Lies, damn lies and statistics.

My friend Jim Wilson eloquently defined the term 'statistics' to me once. He said (can't use quotes as I may get this wrong) statistics are how to lie with numbers. What I found out today after our meeting with the oncologist is that there is surprisingly little data out there that is conclusive and specific with regards to breast cancer. Sure there is alot of data and a tremendous amount of statistics but all of these things come together to form a set of guidelines. Just suggestions...ideas about things that may work in some situations. The other thing we learned is that the majority of the breast cancer research to date has been done on stages II+ cancers...the 'big, bad' ones as opposed to the 'little' one that I have. So after pouring over statistical reports, reviewing all of the NNCN and ACS guidelines, we learned today that there are no absolutes and that my situation does indeed fall into the gray zone.

Mary and I went to the Piper Center to see the oncologist together. We arrived promptly on time but had been tipped off by the nurses that he doesn't run on time very often. We settled in for a long wait and were pleasantly surprised to be roomed and had all of priliminary stuff taken care of quickly. Everyone was incredibly nice as well. He came into the room a few minutes after that and pulled up a chair. 90 minutes later we were still talking. At no time did he ever glance at his watch or make the slightest leaving motion. He took us through my entire pathology report (now totaling 13 pages) as well as all of the possible combinations of long-term care plans from doing nothing more to doing chemotherapy and hormonal treatment.

One thing he showed us was particularly interesting to me. This is called Adjuvant Online. It is a computer-based treatment decision making tool. You input the patient's information: age, health status, tumor information and it calculates the risk of the breast cancer recurring in 10 years. This is my chart. If you look at the bar graph, the green bars are the number of women who are my age, have good health and have my kind of tumor who are cancer free in 10 years. The red part of the bars are those women who have a recurrent cancer within 10 years of diagnosis. The tiny blue part are those women who will die regardless (car accidents, heart disease, other causes) and this number doesn't change: 2.1/100. If you look at the 3 bars, the first one are women who use hormone therapy only. More of them are cancer free at 10 years. The same is true of women who use chemotherapy only. More of them are cancer free at 10 years too. If you look at the bottom bar, those women who used chemotherapy followed by hormonal therapy had the best outcomes. Only 5.6/100 women had cancer recur in the 10 years that followed their treatment. The red part of the bars (the number of women who get cancer again) gets smaller and smaller. After reviewing this together, I decided (with Mary's support) to do chemotherapy followed by hormonal therapy.

After we talked with Zander more about the chemo process, drugs, scheduling, etc. Mary asked him essentially what he thought of the decision I had made. He said that if I were his wife or daughter, he would have recommended the same thing that I chose. That cinched the decision in my head.

So. The date is set. Chemotherapy will be 4 rounds of drugs spaced 2 weeks apart beginning the first week of April. We have a vacation planned and I am scheduled to study for and take my acute care boards (additional NP certification) in Florida during the last week of March. Zander wants me to be fully recovered from my surgery before beginning chemo so said he won't let me start until after we return. Statistically there is no difference in waiting 2 weeks to begin treatment.

But here's the big news of the day! I got both of my drains out. Those things were HUGE! No wonder I was so uncomfortable with them in. I feel like a new woman without them.

There is finally a plan in place for treatment of my cancer. I feel good about the decisions I have made. I also feel supported in these decisions by my partner and my oncologist. Perhaps that is contributing to my feelings of contentment this evening.