Targeted

Decision day was upon us.  And no, I’m not talking about the political primary elections.

This morning we went to see the oncologist for the third time since this diagnosis was confirmed back in January.  Before the appointment – both last night and this morning – Deb and I have been discussing which way she should go.  Chemotherapy?  No chemotherapy?  We were decidedly on the fence.  Partially that was because we still had a few questions.

Then we met with Dr. Ahmed (the aforementioned oncologist).  She didn’t answer all of our questions, but I think she did answer all of the ones that she could.  Somewhere in the hour that we spent there we came away with the decision to have the port placed next week and begin chemotherapy sometime around March 21^st.  I’m still not sure exactly how the decision came about (and I was there!), but it did.  She will begin with a targeted course to chemotherapy that will consist of weekly infusions of Taxol and Herceptin for 12 weeks followed by infusions of just Herceptin every three weeks for the remainder of a year.

There are some caveats to go along with that, though.  At the first sign of any significant Taxol-induced negative side effects (and the one Deb is worried most about is neuropathy), the Taxol course will be discontinued.  Also, if the cardio-monitoring she will undergo indicates any signs of the onset of cardiomyopathy, the Herceptin will be discontinued.

This list of side effects that will halt therapy does not, however, include hair loss.  That’s just something that the majority of patients just have to deal with … until recently.  There is a new option for chemotherapy patients that might prevent hair loss during treatment. 

Cold caps have been shown to have some amount of success at preventing hair loss and have only recently (meaning within the last couple of months) been granted FDA approval.  A cold cap is just that – a cap that keeps your head cold.  The idea is that, by applying deep cold to the scalp for a period of time before, during, and after treatment, the cells in the scalp where the hair follicles are do not take up the Taxol and are thus unaffected.  The success rate isn’t 100%, but it is high enough that some people are willing to put up with the pain (and it can be painful) of the scalp deep-freeze.  It’s too new for any of the local chemotherapy clinics to stock the necessary caps and refrigeration equipment.  It’s also new enough that insurance isn’t likely to cover it.

Deb and I are looking into dealing with the cold caps ourselves.  There are some companies that will rent the caps and coolers on a monthly basis, but we’d have to be able to source dry ice ourselves in order to keep the caps cold enough.  Renting them isn’t exactly cheap, but some companies have more reasonable prices than others.

Will it work?  I don’t know whether it will work if we decide to go that route, but if we do and it doesn’t, we have a bit of a backup plan.  We stopped by Target on the way home from the appointment to get a couple of things we needed.  After we checked out Deb looked at the back of the receipt papers to see what the printed coupons were.  One of them was for Women’s Rogaine.

               [cue eerie music]  

HOW DO THEY ALWAYS KNOW?!?  

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