Sunday, October 25, 2009


Treatment options are tricky. Our oncologist gave us a few to "choose" from even though, in the end, he pretty much did the choosing! Since Casey's tumors were considered to be stage 1S (s is equivalent to b, which is one level worse then if he had stage 1a) he could opt for 2 cycles of BEP chemotherapy. BEP is a combination of Bleomycin, Etoposide and Cisplatin, three pretty common chemo drugs used for more then just TC. Or, if the doctor liked the looks of his next blood test he could opt for active surveillance. Surveillance is not just "watching and waiting." They take weekly blood draws to watch your tumor markers, they schedule regular CT scans to monitor any possible re-growth or spread. The oncologist explained that 30% of those who choose active surveillance have a recurrence at sometime in their life. 70% do not- not terrible odds but I don't know that I would want to wake up every day wondering "is today the day they will find out it has come back? Will I officially join the 30% club?" If you were to have a recurrence you would have to have chemo done anyway, so it makes sense to just do the cycles now, get them over with and (hopefully) move on with your life and leave cancer in the past. Easy enough, right? Almost. Chemotherapy has a lot of negative side effects including sterility. Bleomycin is a very potent drug that can wreak havoc on your kidneys and lungs. Vomiting, nausea, hair loss, mouth sores, weight gain, weight loss, dry skin- the list really does go on and on! Plus, for Casey, he had school to consider! He had just started his law school mid-terms. While his school would allow for a medical leave of absence they would not give him credit for the classes he had made it half way through for this semester so he would essentially be starting his 2nd year all over again post chemotherapy! Yuck.
So, we sat at a crossroads. What do you do? What does Casey want to do? We had lots of talking and considering to do and the oncologist wanted Casey to get another blood draw and a chest CT scan (to ensure the cancer did not spread to the lungs). We left his office feeling foggy and even more confused then when we went in. How would we decide which treatment was the best for Casey? Well, we wouldn't have to.

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