Download survival after treatment

It’s about Living
By Deborah Davis
An Essay of Lessons from my Cancer Experience
It's not about survival. It's about life. Cancer makes
you think about your life and what you're going to
do with it.
Hi! My name is Debbie Davis, and I have just
returned from a year and a half spent battling
cancer. This is my story, infiltrated with a few things I
learned along the way.
All of us should know that every month we should
each check ourselves for changes. Get together
with your spouse to check the places you can't see.
You’re looking for changes. That's why you only do
this once a month. If you do it more often, you may
not see the changes. You aren't just looking for
lumps. Look for a rash, a swollen place, and a new
mole, dimpling of the skin, anything different from
last month. Not just a lump. I know. I didn't have a
lump.
When I did my monthly self-exam in January 1999, I
discovered that my right breast was a bit swollen. I
waited a week and checked again. It was worse.
So, I called my doctor's office and they said they
might get to me in March. I took the appointment
and hung up the phone. I hadn't even released it
when I said, "No, that's not good enough." I called
back and was put through to the breast care
center at Bethesda. They made an appointment
for the following day.
The doctor at the Breast Care Center took a look
and said, "this might be just an infection, but it
might be something more serious." He gave me
antibiotics and a referral for a mammogram and a
sonogram for two weeks. I was scheduled for a
mohs surgery to remove basal cell carcinoma on
my face, for that time, so I bumped the
mammogram two more weeks. By the time I went
for the imaging studies, I was swollen to nearly
twice as big as the other side and in terrible pain.
We went from mammogram to sonogram to biopsy
in a period of less than three hours. The pathologist
was in the operating room with us. While the final
results wouldn't be confirmed until over the
weekend, we knew it was cancer.
Many women avoid mammograms because they
think they might be painful. You can take my word
for it that it is not nearly as painful as cancer. There
are those that say it is similar to being clamped
between two irons, which have been kept in the
freezer. I think it is closer to lying on a garage floor in
the middle of winter and being squished by the car.
In any event, while not a comfortable study, it is a
relatively pain free and pretty accurate study
which is crucial to early detection.
Every woman over 40 should have a baseline and
follow-up every three years. But, keep in mind, it
doesn't really detect everything ... it doesn't usually
detect inflammatory cancers. In my case, it did
show abnormalities, which led us to the sonogram,
which showed a "suspicious thickening of dermal
tissue." It was the core needle biopsy and incisional
biopsy that gave us a confirmation of malignant
cells in the breast tissue, in the lymph nodes, and in
the dermal-lymphatic tissue. That is what led us to
a definitive diagnosis of inflammatory breast
cancer.
Biopsies are done by "shave," which is where they
cut just a wee bit into the skin, "punch," which is
where they take a little cookie cutter through all
layers of the skin, "standard needle," which is just a
tiny needle to extract some fluid; "core needle,"
which is a long hollow tube they shove deep into
your body to extract tissue; "incisional," which is
where they actually cut open your body to extract
a piece of tumor. There is also "stereotactic," where
they suspend a body part through an opening to
allow gravity to extend it, and then insert a set of
needle probes to stabilize it and give ultrasound
direction for a needle biopsy. This is commonly used
on a very small tumor which is highly suspect.
My immediate response was to say, "Okay God,
you have cancer. Oh, and if you're going to take
me home from this convert my husband before you
do." You see; being a Christian has been a
sustaining force for me throughout this whole
ordeal. I immediately felt as if I was being hugged. I
have referred to this feeling as being wrapped in
angel's wings. It has helped me through many
difficult days. My friends have commented that
God obviously found it easier to heal my cancer,
than to convert my husband.
The doctor set up an appointment with the whole
team from Bethesda for Tuesday, March 9th. I told
the doctor that, "by then, I will know." When he
asked, "Know what?" I told him, "All there is to
know." I went from his office to the medical library
there at Bethesda, and from that library to the NIH
library, and from there, home to the internet. You
see I am an infomaniac. I take comfort from
knowledge. I believe knowledge is power. In an
uncertain time in my life, it was critical that I learn
everything I could.
My illness is inflammatory breast cancer. That
probably doesn't mean a whole lot more to you
now that it did to me then. But, I became
educated in a hurry. Here's some of what I learned.
You may have heard that one in eight women will
get breast cancer. That is over the span of a
lifetime. So, the odds go against you, as you get
older. Note that one in 1000 men will also get breast
cancer. This is about 1300 per year. Of these, nearly
one-third will die because they didn't recognize the
symptoms and seek help fast enough. Men are less
likely to go to the doctor, and are really less likely to
suggest they have a breast problem. More likely,
they will claim a strained muscle in the chest. I get
these stats from the American Cancer Society and
the National Cancer Institute.
Only about 5% of breast cancer patients are under
age 40. But, it does happen. But out of those who
do develop a breast cancer, less than one in 20 will
develop an inflammatory carcinoma. This is
important. The recovery rate for a noninflammatory breast cancer is greater than 97%
these days. Most women who get breast cancer
detect it early and get treatment, and never have
to deal with it again.
Some will get it again and it is important to note
that a recurrence of breast cancer is still breast
cancer. This is true, even if it is found in the lungs,
the liver, the bones or the brain. I hear many stories
of people, who had breast cancer years ago, but
now have lung cancer - perhaps for some that is
true, but it is far more likely that it is a recurrence or
metastasis of breast cancer. A biopsy will determine
the type of cancer, and the type of cancer is
critical in the treatment of cancer. There are
specific chemicals, which work better against
certain types of malignancies.
A so-called "normal" cancer forms in layer upon
layer of cells creating a small knot or lump, which
feels something like a raw pea. However, it takes
thousands of these cells to get large enough to
feel. Doubling time becomes a critical factor.
If the doctors can determine the doubling time of
the cancer, they know how quickly they have to
act. Doubling time is the time is takes for the cells to
double in number. Inflammatory has an incredibly
high doubling time. Most breast cancers have a
relatively low doubling time, which is why, usually, a
patient can take time to consider all the options.
Early detection buys time for treatment. A
mammogram can detect calcifications, which
indicate a greater potential for malignant cells. It
can also indicate a lump too small to be felt. A
mammogram can detect a mass that is literally no
larger than the head of a pin. And early detection
is the key.
Unfortunately for me, inflammatory carcinoma
does not grow in a knot. It grows in sheets with little
tentacles on the edges always searching for more
places to adhere. As a result, it is usually not
discovered until its insidious presence is well
integrated into the lymph system. The lymph system
runs throughout the body. It is alongside the
circulatory system even into the skin tissue. So, when
you hear of cancer in the lymph system, you know
its potential is devastating.
Breast cancer is usually one of two forms - ductal or
lobular. The most common kind of breast cancer,
and the most easily treated is ductal carcinoma in
situ (DCIS). This means cancer completely
encapsulated inside a mammary duct. It is easily
removed with little further involvement. It often
presents accompanied by a cyst and is removed in
the process of removing the cyst and discovered in
pathology.
This brings us to staging. People often refer to their
cancer by stages. The stages are I, II, III, and IV.
Each stage is leveled by A, B, C, and D. Basically, if
it is small and local, it is stage I. If it is larger (2-5 cms)
then it is stage II. Over 5 cms (2 inches) is stage III –
this can also mean local metastises (extra cancers
nearby). Distant metastases are stage IV. The area
of surrounding involvement and number of lymph
nodes give the rating A-D.
Lobular cancers present between the ducts and
are not as often in situ because lobes are a
broader expanse in which to develop than ducts.
This simply means that lobular may not be as easily
discovered on self-exam as ductal. Ergo, you have
the importance of mammograms. An invasive
carcinoma is one that has gone beyond the
boundaries of in situ.
Inflammatory breast cancer is an automatic rating
ofIIIB because of its size and lymph node and
adjacent organ involvement (skin). The really
critical thing to learn about all of this is that the
more lymph system involvement, the worse the
prognosis. When I was diagnosed, I was told that
only 5% of people diagnosed with my illness would
live for two years. At NNMC, they also told me that I
could get better treatment across the street at
NIH/NCI. And they set up the appointment for the
following week. The bottom line was that within two
weeks of confirmed diagnosis, I had a catheter in
my chest, and chemo in my bloodstream.
My cancer is an infiltrating invasive ductal
carcinoma with dermal and lymphatic
involvement. Fancy name isn't it? That
means that my cancer started in the ducts, but by
its nature was beyond the walls of the ducts as if
they didn't exist and looking for other places to live.
It liked my lymph system, and found a home there.
This brought it into the skin tissue (which you may
recall is riddled with lymphatics) and into the lymph
nodes under my arm.
That, again, is different from the treatment for most
breast cancers. Cancer can be treated in two
methods - systemically, and locally. Each of these
treatments has multiple venues. Systemic treatment
includes such things as chemotherapy, hormone
treatment and bone marrow transplants. Local
treatments include radiation and surgery (including
laser, gamma knife, and cryosurgery).
For most cancers, primary treatment is local,
surgery. Depending on the nature of the cancer,
that may be the end of the treatment. Further
treatment may be advised. For breast cancer, if the
cancer is an Estrogen feeder, hormonal treatment
with tamoxifen (which keeps estrogen levels down
to near zero) is often prescribed. The idea is to cut
out the cancer as soon as possible and therefore
try to prevent the spread of the disease. However,
remember what I said about inflammatory cancers.
By their nature, they have these little tendrils
spreading and seeking new homes. So, if surgery is
performed first, there is a substantive risk of leaving
cancer in the system. The goal with neo-adjuvant
(before surgery) chemotherapy is to cutoff those
little fingers from invading other systems. Then, you
have nice solid tumors you can readily remove. In
my treatment course, I was involved in a protocol
that used high dose chemotherapy before surgery
and standard dosage afterwards.
With chemo, the concept is that cancer cells divide
very quickly. So, you are basically given a poison
that will kill fast growing cells. As a consequence, all
the fast growing cells in your body die. This includes
those in your hair roots; tear ducts, digestive system
linings, fingernails, white blood cells, red blood cells,
etc. And so, your hair falls out, your eyes dry up,
your stomach hurts, and you may lose your
fingernails (at the least you get impairment ridges).
You also become severely anemic and
neutropenic (lacking in immunity defenses). It is not
fun. It is critical that you take the anti-emetics (antinausea) drugs on schedule or you will find you can't
catch up to them and are basically sick for days.
For my chemo, I would be three days on, three
weeks off. So on Wednesday, Thursday, and Friday I
would go to Bethesda and be filled with chemicals.
I would even bring them home in an intravenous
fanny pack. On Saturday, I would go back to be
disconnected. In order to fight the neutropenia, I
would spend the next week giving myself shots of
Neupogen to push my bone marrow into making
more blood cells. By Thursday afternoon, I would be
unable to see well enough to read. I would have
neuropathy symptoms (numbness and tingling in
my hands and feet). These would last until about
the following Tuesday. I would also get the general
nausea, burning eyes, and sense of weakness.
I usually seemed to get sick on Friday and Sunday.
Then, as all that would resolve, I would get bone
pain from the Neupogen shots. That would last
about a week. Usually, by the week before chemo,
I would feel pretty good. But each time I felt a little
worse, and it took a little longer to recover.
I cried hardest when I lost my hair. I'm not sure why
that was such a significant issue for me. I
understand for many people it is one of the most
traumatic pieces. I think it is because it is an
outward and visible sign of your illness. During those
brief weeks of feeling well, I would almost forget
how sick I was until I caught sight of myself in a
mirror or window. Then it would hit me like a
physical blow.
Now I have hair, and it is curly, which is a very new
experience for me. And, although I had colored it
for years, I don't think it was really this gray before.
But hey! It's hair! It is critical for folks who are going
to have chemo to deal with the hair issue in
advance. I elected to wear wigs. I acquired my wig
before I lost my hair. During the summer, I wore a
hat with hair attached to the edges. This is another
one of those incredibly personal decisions. Some
folks are comfortable without hair. As much as I
hated my wigs and hats, I would not go some
places without them. But, I seldom wore them
around the house.
My neo-adjuvant chemo cycles continued for
seven cycles. Every two months, we would do
complete body scans to check on the condition of
the tumors. Then I got a six-week break from chemo
to become healthy enough for surgery.
Right after my illness was discovered, I felt a mass
on the other side. My doctors said that to biopsy it
would not change the treatment cycle. And after
two chemo cycles, the mass was gone.
Nonetheless, I believed in my heart it was cancer.
So, when I was scheduled for surgery, I requested a
bilateral mastectomy. It took some extensive
argument, and a lot of talking to this person and
that person, but I got it. The post-operative
pathology report indicated that there were
necroses (dead cancer cells) in the other side so I
felt somewhat vindicated for my push for removal.
The most important things to note about
mastectomy are that it doesn't hurt as much as you
think, and you must do your exercises everyday to
recover. There are all kinds of issues detailed to
prosthetics and reconstructive surgery, but I don't
want to address them in detail. Suffice it to say that
insurance covers both. With some insurance, it is a
huge headache to get the required approvals and
you may have to front the costs for prosthetics
(about $600).
After the surgery, I had six weeks to recover and
then started chemo again. The little peach fuzz I
had grown fell out, but it wasn't as devastating this
time. The side effects were pretty much the same,
but this time I only had one day of injection and
four weeks to recover.
During all these months of chemo, I learned some
of the most important lessons of my life. I learned
that my family was really there for me when I
needed them. I learned that the Marine Corps
really does take care of its own. I learned that
Angel's wings would keep you warm even in the
worst chills and fevers. I learned that no matter how
sick you are, the sun comes up in the morning. And
I learned that clean sheets always make you feel
better.
More than once, I was hospitalized because of
infections. When you're on chemo, your body
simply does not have the capacity to fight
infections. So, when you get a little infection, it
becomes a raging infection very quickly. What is
usually just a cold becomes a critical sinus infection.
A tiny mouth ulcer from breaking cells in the lining
of the mouth becomes a huge infection. The tiniest
damage to the catheter becomes a dangerous
site infection that can cost you the catheter.
Because your body' cannot fight infection, the
slightest fever can indicate an infection and can
lead to sepsis and death. More people actually die
from side effects of treatment than of their illness
these days. An amazing number of cancer patients
die from dehydration or malnutrition. This is because
it's hard to eat and drink when you fear everything
coming up again. Just remember the worse flu you
ever had. Now, multiply that times fifty. Now
imagine it coming on schedule every few weeks.
The good news is that when you want to eat, you
can eat anything you want.
After I had finished chemo, I was given six weeks to
regain my strength for a bone marrow transplant.
That's not technically correct. I received what we
term HDC/SCR. This is High-Dose Chemo with Stem
Cell Replacement. You may have heard from folks
who had bone marrow pulled from their hips? Well,
with modem technology, they can pull from the
blood stream the stem cells from which bone
marrow regenerates. The process is actually very
similar to a heart catheterization. They insert a large
catheter into the femoral artery in the groin.
Then they insert a second one into the vein next to
it. Then they extract the blood, remove the stem
cells, and return the blood products. When all this is
done, they pull out the catheter and put sandbags
on your leg for two hours to stop the bleeding. Then
they attach a really sticky bandage. Then you are
off your feet overnight. The bandage stays on for
several days. It is not pleasant. The products from
this process are cleansed and reviewed under the
microscope on a broad sampling basis to check for
malignant cells. Then they are frozen with a
preservative.
Months later it's time for the transplant. This
transplant is termed autologous because you’re
getting your own cells back. This is a good thing
because there is no risk of rejection or graph versus
host disease.
have? Well, melanoma and inflammatory
carcinoma are very different critters. Still, it was one
more detour on my path to good health.
Shortly after the extraction, I had my routine
dermatology appointment. Remember, back at
the beginning of this diagnosis, I had deferred my
mammogram because of basal cell carcinoma?
Well, it was time for my checkup. I wanted to get it
while I was between chemos. I told the doc there
was a mole on my leg that had a dark spot I
wanted him to check. He thought it was nothing,
but biopsied it anyway. It was malignant
melanoma. We did surgery to remove the
melanoma, and decided that was sufficient
treatment for now, but we would watch it closely.
For me, transplant time came in January 2000. I
went into the hospital on a Tuesday. I received
extremely high doses of chemo on Wednesday,
Thursday, and Friday. Then we waited for my counts
to drop; and drop they did. We watched my white
blood cells go from thousands down to hundreds,
down to tens, and to single digits. The red blood
cell count wasn't far behind. So, when I was down
to nearly just plasma, they poured the stem cells
back into my blood stream. This went through the
catheter in my chest.
Melanoma is one of the fasted growing cancers,
and rapidly becoming one of the more common.
When I was a youngster growing up in California,
we didn't give a lot of thought to sunscreen. We
should have. Now I use a sunscreen in my
moisturizer and if I'm in the sun, I'm pretty well
covered. But, the damage is done. For me, the
hardest thing about melanoma was that it came in
the middle of this breast cancer treatment. I
couldn't see how anything could grow through the
chemo I was taking.
A tick had bitten me and it died. But remember
what I said about knowing what kind of cancer you
The night before I was to receive the cells, I
became very agitated. I felt like I was under some
kind of attack. So, I wrote affirmations on paper
and posted them all over my room. My favorite was
"I can do all things through Him who strengthens
me, and this treatment ain't nothing but a thing!"
That became my motto for the difficult days
ahead.
The stem cell replacement was cold, and it smelled
funny. I became quite ill. It takes several days for
the stem cells to find their homes in the bone
marrow and get back to work making new cells. At
this point, you are so ill as to be in and out of
consciousness for several days. There are about
four days in there of which I have no memory. From
what I've heard, that is probably best.
As counts start to rise, the hardest thing is to eat
and drink enough. It takes bunches of fluids to
make new blood cells. And it takes lots of calories
to regain strength. However, when the entire lining
of your entire digestive track is gone, and
everything smells and tastes like chemo; food is not
desirable. Once I was home, it was easier. But, they
wouldn't let me out of the hospital until I consumed
enough calories in one day to sustain me. I went
back to that which had sustained me during
chemo: buttered noodles and cherry Kool-Aid. I
found (and this is a good hint to help others going
through chemo) that anything cooked or made in
metal tasted like metal. Actually, everything tastes
like chemo, which is kind of like after you've been
to the dentist, but about 100 times worse. Using
metal only increased the metallic flavor. So,
everything had to be cooked in glass. Also, it took a
strong taste (like cherry Kool-Aid) to get past the
chemo taste.
I was very blessed. I recovered quickly, and came
home safely. My blood counts rose to normal levels
for the first time since I had been in treatment. It
took many, many months for the chemo taste and
feeling to get out of my mouth and nose and eyes.
It may never be completely gone. But, the worst
was over. The all-consuming weariness is the worst
part of this recovery process. When I first went
home after the transplant, I would sleep about 20
hours a day. I would get up and take a bath, then
take a nap. I would go downstairs and rest, then
eat and rest, then go upstairs and sleep.
Sometimes, my family would come up to eat with
me in my room. It took about three weeks before I
had enough energy to walk to the mailbox at the
end of my driveway, and that was only about 50
yards.
Six weeks after the transplant, they started me on
Tamoxifen. The chemotherapy had thrown me into
menopause. The tamoxifen would keep me there.
Tamoxifen keeps the estrogen out of the body by
enhancing enzymes which act as glue to the
natural estrogen my body produces. But, instead of
letting the estrodials flow through my bloodstream
and into my body, they stick to the tamoxifen and
get flushed away as waste. Side effects include
mood swings, hot flashes, and weight gain.
Everyone I know on Tamoxifen gained 20 pounds
within six weeks.
Beginning in March, I started radiation therapy.
Radiation therapy required daily treatment. That is
to say a daily drive of over an hour to Bethesda for
a twenty minute treatment. The first couple of
weeks weren't too bad, but about the fourth week,
the blistering and peeling became quite severe.
After six weeks, we had to take a break to let my
skin recover a bit. Then, we finished with another
ten days of electron therapy.
Radiation therapy patients refer to the treatment as
"the gift that keeps on giving." For weeks, months,
and even years after treatment, the radiation
continues to burn tissue in your body. It is nasty stuff,
but it does kill cancer cells.
I thought I would be able to return to my prior
activity level soon after finishing treatment.
However, I have since learned the fallacy of that
thought. My reading tells me that it takes at least
150% of time in treatment to recover from
treatment. I was in active treatment for about 15
months. That means for 22 months I will be in
recovery. And it will never be the same.
It's not about survival. It's about life, and living each
day knowing that there are a limited number of
them. A young friend of mine (10 years) was
recently told that after three years of treatment,
there was nothing more they could do. Her illness
was terminal. Her response was classic, "So is yours."
She captured the most important aspect.
Shortly after my diagnosis, my son James asked if I
was going to die. I told him, "Everyone dies. It's just a
matter of when." When he responded that I would
be healed, I asked him how. He told me, "God only
heals in two ways: he'll either fix the body you have,
or take you to heaven for a new one." This
authorized me to be prepared for either
perspective.
I once heard him tell someone I was "doing pretty
good right now, but we never know when it might
come back. After all, the goal is to keep it away
until there is a better treatment." He's right.
Inflammatory Breast Carcinoma has one of the
highest recurrence rates of all cancers. It is right
behind malignant melanoma. So, my risk is
exceptionally high.
Every day, I give it back to God. In the dark of the
night I frequently take it back again. And there are
after effects I didn't expect. One day I panicked
because I could not find a parking space. I felt
really stupid about it. But, another woman who had
been through my illness told me she had a panic
attack at McDonald's because they had no apple
pies one day. This helped. I felt a bit better.
I strongly agree with the study that reflects that
people in support groups do better overall. And
there are support groups for most every illness.
There are also support groups for the caregivers
and family members. That is important. In some
ways, it is harder on the people who love you
because there is so little they can actually do.
Cancer reminds you that you are not in complete
control. That is a frightening thought, particularly for
the overwhelming numbers of type "A" personalities
in the world. But, sometimes, that reminder is a
good thing. It helped me become more
dependent on God, on my family, on others.
Check yourself monthly for changes. If something is
suspicious, see a doctor. If your gut tells you to push
for answers, don't give up until you are satisfied. If
you do have a cancer, make an informed
treatment choice. Get a second opinion.
I found email to be a wonderful tool. I could
receive sentiment and smiles from all kinds of folks,
and keep them informed. My “Deb Reports” also
served as a sort of journal. Journals are great tools.
They let you express your thoughts and feelings and
then go back to them and realize how far you
have come. The nice thing about email was I could
deal with it when I was up to it. There were days
and weeks when I didn't want to talk to anyone. It
just took too much energy. But with email, I felt I
had a little bit of control about what to say and
when.
Investigate for metastases prior to treatment. You
are the leader of your treatment team. Also, find a
support group. Be honest with yourself and your
family. It' s okay to be scared, to be strong, to be
confused, to be focused. Don't lie to your children,
they will always think worse than it is. Let others
help. They really want to and it makes them feel
better. It makes you feel better, too. Exercise when
you can, but rest when you must Keep a list of little
things for folks to do – let others wash the kitchen
floor, pick up milk at the grocery, or bathe the dog.
More people die from heart disease than from any
individual cancer. But, more people are being
treated for cancer than ever before. The
treatments are more and more successful every
year. A diagnosis of cancer does not have to be a
death sentence. But, it is a chance to look at life
differently. Among women age 40 - 55, breast
cancer is the leading cause of cancer deaths. Think
about this: Every three minutes, another woman is
diagnosed with breast cancer. Every 12 minutes,
one dies from this disease. Also, 70% of those
diagnosed have no indicators – no family history,
etc.
If you know someone who has cancer, learn about
it. Be able to listen to them, they may need to talk.
But, don't push too hard, they may not want to talk.
The goal is to diagnose early and make an
informed treatment decision. Then, you can find life
beyond the question of survival.
These are some helpful web sites:
www.4llcancer.com - insights to new treatments
and new clinical trials.
www.abreast.org - news articles and new
information about breast cancer
www.acor.org - Association of Cancer Online
Resources has a plethora of information and links.
Also, this is the home site for many mailing lists for
cancer issues.
www.ibcsupport.org - information and support of
inflammatory patients, dedicated to supporting the
patient and family members.
www.nci.nih.gov - The National Cancer Institute at
the National Institute of Health web site is a
tremendous resource for finding health care
centers and clinical trials.
www.breastcancer.net - information and more
information and links and lists
www.quackwatch.com - While alternative
therapies abound and have been found very
successful, there are those who will sell hope at a
high price. Quackwatch is a great site to review all
treatments and find out what is known about them.
www.cancer.org - The American Cancer Society
web site.
www.thebreastcancersite.com - Information and
donations by sponsors.
www.cancerlinks.org - a listing of links, which will
help acquire information
www.y-me.org - Information by patients and
caregivers about patients and
www.cancersupportivecare.com - hints and helps
for patients and caregivers
caregIvers.
www.cancersupportivecare.comInformationforpatientsandcaregivers.This is
especially useful for new patients.
www.ibcresearch.org - information and support of
inflammatory patients, dedicated to spreading the
word about ibc.
QUESTIONS FOR YOUR DOCTOR
Regardless of your choice to seek other medical
opinions, there are some important aspects of your
treatment with which you need to feel
comfortable. You should expect to be informed of
all the procedures, tests, and treatments that are
planned for you, and the risks and benefits of each.
You should also expect to be informed of all
possible alternatives open to you, and the
consequences of each alternative. Some questions
you may have for your doctors:
1. Why do you recommend this treatment or
procedure? What do you expect this treatment to
do for me?
2. What are the possible risks of this treatment or
procedure? How likely is it that I am at risk for
certain side effects or negative reactions?
6. What are the symptoms that usually develop with
my type of cancer diagnosis, and how are those
treated? Is this treatment any different than that
aimed at remission?
7. How will each of these options affect my quality
of life? Will I be able to do the things I enjoy? Can I
work, take care of my kids, go on vacation?