession is too stuck on slash (surgery), burn (radiation) and destroy (chemo) and as such are not open to other methods that are also proven but knocked by the medical profession. If you ask most cancer survivors about “surviving,” they will tell you that its not cancer they survived but rather the treatment.

I think outlook plays a big role too. From the day, I heard you have cancer, I said to myself that I would not be a cancer victim and be woe is me. And I haven't since that day 4 years ago :-)
02:50 PM on 03/06/2011
I am happy to see you are embracing an integrated approach to your breast cancer treatment and recovery. There is a specialty of naturopathic medicine you may want to explore. Naturopathic oncologists provide scientifically researched treatments which increase the effectiveness of conventional therapy while decreasing the side effects. Patients express feeling an increased sense of empowerment when participating in their health care, particularly when dealing with overwhelming and life threatening conditions such as cancer. Natural medicine increases a patient’s quality of life not only while they undergo cancer treatment but also after treatment, in preventing recurrence of disease. More information can be found here http://maui-naturopath.com/holistic-oncology/ and here http://www.oncanp.org/
I wish you the greatest success on your journey.
07:52 PM on 03/07/2011
Thank you for your note and recommending the website. An increased QOL and preventing recurrence are two of my biggest goals. I really appreciate your thoughtfulness!
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02:36 PM on 03/06/2011
I have been part of the "we" during my mother's breast cancer treatment and your attitude and list of questions is spot on. kudos!
07:52 PM on 03/07/2011
Thanks so much! All the very best wishes to your Mom!
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
02:25 PM on 03/06/2011
Good luck with your situation. I have a similar problem but it's not me -- it's my cat. And it's similarly expensive with limited sensibility toward "beating" it. And I have no clue what kitty wants, except to stay away from car rides.
04:10 PM on 03/06/2011
No, dear. . . . Your cat is NOT a similar situation.
"Similarly expensive" . . .are you lucid?
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
04:42 PM on 03/06/2011
Not similar? Let see: one of the chemo meds listed is doxorubicin. And for cats it's $300-$400 per dose. Some of the side effects include losing hair and nausea and lack of appetite. Radiation is another therapy. Finally, a surgical therapy is taking healthy tissue, in the case of kitty multiple mastectomies. It runs into the thousands of dollars. Both of these are beyond my ability to pay.

Do you know why advanced biology students are given cats to dissect? Because they have similarities to humans, as do pigs.

So, I think you are quite wrong and not lucid.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
05:12 PM on 03/06/2011
And BTW I've spend over $2K already on the cat without even doing chemo. I had surgery last year and my out-of-pocket cost was under $500.