Stage IV

I guess since I'm all done with classes and I'm being lazy, I'll probably blog a lot more. Plus, a lot has been on my mind this semester and I just haven't had the time to write as much as I wanted to. Last week I turned in my Master's Paper, and it got to the point where I was like, enough with the damn cancer. But at the same time, I love oncology. I struggle to find that balance, of loving my work but not letting it consume me and define me. I also struggle with finding hope on a daily basis, in oncology. Are we making strides? Yes. But there is still so much pain and hurt and suffering in it. Adolescents and young adults are the ONLY age group in which cancer survival rates have not increased. 1 in 8 women will still get breast cancer in her lifetime. We still put people through living hell for a bone marrow/stem-cell transplant. Kids still die. Which leads me to this....A good friend of mine, whom I met through the Lance Armstrong Foundation's Summit, was diagnosed with Stage IV breast cancer, after being cancer free for 17 years. Stage IV. There is no stage V. We cannot cure stage IV breast cancer, only control it. While I am so glad to be there for her, since many people who aren't in the field don't like talking about cancer so candidly (she's also in the field), sometimes it is also hard for me to hear her say things like, "Only about 15% of Stage IV breast cancer patients are alive 5 years after diagnosis", or "My doctor said he's basically buying me time for a few years, and hopefully there'll be something new out." Excuse my language, but fuck that shit. This is 2009. I should not be having this conversation. We need better ways of treating "terminal" cancers, better ways of everything with this. I can't even form thoughts in a coherent way when I think about this, because it's so different than anything I've dealt with. Ever. She's only 54. She should die in her 90s, of old age. Not be on chemopreventative drugs and radiation for the rest of her life. How do we, as people in oncology, as advocates, as physicians, as therapists, help these patients and their families and friends and loved ones? Why is Stage IV cancer still so damn scary? Don't give me lines like 'we have tamoxifen and herceptin and arimidex and aromasin...' - I'm fully aware of what the options are. I'm also fully aware that they might stop working in women, that this does not replace a cure, or better treatments that give better quality of life and aren't so damaging to other parts of the body. 

As someone in the oncology field, I'm not immune to the terror that goes through your veins when you hear Stage IV. I, too, have avoided thinking about Stage IV patients and what it means in general.....until now. That was before. This is after. After is about trying to find a kernel of hope and wrapping it in my fist, hoping it doesn't slip through my fingers. After is about listening to my friend and her fears and concerns, even if it means I get off the phone and cry. And after is definitely about not giving up in oncology, and being part of the change that I hope is on the horizon.