Monday, April 23, 2012

EVALUATE FIRST, POISON AND BURN AFTER

Last Friday, we were provided with still more proof that we are not losing are minds.  We've already lost them.  Tomorrow morning, when I'm in the oncologist's office for my six month check up, in addition to haunting him about:
  • The constant lower back pain that seems to begin about ten days prior to each oncology follow up and goes away within 48 hours of seeing the doctor.
  • The shooting pain that penetrates my temple...... time frame for this?  See above.  Pretty much identical to the back pain.
  • The funky looking brownish dot.  Eraser size.  On the inside of my right wrist.  No, it's not from a watch.  No, it's not from banging it because despite my clumsiness being a 12 on a scale of one to ten, there is no way for me to contort my arm to bruise it in that spot.  Besides, The Big C is four episodes in.  Who doesn't want to share the melanoma journey with Laura Linney?  Is this some kind of a joke??
  • What's up with the Choosing Wisely stuff?  Will we continue to do these tumor marker blood tests?? I feel better having them done to be quite honest.  I don't like the idea of being a cancer patient with NO follow up screening whatsoever.  Seems irresponsible.  If I DIDN'T have cancer, I'd be going for an annual mammography.  Now I HAVE cancer, NED, but yes, I HAVE cancer and NO screening?  Yeah... that's not working for me......  That's going to be a big conversation.
  • Then, we can talk about his patient..... the one I talked to..... the one who specifically asked about chemobrain..... the one who was advised by three oncologists that chemo was indicated in her case.  And yes, it was a total coincidence that I spoke to her and yes, it was totally unknown to both of us that we had the same oncologist until we were well into our conversation.  One of those odd coincidences.
  • Finally, we can talk about The Giants!  He has season seats.  We have season seats, too.  Possibly we'll be divvying up the tickets if we can't get our act together (back story) but technically, one of those seats IS mine.   
Apparently, I will also bring him the interview, MY interview, that was published in the March 15 edition of ASCO Post.  You didn't see it? Well... Here You Go

I made an observation in that interview piece and once again.... VALIDATION!  On April 20, Science Daily printed a column titled:  Cancer Therapies Affect Cognitive Functioning Among Breast Cancer Survivors.  This is most definitely NOT breaking news.  It's just more proof that we really have lost our minds.  Or, our brains are playing some kind of twisted hide and seek game.  And, I've always known "chemobrain" isn't exactly the most accurate description.  The research presented in this article from seems to point to the fact that those of us who received chemotherapy performed similarly as those who received radiation and WE all performed subpar to the control group of women who were matched by age and zip code and better luck.

I have chemobrain.  You might have radsbrain.  Doesn't have that same, nice melodic ring-radsbrain.  The thing is, the study which was done at Moffitt Cancer Center in collaboration with researchers at the University of South Florida and the University of Kentucky seems to point to what WE already know.  Basically, our brains have exited the building along with Elvis.  What I especially like in this article?  The lead author's take away.  His suggestion?

"Since patients report cognitive problems that interfere with their daily activities, early workups should include tests to determine cognitive functioning prior to treatment."

I LOVE that suggestion......  Ya know why?  In October, when I was talking the the Jo Cavallo at ASCO Post,  this is what I had to say....

"Had I known developing chemobrain was a possibility, I would have insisted on a neuropsychological evaluation before starting any treatment so I could compare the difference in my cognition before and after therapy."

I feel like being a 6 year old whiny wise ass.  Na Na NA NA NA....... Ha Ha.... Said it first.  Beat you to it.  Really, I'm boasting right now and I'm pretty damn proud of myself.  I know, I KNOW... it's one of those Seven Sin Things.  I'm so thrilled I was able to make this observation with my chemobrain and have a brilliant researcher with a Ph D come to the same exact conclusion after studying hundreds of women over several years. I think I earned the right:  Be Proud.  ARMY Proud.  That's what pops into my head.... and guess what.... There's even a RIBBON for THAT....


In case you are a geek like me and need the "official version" rather than magazine version, this is what the abstract says.......  

Abstract

BACKGROUND:

This study examined the influence of prior treatment on the course of cognitive functioning in breast cancer survivors. Changes in cognitive functioning over time were compared in breast cancer survivors treated with chemotherapy plus radiotherapy, breast cancer survivors treated with radiotherapy only, and women with no history of cancer.

METHODS:

Stage 0-II breast cancer patients treated with chemotherapy plus radiotherapy (CT group; n = 62) or radiotherapy only (RT group; n = 67) completed neuropsychological assessments 6 months after completing treatment and again 36 months later. Women with no history of cancer (NC group; n = 184) were assessed over a similar interval.

RESULTS:

A significant group × time effect was found for processing speed (P = .009) that reflected a tendency for the NC group but not the RT and CT groups to improve over time. There was also a significant group effect for executive functioning (P = .006) that reflected the NC group performing better than the CT and RT groups. Additional analyses found the administration of hormonal therapy was not associated with change over time in cognitive performance.

CONCLUSIONS:

Findings provide limited support for the view that changes in cognitive functioning in cancer survivors are attributable to chemotherapy administration and illustrate the importance of including a radiotherapy comparison group. Future research should seek to examine possible mechanisms that could explain the apparent prolonged impact of both chemotherapy and radiotherapy on cognitive functioning in breast cancer survivors. Cancer 2012;. © 2011 American Cancer Society.



7 comments:

  1. AnneMarie,

    I wish you luck at your oncologist's appointment tomorrow. I know, all too well, what it's like to have aches and pains assail my mind.

    Speaking of the mind, chemobrain DOES exist. I can't tell you how many doctors didn't believe me, and, like you, I wish I had my cognitive skills tested pre-chemo.

    Pre-chemo: I was sharp as a tack.
    Post-chemo: Like a tack that's been run over by a flattening truck.

    Good luck tomorrow, my friend.

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  2. By the way, I read your ASCO Post article, and it was amazing!!

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    1. Thanks, Beth. Now, to attempt to control the mess that managed to accumulate in my office. IT WAS organized little more than one week ago. Now.... a disaster again. As for ASCO, I was pretty flattered to be asked. Off to don the hazmat suit and enter The Disaster Zone.

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  3. AnneMarie,
    So bizarre and yet, so predictable, the inner workings of our post treatment brains. I'm predicting that you're absolutely fine. If James were here, he'd tell you the little dot on the inside of your wrist is an AGE SPOT!!. In our household, he would just say, "It's the "A-word." Anything and everything he'd jokingly blame on age. Regardless of whether it's due to age or not, it's not so funny.

    XOXOXO,
    Brenda

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  4. PS: A comment about Beth's comment... LOL:) If she can write that line about "run over by a flattening truck," I'd say she's still sharp! That goes for you as well and your ASCO piece. Very impressive!

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  5. AnnrMarie

    Sometimes I feel like a babbling idiot that suddenly runs out words because the words have vacated my mind. Lord it's frustrating to forget your bank debit pin number standing in a grocery line with 50 people behind you starting to whine.

    Chemo brain is real, I was told get over it....

    yes the cognitive skills testing pre-chemo would be an excellent idea. After all they test you for everything anyway.What's one more test?

    Love Alli xx.

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  6. I don't know what my excuse is then because I didn't have to have chemo or radiation treatments. I think it's the tamoxifen. I am surprised I remember my name sometimes.

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