03/06/2011 12:19 pm ET Updated May 25, 2011

Breast Cancer Chemotherapy: Decisions, Decisions

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" 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 ( You may email her at