Course 6 (of 12)

I'm hanging out at Dana-Farber again today for the sixth course of treatment.  In two days I'll officially be halfway done with chemo.

But...

Today I also learned that radiation therapy is more or less a given.  My right ovary - the one to which this cancer had metastasized, then became abscessed and infected - was pressed up against the pelvic wall when they removed it, leaving behind suspected microscopic cancerous cells.  I remember my surgeon saying she marked the spot to facilitate radiation, so there's that.  I won't start that therapy until chemo is over; it will add another 5-6 weeks to my visits here (and radiation visits are daily... fun).  I haven't even met the radiation oncologist (next time) but my primary oncologist was quite certain it will be recommended.  Nothing about my case is on the fence, apparently.

I also learned that my white cell count has taken enough of a hit to warrant mitigation.  Starting with this course, I'll have to come back to DFCI after we disconnect the pump to receive an injection of neulasta.  This drug will stimulate the production of white blood cells.  The only alternative is waiting additional time in between courses, but all of us would rather stay the course.  He asked if we would be up for self-injecting at home and I quickly declined; my experience with Lovanox was enough to know that I'm not capable.  Pulling needles out is one thing (that I can't even do, my husband has to) - putting them in is a line I'm unable to cross.  It's also an insurance consideration - apparently it might not be covered if it is administered at home.  Interesting.

I was supposed to have a consult with a genetic counselor today but had to reschedule til next time as we were running behind and another consult got in the way.  I did agree to participate in a clinical trial titled, "The use of sequencing to guide the care of cancer patients."  It is a research study that "will help doctors and scientists better understand why cancers occur and to develop ways to better treat and prevent them.  The study is also to help researchers understand how best to communicate the results of complex genetic studies to patients and doctors, and to help them use that information to choose the best treatment plan."  Okay, cool.  The researchers will sequence the DNA of my tumor and my blood and basically do a giant comparison to see what abnormalities may exist that may explain why my cancer occurred.  They could learn something that would benefit any future treatment I might need.  I have to donate an extra tube of blood at some point and complete a couple of surveys and an interview.  There is always some legal mumbo-jumbo about privacy and protected health information, as they have to attach my name and medical history to results for them to be useful, but I'll admit I don't give that a second thought.  Anything to fight the good fight.