Today at 11 am I had a meeting with my oncologist – our first. My friend Ingrid Claassen joined me for the meeting, since Victor was too late to cancel his assessments. Ingrid has written quite a lot of patient brochures for different organizations, such as the Dutch association for general practitioners, and she is familiar with the medical terminology. A great friend to have by your side at a time like this. The sun was shining as we walked into Tergooi Hilversum.
The oncologist was a young man. As soon as we sat down, he said to me: “I have bad news. Very bad news. The cancer had spread inside your liver.” He gave me a moment to react, and I nodded. “Do you understand what this means?,” he said to me earnestly, “It means we cannot cure you.” I explained that I understood exactly what he meant and that I had seen this coming, and was prepared for this answer. He couldn’t believe I was so calm. He apologized for starting our first meeting this way, normally, he explained, we meet the patient first and then go through the process. Now, he had to start with the news that I cannot get better.
He asked if I had seen the CT scans of the liver and since I had not, he showed them to us. The scans showed a large, no a huge liver. The liver had grown past the left ribcage into the area where the heart is, and was pressing against the lungs and stomach. That explains why I have been short of breath, my longs have less space to breathe. The scans also showed darker spots spread around the liver; these are the metastases (uitzaaiingen).
Next, the oncologist asked us to get my blood analysed and then to come back. Basically, he continued, we have to start the chemo as soon as possible. It is the only way to try to reverse what is happening in the liver. It is more important to treat the liver now, than the breast. You won’t die of the breast tumor, but of the liver. He conducted a quick physical examination and asked if anything hurt. But that was not the case. Ingrid said later that while I got dressed he told her that one cannot get used to this (meaning the bad news). Also, he was extremely surprised that I was in such good condition (which is funny, since I thought all this time that my condition was poor). That may be a blessing in disguise. He said we have no time to lose.
The doctor had discussed the results with two colleagues and agreed on the following: 3 rounds of chemo. So this wednesday will be my first day of chemo. I will get the AC chemo, at 80% strength. There is a risk that the liver cannot handle the chemo and will fail. But there is also a chance that the chemo will help to reduce the tumor size. In three weeks time, a blood test will show whether the chemo has effect. Then the second round of chemo will start. After the third round, the team will discuss the state of the liver and perhaps introduce other therapies. In the meantime, I can eat what I want as long as I don’t lose more weight. So I think I’ll add some french fries to my diet of vegetables and oatmeal! He stressed that it was very important to be honest at all times. I could ask anything but I should stay clear of unconfirmed stories and sources. He also stressed I should not take any form of vitamin supplements since it could interfere with the working of the chemo and could cloud the results.
We had to come back at 1 pm to talk to the nurse about the chemo, so we had a chance to have a bite to eat. I was starving, so no issue there.