Monday, September 23, 2013

Dandelion weeding

My oncologist is over the moon about my tumors’ response to chemotherapy. It was clear from physical examination that my tumors shrunk, and an MRI last week indicates my largest cancerous lymph node shrunk from about 2.5 cm to 0.8 cm. The masses in my breast are also reduced. Conclusion of radiologist: “Right breast: Marked response to chemotherapy, with much diminished residual tumor.”

My oncologist added a hand-drawn smiley face and this comment: “Awesome! Strong work. Very nice response thus far.”

I have two more taxol treatments, which I find slightly less abhorrent than the adriamycin-cytoxan cocktail. It’s gratifying to know that the poisons are having some effect beyond stopping up my excretory system and making my eyes and nose leak. Still, tumors are kind of like dandelions--the roots are tenacious. Chemotherapy is whacking back the tumors but, as with dandelions, only with constant application of force (or, say, Roundup) will the weeds stay at bay.

The hope is that the smaller masses will be easier to remove in surgery with clean margins, i.e., no residual cancerous cells. It’s possible that some errant malignant cells already migrated through the bloodstream and lie in wait until some unknown date to metastasize, but nothing in life is certain anyway.

My doctor had prepared me for very little response because hormone-receptor-positive tumors tend to show less response to chemotherapy. About 75 percent of breast cancers are estrogen-positive (usually, as in my case, they are also progesterone-positive), which means the cancer cells have receptors for estrogen and progesterone, and multiply in the presence of these hormones. This means the cancer cells can be fairly effectively shut down by blocking production of estrogen and progesterone, which means HELLO, menopause!

It’s tempting to give myself credit for my cancer’s response to chemotherapy. I’ve been diligent about diet and exercise and have tried to maintain a calm and positive outlook. But I know that crediting myself for shrinking my tumors is like claiming crediting when my kids do something right: the flipside is you have to take the credit when the kids aren’t perfect, or for getting cancer in the first place. So I will chalk up the struggles as well as the triumphs in my children and my health to chance.

I attended Kol Nidre services last week (thanks to a generous friend who made a contribution on my behalf before I could even blink). A Seattle rabbi and author of the book Arguing with God led services. He told us someone once asked him, “Rabbi, do you believe in God?” He responded, “Well, what do you mean by believe? And what do you mean by God?”

When he finished his explication, which effectively threw open the gates of belief and God to anyone’s definition, an older man next to me, with whom I had chatted before the service, whispered: “I think I’m too conservative for this rabbi. I have a feeling you are too.”

“Nah, not me,” I said. I never personally argued with God or really believed in God, and I appreciated the rabbi’s expansive perspective on the concept of deity.

A friend whose struggle with cancer rekindled his lapsed Catholic faith has difficulty believing that my recent life experiences have not led me to God—especially given my affinity for my Jewish identity. I explained that my attachment is to the community, the food, the music, the sound of Hebrew, the familiar and familial feeling I get among Jews—with their big hair and big mouths—anywhere in the world. It’s an intangible gift, this sense of belonging, and for me, God has little to do with it.

But I usually find something during services, whether in the recesses of my quieted mind or the pages of a prayer book, that takes my thoughts along a new trajectory. I scribbled this nugget from the prayer book onto an envelope after Kol Nidre services:

“This is a time to open wide our vision of ourselves, to stretch our souls that they might conceive a life of the broadest possibility…” 

The lines led into the recitation of confession—this being Yom Kippur, the Day of Atonement—but they bathed me in a wave of generalized optimism. Surprises like death and disease jolt us into awareness of life’s negative possibilities. It hit me that the positive possibilities are as endless as the negative... if life is so quirky and unpredictable, maybe I really will ____, or ____, or ____, or something I haven't even thought of yet. 

If life doesn't follow any rules, why should I?

Alder's fairy house at Point No Point beach (a very prepared fairy brought M&Ms). In my mind they are always dedicated to Ali, who introduced us to the magic.
Brian and Alder at Sequim Bay, where we camped Friday night

Banana slugs exchanging sperm (they're hermaphrodites)
Thanks for stopping by, Mike! And for hand-delivering mail to Seward St. after the Juneau PO stamped "no such street" on the envelope and sent it back to me
In Trader Joe's aka my mobile office dealing with car business. Joy Neyhart not only saves babies but went to the DMV for me--twice. Now that is friendship.

A shout-out to Sarah Horwich for the Cancer-Fighting Kitchen, my new favorite book! Brian made this feast last night. Shoot me if I start posting everything I eat.