Hope and Promise

Today, was an emotional day. Last Monday, I had a a Bone Marrow aspiration to determine whether or not I would qualify for a study being conducted at UCSF. The study is to test a drug, that is already FDA-approved for another use, to document its effectiveness on preventing the recurrence of breast cancer. Anecdotally, they've seen a reduction in recurrence by as much as 20% but there's no hard data to support it. 20% is significant. I'd take the drug just to take it for those kinds of numbers, and the good news is, it's already deemed safe. 

My Oncologist informed me about the study last November. To determine the effectiveness of the drug being studied, you have to be a slightly higher risk for recurrence. The geniuses at UCSF figured out that there is a population of Breast Cancer survivors that have special cells in their bone marrow that puts them at higher risk. They are not cancer cells. They are best described as "non-bone marrow cells." These non-bone marrow cells could or could not be precursors to cancer cells. The significance of their presence in the bone marrow indicates a higher rate of recurrence although not all women with these cells will relapse. The drug that they are delivering for the study would have an impact on  these cells by strengthening the bone (the drug is given to prevent fractures in patients with weak bones) and reducing a patient's risk. 

I said, "sign me up!" I'll do this study. If I have the potential to reduce my risk of recurrence by 20% with very little risk to my personal health and an opportunity to strengthen my bones, that, my friends, is a no brainer. One of the things I worry about is Osteoporosis. Having been an athlete most of my life,  I have kept my body fat rather low. This produced a state of amenhorrhea (no menstruation) and put me at risk for Osteoporosis, and the chemotherapy and radiation therapy did not help. Weight lifting has helped to strengthen my bones but as I get older, bone-loading will be harder to sustain. While I plan to continue utilizing weight lifting in my training until I'm well into my 80's, the toll of overuse may play a part in my ability to continue on that plan. I've already replaced one joint, and my knees are not far behind. 

Back to the study.....So, the caveat to qualifying is that I have to have these "non-bone marrow" cells present in my bone marrow, and the only way to determine that is to have a bone marrow aspiration. This is not a comfortable procedure. They drive a skewer into your pelvic bone and suck out the middle. It's not pleasant and I've seen it done in my job as a nurse. People don't like it. It's painful and awful. But 20% is too compelling and worth a little pain. I had the procedure done. The physician, Dr. Li, did a fantastic job. She numbed me up with  prolific use of lidocaine, or marcaine, or bupivicaine or some caine that made me not care about the skewer. The hard part was the bone-marrow sucking part. You can't really do anything about this and having your bone marrow sucked out is painful. It only takes a couple of seconds and Dr. Li warned me well. Still, when she sucked out my bone marrow, I thought my head would cave in. Yeow. If I were to qualify for the study, I would have to have two more of these to measure the effectiveness of the drug. Not fun. But neither is chemo and anything that keeps me out of an infusion chair by a margin of 20% is worth a little bone-marrow sucking.

All of this was done last week. It takes a few days to run the assay and they are sucking a lot of bone marrow to find candidates for their study. I waited as patiently as I could. Here's the skinny: If I qualify, I get the drug. If I don't qualify, I still get a drug to prevent osteoporosis that reduces breast cancer risk by 10%, and by not qualifying, it means that I have relatively healthy bone marrow and a lower risk of breast cancer recurrence. Being a Stage III survivor, it's always in the back of my mind that there are cells in my body swimming around just waiting for an opportunity to build a tumor somewhere. My biggest fear was that they were in my bone marrow, a common place for metastasis or the spread of cancer from another area. This will always be in my mind which is why my current lifestyle is geared around beefing up my immunity to decimate such cellular uprisings. I have quit (cold turkey BTW) coffee and caffeine, aspartame or artificial sweeteners of any kind, and alcohol. Still working on the sugar. That's a tough one, but the reduction in my consumption of sugar is hopefully a step in the right direction. 

Today I got a call from my doctor. 

"Hello?"

"Yes, this is Dr. M from UCSF, is this Tori?" (he knows it is, but he has to verify due to HIPPA, the bane of all healthcare workers' existence....)

"Yes, this is Tori."

"Hi Tori, I have the results of your bone marrow aspiration. "

<compensatory pause>

You don't qualify."

<another compensatory pause, presumably awaiting reaction>

Silence.

"It's a good thing," he adds. 

As an athlete, anytime I've been told that I didn't qualify, it was usually a devastating blow because it meant I didn't get to advance or go to the next big race or make a team. It's almost Pavlovian to be disappointed to hear those words and I was at first. I don't qualify. Darn. Wait a minute.....

Tears of joy flooded out of my eyes. I don't qualify. I don't have the cells in my bone marrow, cancer or non-bone marrow, that predispose me to recurrence. For once, I am catching a break and I find myself so overwhelmed with emotion, I can hardly speak. 

These are the days I live for. It's like someone granted me all the wishes I made when I was sick. I remember pleading, wishing on the first star I saw every night for a year, please let me watch my daughters graduate High School. Please let me watch them grow and change into the amazing women I know they will become. Please let me watch my husband thrive and excel in his new job. Please don't take me away from these people that I love so very much. I will quit my job, I will be nicer to people, I'll help others, I'll cook more, I'll do anything. Please, just let me have a few more years with the incredible people in my life and an opportunity to reach out to all those I have lost touch with. I will do my very best to earn that privilege.

Today, that wish was granted, at least for now, and I intend to keep my promise to earn it. From tears of joy spring hope and pure, unadulterated happiness. I am elated to share this news and keep my promises.