[2021-01-08] Carrying on

My simple little post about Eyebrows and eyelashes generated such an incredible response that I'm still replying to comments today. You will never know how timely your encouragement was.

Today, I had a follow-up oncology appointment. Such appointments always make me nervous as I find the doctors somber as they discuss ovarian cancer. I think I was tired too because even though the news I got today was mostly positive and neutral or, if negative, nothing new, it felt a little overwhelming.

First, the good news. Dr. Alduwaisan said that they are very happy with the result of my CA125 test after three rounds of chemotherapy. The CA125 test measures the cancer antigen 125 (CA125) protein found on most ovarian cancer cells and secreted into the bloodstream; this test may be used if ovarian cancer is suspected, to determine whether cancer treatment is working, and to assess whether cancer has recurred. My first result, taken at the emergency department of my local hospital back on July 29, was 920. My second result, a month after surgery but before chemotherapy, was 862. My third result, after three rounds of chemotherapy, was 19, as I shared in Chemo #4 and good news. Anything below 35 is considered normal. Dr. Alduwaisan noted that some people remain above 35 even after six rounds of chemo, so I'll take that as a win.

Also positive (though not new information) is that I am eligible to take a drug that works particularly well for people who have a BRCA gene mutation. As I explained in Genetic testing, a BRCA2 gene mutation was found to be present in my tumours; this is actually good news overall because the mutation makes my tumours more responsive to treatment and lowers my risk of cancer recurrence. I am waiting to receive the results of genetic testing to determine whether the BRCA2 gene mutation exists in all my cells; if it does, I am at increased risk of other types of cancer, such as breast cancer. But that's not something to worry about today. For now, in addition to making my tumours more responsive to chemotherapy, the BRCA2 gene mutation makes me eligible for additional therapy in the form of a drug called LYNPARZA, whose active ingredient, Olaparib, I mentioned in Staying strong. According to the information booklet provided by the manufacturer, AstraZeneca, "LYNPARZA stops cancer cells from repairing damage to their DNA, which helps to kill the cancer cells." Dr. Alduwaisan explained that the drug, known as a PARP inhibitor, will increase my chances of a longer period without a recurrence of tumours or progression of the disease.

Of course, LYNPARZA is not without potential side effects, which is the less good news. In fact, AstraZeneca's patient booklet is mostly devoted to potential side effects and monitoring for them. They include nausea and vomiting, diarrhea, anemia and fatigue. Dr. Alduwaisan noted that side effects are usually felt more strongly in the first month, before becoming milder over time. On the plus side, the side effects are typically less bothersome than chemotherapy, but can include fatigue and insomnia, Dr. Alduwaisan explained. Further, she doesn't expect that I will experience nausea and vomiting. She did say that the drug could cause my levels of white blood cells, red blood cells and platelets to drop, and could even affect my bone marrow. Consequently, I will have weekly blood tests, stretching to monthly over time, to closely monitor the effect of the drug on my body. I will continue on the drug unless we find that the downsides outweigh the upsides or that cancer has returned. That said, Dr. Alduwaisan stated that the drug has been in use for about four years and has shown great effect in prolonging life; her opinion is that the drug is worth it, and she agreed with my decision to take it.

Life-saving treatments for cancer seem to inevitably come with a degree of pain or discomfort. This was true of surgery and chemotherapy and appears to be true of the next intervention in my treatment: maintenance therapy. Nevertheless, I'm grateful for any assistance in fighting ovarian cancer. Dr. Alduwaisan noted that ovarian cancer is treated as an incurable disease; patients are never discharged from the cancer clinic, even after 10 years. While I prefer Dr. Le's statement that ovarian cancer is increasingly viewed as a chronic disease, the reality is that no matter how you look at it, ovarian cancer is a tough illness. I took heart in something cancer nurse Jacinthe reminded me of: there are lots of options for treating ovarian cancer. So I shouldn't lose hope.

My niece, the nurse, who listened in on my appointment, summed up today's meeting: there was good news in my CA125 result; there was good news in a drug that will help maintain the gains of surgery and chemotherapy; there was no bad news per se, just a restatement of what we already knew.

Jacinthe's final words to me were these: "live your life."

My life includes a delicious tea I ordered from the United States: Bigelow's Decaf Spiced Chai. Yesterday, I went looking for my stash (I ordered 18 boxes), but couldn't find it. That got me down. I worried that it might have been thrown out by accident with all the paper and cardboard from Christmas. This afternoon, I found the tea in a most unlikely place: a rarely used cupboard. That lifted my spirits more than I would have expected it to.

Thanks to your outpouring of love, a pep talk from my niece after my appointment today, my husband's success in fixing our dryer, a lovely conversation with my mom, and my sister's checking in on me, I feel rejuvenated.

I'm reminded of one of the pages in The Boy, the Mole, the Fox and the Horse:

"Sometimes," said the horse.

"Sometimes what?" asked the boy.

"Sometimes just getting up and carrying on is brave and magnificent."

To carrying on....