I had a bit of a scare almost two weeks ago, but I’m back in the safe cozy of denial now.
These CA 125 numbers are an enigma. Or maybe paradoxical, I’m not sure. After shooting up to over 1500 during the early recurrence, and continuing to climb while I was on Etoposide, they started going down a bit after a couple of doses of Doxil, then suddenly shot up to almost 3000 after the fourth dose. When my oncologist entered the exam room for my last appointment, she had a look of condolence on her face. Not good. Doctors rarely have looks of condolence. She went to the computer and hemmed & hawed over one thing or another before showing me the results of my recent CA 125 test.
“It’s not working, I’m afraid,” she said. I didn’t miss a beat; showed her the information for the clinical trial I’ve been considering. It’s a double-arm trial in which I would either get the drug being tested (Lurbinectedin), or would be given Topotecan as a control drug. Since Topotecan is the next drug my oncologist would be trying, I figured I can’t lose. Anyway, with this particular trial, it’s now or never – at least before I move on to the next drug or never. I can only have been treated with three prior regimens to be eligible for the research.
According to an article or two, Lurbinectedin, which was originally derived from the Caribbean sea squirt but is now made synthetically, had some modest advantage over Topotecan in early trials. Since the control was to be Topotecan, even my oncologist thought it would be worth it to get involved. She just needed to check with her department chief to get the okay. In the meantime, she sent me over to Radiology for an immediate CT scan, and said if she didn’t have the results by the next day, we’d postpone my next Doxil treatment until she knew for sure (although she didn’t have any doubt, looking at the numbers) that Doxil wasn’t an effective drug for my particular cancer cells.
Marc and I drove home with our proverbial tails between our legs. Beaten back once again. Even so, I couldn’t help noticing the vibrant perfection of the springtime landscape: verdant slopes of foothills punctuated by burgeoning oak trees, orange swaths of poppies underlining dark pinnacles above the dam, the glassy surface of Lake Berryessa approaching the Blue Oaks and green grasses growing along the high water line. Saying goodbye, I thought to myself. Saying goodbye to my hair, my almost normal level of energy, my ideally-functioning digestive system. Always saying goodbye. But also saying thank you for one more springtime.
We went about rounding up cats when we got home, put away the milk and bananas we got at Lorenzo’s Market in Winters. Started thinking about dinner, when the phone rang. We always wait for the phone caller ID voice so we don’t answer any “out of area” or “name not given” calls. If it’s really someone we know, we can pick up when they start to leave a message. Do you have any idea how much time I would spend on the phone if I answered all those calls? So much time my plants would wilt and my pottery would never take shape, I assure you.
“Ka-syr Per-man-it” the phone voice said in her stilted Robotish accent. I always answer when Kaiser calls. It was my oncologist, with her runaway Chinese accent, telling me she had gotten the CT scan results, and she was very surprised to read that there was shrinkage in a couple of areas, and she really didn’t expect to see that and at least two places the tumors went down from almost 2 cm. to one-point-something and she wanted to let me know right away and we will go ahead with Doxil treatment tomorrow and she was so surprised and it made her so happy to see that!
It made me happy too.
The next day, I had my 5th treatment of Doxil. The nurse printed out the CT scan report for me, which I read on the way home, car queasiness be damned. It seems all the tumors had shrunk a bit, and one mass that had been 3 cm. in the prior scan did not even show up.
What that means, I cannot say for sure, other than “the numbers” are not accurate measures of growth or shrinkage and, as my oncologist says, that’s why we should “go by image and not by numbers.”
What else it means, at this point, is that I’ve been spending a lot of time out pulling weeds, spent an afternoon glazing my pottery, and am thankfully enjoying my colorful world—sunshine, grasses, rain, poppies, gray clouds, lupine, gray pine, irises, blue oaks, yellow fiddleneck and bees on lavender. I'm welcoming every aspect of springtime except the little black deer flies that keep trying to enter my brain through my ears and mouth, even more so when I spray myself with bug repellent. The persistence of those flies, like that of the dratted numbers, is disconcertingly inexplicable and annoying.
I do my best to ignore them both.