Update November 15, 2010

I had the third installment of my sixth chemotherapy session of my third round  treatment today.  I'm not exactly sure how to correctly term it, but I have been receiving paclitaxel (the taxol derivative) since June.  The course is three weeks on, one week off.  I have been lucky that the side effects have been so minimal up to now.  But last week, I developed a mild neuropathy in my toes- a slight tingling and numbness that did not go away in a day or two, as it has done previously.  It was mostly gone today at the oncologist's, but not entirely.  The Physician's Assistant  Sarah and I spoke with said that eventually should this side effect continue to grow and encompass not only my toes but my ankles, then we will have to discontinue the chemotherapy.  She said that the effects generally are more pronounced by the eighth session.

This is always a balancing act--balancing the efficacy of the treatment, the introduction of a poison to slow or stop tumor growth, against my quality of life.  I liken it to peeling an onion, starting with the skin and working layer by layer into the interior.  It's a judgment call when to stop, and although I am not there, it is a sobering reminder of  the end point of my journey. 

We will all die someday, but one way we keep ourselves 'sane,' if you will,  in the face of this dread outcome, is not to deal with it, to assume that we will live forever.  To constantly reflect on mortality would leave me with an overwhelming fear, and freeze my ability to enjoy each day.  As it is, I find my life seriously circumscribed by my loss of voice, so I do have a regular reminder.  Just as when I look in the mirror.  I try not to let these things bother me, and I've succeeded for many months using a number of distractions, but today it just got to me a little.  Damn.