Lions and Tigers and Chemo—oh my!

I’ll cut to the chase. Friday, I was back to the Sutter Cancer Center, where they park your car for free. The third floor is the Sacramento Center for Hematology & Medical Oncology—SCHMO for short. No shit, they call it “SCHMO’’. I met my medical oncologist Dr. Rahatgi, a small, round Indian man with a voice like a melody.
50% of women who have the Oncotype DX test come back with a score in the intermediate range; between the score of 11 and 25, mine is 18. Smack dab in the middle. What this means is no one can tell me whether I should have chemotherapy, or not. Radiation and aromatase inhibitors, which decrease recurrence and increase survival rates significantly, offer weighty percentages. Chemo offers another small piece of insurance. I ask the kind doctor the obvious question, “if I was in your family, would you suggest chemotherapy? He shrugs; there isn’t clear data for the answer I’m looking for. There is a trial (randomly assigned to chemo, or not—no obvious incentive here) that will provide that answer in 5, 10 or 20 years. For now, this decision is all mine. Chocolate or vanilla? Bachelor number two or number three? Bald and weak or, well, you get the picture.
I call two experienced cancer-chicks. Both say that cancer survivors worry about recurrence; do I want to second-guess my survival by not giving myself the best chance? I also am assured I will get through chemo fine. My gut has an answer that my head doesn’t want to hear.
Further reading points out that Taxotere-Cytoxan (the chemo of choice for breast cancer treatment) bestows a 24% improvement in overall survival over the previous chemo used for my senario. I’m, well, impressed. With radiation, drugs (aromatase inhibitors, Arimidex will be mine for 5 years) and chemo, I’m knocked to nearly 90% no recurrence stats. I cry. I party. I decide. Sign me up.
The bright side: the chemo will be 4 treatments over a 12-week course; the treatments are about an hour and a half; and nausea is managed with drugs given prior to chemo. Yes, I'll lose my hair but I’m pretty sure I can put aside vanity for a few months. Think of the money saved on these pricey (but fabulous) haircuts. I will be fatigued. I will kick the crap out of cancer and see that it never shows up here again.
Oh, and Santa, I'd like several hats this year.

http://www.medpagetoday.com/tbindex.cfm?tbid=1030
http://www.medpagetoday.com/HematologyOncology/2005SABCSMeeting/tb/2308
http://professional.cancerconsultants.com/oncology_main_news.aspx?id=35701
http://www.breastcancer.org/treatment/chemotherapy/index.jsp