Peggy's Cancer Spreads

Peggy had a high definition MRI on Monday, blood tests on Wednesday, and saw her oncologist (Marc) on Thursday. The tests showed spots on her lungs, spots on her liver (all of which are too small to biopsy), and an elevated CA-19.9 cancer marker. Marc is trying to get her access to the new pancreatic cancer drug before its FDA (Food and Drug Administration) approval, but doing so involves a lot of paperwork and a lot of people’s approval, so it could take six weeks. 

He cautioned her that the side effects of the new drug are likely to be worse than the ones reported by the studies (which were pretty bad) because the people who were chosen for the studies were mostly young and had no health problems aside from pancreatic cancer. Marc also suggested that she go back on chemo. 

Chemo usually involves a combination of drugs, and the chemo that made her deathly ill in March is the only combination that is left to her. Neither she nor I supported putting her back on that, so Marc proposed that he only give her the less toxic of those two drugs. His thought was that it would serve as “a bridge” between now and the time that she has access to the new life-prolonging drug. 

Marc’s proposal sounded like a no-brainer to me, but Peggy’s experience with her last chemo was so horrific that she said she would have to think about it. Marc responded that the spots on her liver are likely to be cancer, and if they are, her cancer has the potential of spreading quickly. I sat hoping that she would ask for my opinion, and when she did, I strongly stated that she should take Marc’s suggestion. When she still hesitated, Marc said something about how much I love her, and how she is probably the only woman I ever dated. I don’t know if he meant to imply that she could trust my advice, or that she should do everything possible to stay alive for me, but Peggy and I got a good laugh out of her being the only woman I ever dated. However, she agreed to return to chemo. When she said she couldn’t come on Monday or Tuesday, he scheduled her for Wednesday.

Peggy worries quite a lot about what Marc thinks of her, and she often questions what he really means by what he says. I consider her suspicions groundless. Despite what she thinks, yesterday was the first time that he has urged her to take a particular course of action, and I interpret the fact that he never did so before to mean that he never had enough hope before. Right now he has ten patients with pancreatic cancer (the clinic where he works has many more), so he is well aware of how very deadly the disease is, but now that there’s hope, he wants her to stay alive long enough to avail herself of it. 

I am ever surprised by how rationally Peggy behaves under pressure, but I’ve also seen her become so stressed that her thoughts go awry. For some reason this happens in her relationship with Marc. It’s as though this youthful Asian man is her father, and she is his daughter who is desperate for approval (she would probably disagree with my analysis). What I see in Marc is a caring doctor who genuinely likes his patient, and has said how moved he is by the fact that I have accompanied her on every visit.

Right now, Peggy is terribly scared of taking chemo again because she was so sickened by her last round that she said it would be kinder to her body to allow it to die of cancer than to subject it to such poisons. I remind her that she vowed to fight this cancer with everything that is in her, and that Marc has assured her that the chemo he’s about to put her on is of such low toxicity that he “gives it out like water.” She can do this, and she must do this because the new drug that is expected to be approved in June or July is the first real hope that pancreatic cancer patients have had in fifteen years, and she must stay alive for it.