Pick Your Poison

Chemotherapy, as I see it, is an contradiction. On one hand, it is the culmination of 30+ years of intense scientific study, hundreds of thousands of hours of clinical trials and observations, harvested from obscure sources like rain-forest plant roots and a tried-and-true systemic treatment for many, many forms of cancer with millions of life-saving success stories. On the other hand, it is a poison. Designed to kill...indiscriminately.

Unlike targeted therapies such as Tamoxifen and Herceptin, which specifically attack cancer cells (or at least the mechanics common to some cancer cells), chemotherapy attacks all cells in the body. Usually injected, sometimes ingested, chemo travels to all parts of the body fed by the circulatory system and wreaks havoc wherever it goes. Although it isn't targeted to specific cells, chemo typically targets a specific cellular function or functions and jacks with it in order to cause the cell to die, whether a cancer cell or otherwise. The functions that it most commonly attacks are the cell division functions. Lo and behold, most cancer cells are dividing like crazy, that's what they do. So when the chemo is present in the body, it messes with those cells that are dividing rapidly, effectively killing them, and leaves the other cells (which aren't dividing) alone. So you may ask, isn't that targeting the cancer cell? Not really, because there are other cells in the body that are rapidly dividing too such as cells in the mouth, stomach and intestine, hair cells, nail cells etc. Guess what happens to them? Guess what the major side-effects of chemotherapy are? Wicked nausea, mouth sores, hair loss, blackened finger/toenails. Tingling in your extremities is also common because of temporary nerve damage. Throw in the inner workings of a woman's body (even in a healthy woman, that stuff is balanced precariously), hormones, hot-flashes, eye-of-newt, toe-of-frog...you can understand why Linda's first round of chemo caused some apprehension for both of us.

Chemos often work better in combination, almost like a one-two punch, or in Linda's case, a one-two-three punch. They are chosen based on the type and behavior of the cancer cells present in the tumor. Her regimen: Taxotere, Adriamycin and Cytoxin, collectively known as the TAC regimen. The drugs are administered sequentially in one sitting (takes about 5 hours in all), then repeated every 3 weeks, for 6 cycles.

On Jan 2, we showed up at Texas Oncology ready for the unknown. If you know Linda at all, you know she plans everything to the nth degree. Lists upon lists of things, plans, backup plans, alternates to the backup plans. There is no doubt we could have camped out in the infusion room for a few days with everything Linda brought with her that day. Every imaginable scenario had to be covered. Flood, drought, famine etc. Blankets (both thick and thin), shoes, slippers, sweaters, 2 ipods (one for me, one for her), sandwiches, fruits, vegetables, cold drinks, hot chocolate, books, the latest grocery checkout line finds of People, US, Ok, Star and others (sorry, those are my secret guilty pleasure), a newly acquired day planner of dates/times/schedules/metric conversion charts...oh and yes, a duck.

The duck is an inside joke between her and her girlfriends, who now call themselves her 'breast friends'. At some point in time, it resided in a lakehouse the girls rented for a weekend getaway. But now, over the past year, the duck has been found randomly by one of the girls in their kitchen pantry, bathroom, freezer, tree or other surprise location.

So Linda, facing the greatest uncertainty of her life, still lit up the room with her trademark smile and brought along a duck for a little comic relief in as much to say "Don't worry guys, I'll be fine". If that is not courage, I don't know what is.