But there was one other thing I
had to discuss.
“I
have this chronic constipation.”
“There’s
no reason the drugs you are on should lead to constipation,” Dr Comfort assured
me.
He
made me feel like I just stood up in class and got the answer wrong. I got defensive
because I had done my homework this time.
“But
I’ve never felt in my life like I feel on these drugs. I feel like I’ve
swallowed a bowling ball on most days.”
“Do
you want a prescription?”
“Yes,
please.”
I
had convinced him. The confidence made me bold. I suddenly decided I wanted
more details about the transplant we discussed in the last meeting. I had
researched it and found out it didn’t entail bloody gloves, an open chest, or a
chilly bin. It was much more benign. It seemed it would only involve an IV
transfusion of stem cells but the side effects could be severe. I had told my
mother and siblings what I knew about it, but I wanted further details.
“Can
you tell me more about the stem cell transplant?”
“The
drugs are working so well, we’ll stick with them and see how it goes.”
“Excuse
me?”
I
was learning to expect the unexpected with this disease. But with that one
sentence all the complications of being in the hospital for three weeks, and
the side effects of anaemia, infections, liver disease and pneumonia flew out
the window. I asked for an explanation. At the time I interpreted what he told
me like this: In the past, the transplant was a last ditch attempt to kill
leukemia cells that were resistant to “normal” drug therapy. Patients who did
not respond to moderate levels of chemotherapy were given a huge blast of the
drug in one go in the hope that the cancer cells would succumb. But the high
dose meant the good cells were getting destroyed along with the cancer cells.
So they figured they might as well take it one step further. They would
deliberately kill all of the cells in the bone marrow, good and bad, and start
from scratch. First they would remove the patient’s stem cells so they could
re-introduce them after the transplant replacing the destroyed cells. The “good
candidates” were those who were strong enough for the transplant but hadn’t
responded to drugs alone. If I got this wrong, forgive me. Again it was how I
interpreted the conversation.
Anyway,
I figured that in my case, because the drugs were killing my cancer cells, he
wanted to hold off on the transplant option. But there was a hitch.
“We
will try to get the cancer to as low a level as possible.” Dr Comfort added.
So
wasn’t it just a band aid? Once I was off the drugs wouldn’t the cancer cells
that were left divide and grow? What if they became resistant to the drugs?
Wouldn’t it be better to kill off all my cells and just get it over with? I
didn’t like the idea of a few cancer cells hanging around waiting for an opportunity
to take over again. In spite of the cruel side effects I read about, the
transplant seemed to be a more determined effort.
I
was mystified by the course I was on. Perhaps sensing my hesitation or upon
hearing my “huh?” as I processed the change from transplant to drug therapy,
the doctor stated:
“There
are more and more good cancer drugs coming on the market in the next few
years.”
He
said it with such confidence I realised he wasn’t taking the easy option with
my treatment. He was telling me to hold out. If I had a set-back or my current
drugs did not continue to kill cancer cells then I might still be alive to
benefit from the new drugs. I didn’t know what to think. I was always someone
who liked a concrete plan and this was all way too vague. Still, in spite of
the confusion, I trusted Dr Comfort.
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