12 May 2023
The oncological team really throws a lot your way in one morning’s time. Both Michel and I were a bit overwhelmed but I’ve had time to cogitate on what was said – and more importantly what was not said.
The average life expectancy for the American male is 74.2 years according to an August 31, 2022 reporting by the Center for Disease Control (CDC), down from 74.5 and 77.28 in previous years. I’m 74.
Based on the stage of cancer (mine is stage 1), age (a negative for me), general health (a plus for me) and the treatment (mine seems to be the most current – for females) the five year survival rate is 82%. If the cancer is restricted to the breast and hasn’t spread, then the five year survival rate is 95%. If it has spread to a distant part of the body (through the lymph nodes), the five year survival rate is 19%. For some reason, cancer organizations and government agencies don’t seem to quote 10 year survival rates or greater.
You think you know what things mean until you start to ruminate over terms. For example, on May 25th, I’ll go in for a chest port (actually more like upper chest near the neck port). I’ve heard of ports before but didn’t really think about the procedure or how they work. In essence, they allow an easy access to draw blood or provide chemo infusions without having to undergo continuous needle sticks. Remember, I’ll have infusions every three weeks for six sessions. Then after a potential mastectomy, then I’ll have a year of additional infusions every three weeks. I’d look like a pin cushion if they did needle sticks. Chemo often degrades the veins in the arms and can cause collapse. A port can be accessed again and again for several years.
The hard part, of course, is in installing the portal. That’s a surgical procedure and depending on where you have it done, it’s either a local anesthetic at the site of insertion or they put you under. I’m hoping for the “putting you under.“ You can get a pretty good idea of the procedure from a YouTube video. I caution you that it’s pretty graphic.
The video above is a local anesthetic. There’s a good deal of bleeding and apparently, it’s become routine for those doing the procedures. I hope they are not as lackadaisical as it seems in the video.
One section of the video was interesting to me and recalled some situations with students dissecting specimens in my lab. At one point in the video, they need to make a pocket under the skin to place the port. You see the surgeon stick their (gloved) finger into the incision and begin the push and sweep, much like you do when you try to put seasonings under the skin of a chicken you are roasting.
When we would dissect specimens in my biology lab, students were very timid and reticent to be aggressive with their dissections. Of course, this can lead to disaster in a dissection but there are times you need to be bold. Students failed to realize how tough some of the tissues are in a specimen and I would have to show them they were not going to destroy tissue by being aggressive. You can really pull and tear and rip on the human body and it’ll survive quite nicely.
To understand how to use a port, there’s another YouTube video.
As I was swimming laps yesterday (I better get that in while I can) it came to me I hadn’t thought about insurance. You hear horror stories how families go bankrupt from cancer treatments.
The chemo for me will require a drug cocktail of four very powerful and toxic drugs: Taxotere, Carboplatin, Herceptin and Petuzumab. Fortunately, my Medicare will cover 75-80% of the costs associated with these drugs. That leaves me on the hook for the other 15-20%. One estimate is that for the initial sessions of chemo, the out-of-pocket costs could be $6000. I have an AARP, United Health Care supplemental plan and I called yesterday to see if they would pick up the other 15-20%. I was informed that as long as Medicare covered the 80%, they would cover the rest. The drugs do not fall under the Medicare Part D plan for drugs, thankfully.
The other big concern was the long term Tamoxifen costs. I’ll probably be on that pill for 5 years or longer. The good news is that 60 tablets of 10 mg runs around $18.37 with insurance.
For years, I told people I would not submit myself to chemotherapy for any cancer. You hear such horror stories. Treatments seem to have improved. Apparently, they give you anti-nausea medication before chemotherapy and provide you with a prescription for nausea after chemo sessions. They also check you white blood cell count and can give you medication to boost wbc’s. Otherwise, I would be susceptible to infections – not good in the age of COVID.
I’m willing to get started on chemo and see how it affects me. I certainly think I can manage the first six sessions over 18 weeks if I don’t have any adverse reactions. I’m more concerned about the additional 17 sessions over a year’s time. There is so much for me to consider. Can chemo shrink the tumor? Will I still need a mastectomy? Can I cope with chemo and for how long? You have to ask yourself the question that if you are already at the average life expectancy of the American male, how much you want to put up with for the potential (albeit excellent odds) for five more years of life. Yes, I know many people have survival rates much longer than five years. Five years is only the bookmark for cancer treatments. It boils down to a quality of life issue. For now, I’ll start the process.
Stay tuned!