To Chemo or not to Chemo?

20150826_114533I’ll start by saying we never really considered not doing chemo. It just didn’t occur to us. Here’s the lowdown on how it all played out. J was diagnosed on a Thursday morning, followed immediately by the whirlwind of activity that surrounds every cancer diagnosis. Somehow we had picked a surgeon and scheduled a surgery date by Friday.  Through the grace of God, good luck and help from friends, we wound up in the office of one of the best oncologists in the world the very afternoon of J’s diagnosis. At that point in our journey, we had no idea what to look for in an oncologist, but let me tell you, when you land in the office of the one who is right for you, you know it. You feel it with every bone in your body. Go with that feeling.

Our next step was surgery and recovery, interrupted by a rejuvenating beach get-away (more on that later). After the surgery we waited 10 long days before finding out the stage. The dreaded staging of the cancer, as in, how advanced was J’s cancer and what were our options going to be? Well, it wasn’t good news. We suspected it since they hadn’t called to tell us any good news before our post-op appointment. But still, it came as a big kick in the gut–an even bigger kick than the original diagnosis had been. It literally took my breath away. So once again we landed  in Dr. C’s office after meeting with the surgeon and once again I was a complete wreck–a blubbering, sobbing, red-eyed, aging-before-your-eyes–wife of a cancer patient. As much as I already liked Dr. C,  I still couldn’t sit down and listen to him for long, but I knew we were in good hands. He laid out the plan we would follow: Recovery (4 weeks), followed by the port insertion, followed by the first of 9 rounds of chemo.

Real tip #1: Try to pick a good one. Oncologist, that is! Yes, a technically good one, but more importantly, one who just FEELS right to you and your loved ones. (Saying “good bedside manner” just doesn’t do justice to the attributes a really good oncologist will exhibit.)

Through the period of surgery, recovery, vacation, and port insertion I began assiduously researching J’s cancer diagnosis and I’ve never stopped. I’ve read books, watched documentaries, been on more websites than I can remember, talked to other cancer survivors and their loved ones, and joined Facebook cancer support and information-sharing groups. We met with 2 nutritionists, chose a non-traditional clinic for complementary treatments, radically changed J’s diet, researched and added supplements to his regime, armed ourselves with information about detoxification and more. So the big question is, “Would we do chemo if we had it to do all over again?” and I would say yes. Or rather, “Yes, but..” as in “Yes, but only in concert with complementary and alternative practices.” As I mentioned in a previous blog, cancer introduces you to a new world filled with grey area, or what I like to call the “BOTH” syndrome. You can give yourself permission to both happy and sad, scared and optimistic, all in the same moment, and you can also follow conventional medical advice while at the same time practicing alternative and complementary therapies.

Real tip #2: Make your own informed decision about chemo. Don’t let the chemo naysayers get you down. But don’t reject nontraditional therapies either just because you’re doing chemo. You can do both. Or one. It’s your life and it’s your choice. And for heaven’s sake, don’t judge other people’s decisions. Offer them information one way or the other if you have it, and then just love them, no matter their decision.

There is no one right answer for every cancer patient. Once you or your loved one is diagnosed with cancer, you soon realize that cancer is a sort of catch-all diagnosis. There are so many types–even types within types–that it’s mind-boggling. Some respond better to one treatment than another, some are so rare there is little evidence to go on, and so on. This is why, above all else, you need to find the right oncologist. Time is of the essence, yes, particularly if you’ve just learned your cancer is advanced, but taking a few extra days in choosing the right oncologist to help you sort through all the different treatment options should be a top priority. Our amazing Dr. C has helped us think through our options on more than one occasion. Since J’s cancer is fairly rare, we have had to make some tough decisions, some based on hard data, others on anecdotal evidence, all with a little “gut feeling” thrown in. Dr. C helps us sift through our options, without ever pressuring us one way or the other. He provides perspective no one else can,  recommends other resources to look at and refers us to other doctors for consultations. And he certainly doesn’t judge our decisions nor does he belittle our interest in complementary approaches as well. This is oncology at its best.

Yet even when oncology is at its best and you feel relatively confident about your treatment plan, your confidence can be temporarily zapped at any given moment when an acquaintance makes an offhand comment, such as “Oh, I can’t believe you’re doing chemo!” or “I’m surprised you and J opted for such a conventional treatment.” If you are able, try to take these comments as another opportunity for reflection. It’s possible the person making the comment has some personal knowledge they could share. I always ask a follow-up question if someone seems eager to share his or her view, and there have been occasions where I’ve been pointed to an interesting resource (book, documentary, etc) that has helped inform our decisions. That said, you can also just smile and say, “Oh, we’ve been researching all our options” or “Thanks for your concern” 0r some other vanilla comment. Generally speaking, people are trying to help and it’s just not worth getting upset about. You’ve got enough going on!

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