Tempus Repit

Today’s post title reflects the opposite of ‘Tempus Fugit’, or “time flies” in Latin.  No, time did not fly these last few days.  It crawled on its belly, undulating along like a snail through a puddle of blackstrap molasses.  But we’re into the weekend now and trying to take a bit of an emotional respite.

We went to two appointments over the last two days.  The first was at the University of Washington on Thursday for ‘genetic counseling’.  That’s basically where they looked at the results of the genetic tests Deb took and said “nice to meet you, but we really don’t have anything to tell you that you didn’t already know.”  To be honest, that’s what we expected when we went there.

Yesterday was a different story, and led to the aforementioned and belabored Latin lesson of a title as seen above.

We, and especially Deb, had expected that yesterday’s appointment would help provide some answers with regard to decisions on whether her further treatment would, in fact, include chemotherapy and what type of course it would be.  We’ve already established that radiation will not be necessary and that long-term hormone therapy (via Tamoxifen) will.  No, answers were not forthcoming quite so easily as that.

Yesterday we went to Seattle Cancer Care Alliance (SCCA) for a second opinion consultation.  We arrived at SCCA at around 11:30 am to check in.  We got into a room not long after with the expectation that we would be there for a while during the whole process.  The schedule was to have a quick medical history review and exam with one of the residents followed by a check of Deb’s range of motion by the physical therapists, followed by Deb and I disappearing for lunch for an hour at 1:00 pm.  While we were gone to lunch the team assigned to Deb’s case would meet with the teams assigned to three to five other patients and discuss each case in a sort of roundtable format.  Deb and I would return to the same room at 2:00 pm and the team would come in for a general discussion, followed by individual discussions with the radiation oncologist and the medical oncologist.

And that was what actually happened, really.  But they weren’t able to give Deb anything in the way of a definitive recommendation.  Again, her tumor and tumor markers put her right smack dab on the fence of go/no-go for chemo.  She could decide not to do chemo and accept the relatively low (but not insignificant) risk that the cancer comes back somewhere else, which would be a lot worse than just breast cancer.  Or she could pursue chemo and reduce the chance of recurrence elsewhere in the body, but then come the potential for very unpleasant short-term and long-term (or possibly even permanent) side effects.  None of the oncologists are willing to say, “You should definitely do ... [fill in the blank] ”.

But a new wrinkle popped up at SCCA for consideration.  There is a drug trial that Deb could try to get in on.  If she ended up on that drug, the side effects would not be the same as with Taxol/Herceptin (the normal course of chemo), but there are other side effects that could come into play.  So now it's chemo/drug-trial-chemo/no-chemo.

Decisions, decisions.  Needless to say (but I’m saying it anyway) that all of this is exhausting to think through.  Add in that we spent almost five hours at SCCA and you might understand that Deb was drained both physically (she is only three weeks post-surgery, after all) and emotionally.  We stopped for a coffee and cupcake at Cupcake Royale on the way home, went home for dinner, and then crashed on the sofa watching old episodes of Greg the Bunny on DVD so she could put it all out of her mind for the evening.

But the decision still looms large on the horizon, like a dark, angry-looking cloud that you know will leave you soaking wet, but that you can only hope doesn’t strike you with lightning in the process.