It was a cool, breezy day, Feb. 14, when my wife Rita and I took Beate to the Swedish Cancer Institute for a visit to the oncologist.
"Boy, that was something I thought I'd never hear," Beate said to us after exiting the doctor's office.
"What's that?" I asked.
"That the cancer is inoperable," Beate answered, and her eyes started to water. "Let's go home."
It's one thing to read about cancer statistics, and another thing when it smacks you in the face. Books and Internet URLs on cancer abound but, really, in order to truly grasp the reasons why a cancer starts one should possess some rudimentary knowledge of genetic embryology. It wouldn't hurt to have studied a bit of cellular biochemistry either.
How else could a breast cancer patient ever expect to understand her diagnosis? The two most important terms for a woman with breast cancer are: stage and grade. Try to explain those words without science terminology.
However, I do not wish to make the argument today for better high school science curricula - perhaps I'll write that column another time. I do desire to share one story from a community member.
Let me tell you more about my friend's case: All was going well in her life until about March 2004, when Beate felt a bump on her right clavicle. "It sort of popped up out of the blue," she commented later. "When it began to feel funny and had a tingle, I went to see my primary doctor who proceeded to tell me that it was nothing to worry about. So, I believed him and did nothing further."
Beate related this to me recently when I began to press her for a complete chronology of her cancer; she'd recently asked me to serve as her power of attorney and executor.
Six months later Beate complained once more about the irritating bump on her neck. She had been in remission for a dozen years following her original mastectomy of one breast. This time a general surgeon was consulted and he operated. It was a recurrent cancer on the side of her 12-year-old mastectomy.
Beate learned afterward that the surgeon also located a second, primary cancer in her left auxiliary sentinel node. He removed both tumors which were staged as IV and IIB breast cancers. She had no idea at the time about the staging or grading of her cancers, because no one apparently explained it to her in terms she could understand.
Subsequently, she was scheduled to receive standard cycles of chemotherapy using Taxol at normal dosages. But her body reacted violently to the toxic drug. She required a hospital confinement for almost a month following her first chemotherapy cycle.
Muscle weakness led to a fall, which exacerbated the condition. Anemia developed as did mouth thrush. Her short term memory evaporated. Bowels moved when they shouldn't. Sleep required medication.
She thought she was dying. At 3 a.m. one day at the hospital she dictated her Last Will and Testament.
After stabilization at Swedish main campus, she was admitted to the Transitional Care Unit (TCU) at the Ballard campus. Twenty-four days later she was sent home in a wheelchair via a cabulance. Through exhaustive physical therapy coupled with visits from nurses, social workers, physical therapists, occupational therapists and around-the-clock Swedish home helpers, she gained back some strength. Still, she could barely move about her condo even using a walker.
The cytotoxic Taxol treatments were resumed, this time at a lower dosage and longer rest cycle. Her white blood cell (wbc) count decreased significantly following the treatment. A hypodermic of a bone-marrow stimulant, Neulasta, was required. The wbc went up, however; her platelet count decreased, which postponed chemotherapy - again.
And, once more, she was living in her condo struggling to walk from her bed to the bathroom before an accident happened. But that was the least of her problems...
Routine blood work revealed a life-threatening spike in Beate's serum potassium. The oncologist ordered immediate hospitalization. Bags of saline and dextrose water were infused over a three-day period.
Stabilized once again, she was released. Home therapy resumed. Her neuropathy was worse.
Throughout this entire nightmare, Beate kept questioning the skin coloration and appearance on her neck, right above the site of her clavicular surgery. The doctor listened, and she had biopsies taken from her neck region because another type of cancer was suspected... and the pathologist's report confirmed it as metastatic skin cancer.
She's desperately trying to live with three primary cancers spreading death throughout her body.
Beate subsequently met with her trusted oncologist to discuss her options. My wife and I were invited to sit in on this emotionally charged session. The doctor, dressed in his typical tie-and-jacket attire, sat on the stool with his reading spectacles perched on his nose.
The exact quotations are not necessary to convey their exchanges. He offered hospice care and she asked for more chemotherapy. He answered her query about longevity with candor. A year, maybe, even if the new drug has any effect. Less, if it is ineffective.
Rita reached out and touched her arm. I blinked - hard. Beate fought back the tears of hearing her death sentence.
Beate wants to live. So she wishes to continue the cycle of hope using cytotoxic chemicals even though she is now unable to drive her car, unable to lift her legs over a curb, unable to type a one sentence e-mail to a friend and must wear Depends as a result of incontinence.
Only 10 months ago, Beate was a vigorous, full-time employee. She'll most likely never return to work since her extensive peripheral neuropathy prevents her from performing standard secretarial tasks.
She's fortunate to have medical insurance and a condo to live in, plus a few dollars to buy groceries.
We all read and hear news reports about the rising health care costs in America... well, Beate can testify to that issue. Her medical bills for the past nine months total about $100,000. She assumes that the next nine months - God willing - will be similar.
Beate is one of 40,000 women currently living in America with metastatic breast cancer.
Bernie Sadowski is a freelance writer living in Magnolia.[[In-content Ad]]
