A preliminary plan of attack

In our local hospital as well as in an academic hospital my case and images have been studied extensively by multidisciplinary teams. My situation is very serious but fortunately I am young and fit. Both teams arrived at very similar plans of attack of the disease. If everything goes according to plan the cancer cells can count on heavy artillery indeed!  ‘According to plan’ means that the cancer cells stop taking possession of my body. That they hopefully even start to make retreating movements so that we need not stop the attacks prematurely. Today we decided to start the first round on Friday (that’s the day after tomorrow!) There is every reason to speed up procedures. Tomorrow a biopsy will be taken from my breastbone. The dangerous spots on my lungs are too small to puncture, or too difficult to reach. 

The 5 attacks in detail:

  1. During the first eight weeks: 4x cycle chemotherapy type I: on the first day an intravenous drip (with or without a coldcap on my head), home the same day; the day after an injection to help my immune system to deal with the blow. Common side effects; nausea, hair loss and fatigue, especially during the first 3-5 days. Two weeks later the next cycle. Then an MRI to see whether the tumour has shrunk. That is the first exciting measuring moment. 
  • After the result of the MRI: 12 weeks of chemotherapy type: 12x cycle chemotherapy type II: the first day an intravenous drip, home the same day, rest of the week recuperating at home. Common side effects: nausea and neuropathy (tingling in fingers and feet and possibly extreme sensitivity for cold and heat). Then a CT-scan to judge whether the spots on my lungs (the greatest danger is situated there and in my bones) have grown smaller. 
  • Operation (amputation). This will be no dangerous or complex surgery, but with all the more impact of course. Revalidation after surgery. 
  • Radiotherapy: 15-18 radiation sessions, one every working day. Common side effects: fatigue, sometimes pain and fluid retention in the arm. Try to regain strength.
  • New rounds of chemotherapy, possibly 8×2 weeks of taking chemo tablets each round followed by one week of rest (so this treatment will last for at least 24 weeks). 

In short: we are going to fight a fierce battle against the rebel cells for more than a year. No one is able to predict how my healthy ánd rebel cells will react to treatment. It will be a battle on cell level, with the knowledge we now have acquired in medicine. 

I want to take up this challenge. I must confess that so far in my life I haven’t really had to fight to the limit, having had loving parents, protective older brothers, my tall great love beside me for 27 years, and good friends and colleagues. I want to take up this challenge, but don’t exactly know how. Now, when it really matters the strategy of the battle will be in the hands of care professionals. Even to into the bone. Fortunately, it will be mainly a physical struggle, for mentally I feel a great deal of stress. But I feel also the presence of God, who holds me. 

I looked at the internist oncologist, a pleasant, experienced man; we had an immediate click. ‘Is there something I can do myself?’ I asked. ‘Yes, try to keep moving (cycling, walking, exercising) as much as possible and try to eat well and healthy.’ On the way home I thought of all the teams which had been formed so far: a shopping team, a ‘do-it-yourself’ team, a ‘walk with Ingebee’ team, a ‘healthy cooking for Ingebee’ team, a ‘making music with Ingebee’ team and a ‘stay close to Ingebee in the first days after each chemo’ team. ‘Hurray’ I thought, ‘the allies have arrived!’.