As I have written about before, those early days after Kate's breast cancer diagnosis were the most difficult of our lives, not that I want to speak on Kate's behalf. We didn't really know what we were faced with, but what we did now was that Kate was very sick. Our GP was the lucky fellow who got to break the news to us. We could tell he was devastated. He had had Kate as a patient for nearly 20 years, me for almost ten and the Bean since she was born. Before we left the appointment, he got on the phone with the Ottawa Women's Breast Health Centre, which got us into the system of cancer care. He hugged Kate long and hard with tears welling up.
The people over at the Breast Health Centre ordered more imaging, tests, biopsies to confirm the diagnosis and and referred Kate to Medical Oncology at the Ottawa Cancer Centre and gave us that first taste of hope. This was treatable over the longer term.
That initial hope, though, was dashed over the ensuing days and weeks. Kate became increasingly symptomatic and was very sick indeed. She had a hard time keeping food down and her mobility was getting worse and worse as her cancer-riddled vertebrae began to fracture. If I am being honest, I didn't think she was going to make it to her first appointment with the medical oncologist. We had a pre-scheduled appointment with our GP, and when we went to see him, I fairly near begged him to see if he could get her into see an oncologist before her scheduled appointment which was still two weeks away. Turns out, I didn't need to beg, he worked the phone and ended with assurances that they would see what they could do. By the time we got home, we had a message that she could see an oncologist in two days.
The day of our appointment, Kate was even sicker than usual. She was in a lot of pain and vomiting frequently. When we finally met the Oncologist, Dr. G, he told us that the news wasn't good in that a stage four diagnosis was never good, but he thought there was a good chance, though no guarantees, that the cancer could be brought to heel and treated as a chronic disease. He is an endearing man. with a dark beard and hair and that day was sporting a red plaid flannel shirt and black jeans. He looked for all the world like a lumberjack. Both Kate and I liked him immediately.
First things were first at that initial appointment and Dr. G began trying to get her nausea and pain under control. As the day progressed, Kate remained violently ill and was in and out of sleep as the doctors tried to control the pain. Kate was in a gurney the whole day before she was feeling well enough, though still not great, to be released. Meanwhile, Dr. G had arranged to start Kate on chemo therapy the very next day.
The next day, still vomiting frequently, we showed up for Kate's first chemo session. One of the first drugs they started her on had nothing to do with killing the cancer. Dr. G explained the day before that Kate was hypercalcemic, meaning that she had excess calcium in her bloodstream. This was a result of the cancer metastases attacking her bones, and could be part of the culprit for her nausea. So they were giving her a drug originally designed for patients with osteoporosis called Pamidronate. The goal was to repatriate to her bones all that calcium circulating in her blood. That part of the treatment went well.
Next, they started her on Herceptin, a biological concoction that binds to the Her2 receptors on the cancer cells and keeps them from dividing. That, too, went well. Next, though, they started her on another drug called Paclitaxel. Within seconds of starting her on that, her face and arms started turning an alarming shade of deep pink. They had to abort the treatment. Turns out, reactions to the medium the Paclitaxel is dissolved in is fairly common. This was on a Friday. They rescheduled the remainder of the treatment for the following Monday and started introducing the drug at a slower rate, which did the trick.
The most amazing part of that first Friday treatment, though, was that Kate's nausea disappeared, the Pamidronate doing its job. Also, while she was undergoing that first round of treatment, she met with a RN, Nurse J, who was able to get her pain to a tolerable level. Nurse J has continued working with Kate and the pain is fairly well controlled now. Also amazing is that with just that one round of treatment, the primary lump in Kate's right breast shrunk noticeably.
Finally, the fear subsided quite a bit and we began to hope that, yes, this might go our way after all. Those first few days, though, with Kate so incredibly sick, I had to consider the unimaginable. That's a place I hope to never have to go again.
If you want to read more about Kate's experience with breast cancer, please visit the blog she has started on the subject: