This was the conclusion of Dr. Munoz today during our visit. Given Susan's remission, the fact that the topotecan is really zapping her bone marrow ("you may need this later" he said) and to improve her quality of life--particularly her hearing, he recommened ceasing chemo until further notice. (I.e, until a recurrence.) We accepted this conclusion. It is pretty much in line with what Dr. Mirtsching had said also. For Susan this was a a relief. "I'm tired of not feeling good," she said, commenting on the increasing difficulty of coping with nausea after treatment. (She is experiencing that today after her delayed topotecan treatment yesterday.)
Just as we felt that our being led to Drs. Mirtsching and Munoz was the Lord's leading, so we view this decision as coming from Him. We thank you for your prayers in this regard, and ask that you continue to pray for Susan: particularly that her remission might be extended indefinitely.
A final note on Dr. Munoz. I continue to be impressed with this man who strikes me as a true servant of humanity. He has been given a special gift: that of an superbly competent surgeon. He works extremely hard (and long hours) using that surgical gift to save women's lives, and at the same time spends as much time as each lady needs to be reassured by him. Once again today he commented: "I believe you would not be alive today if we had not done that surgery." I believe the data supports that conclusion. Even I came in for his direct physical encouragement as he heartily patted me on the back. "Thanks," I said, "I needed that."
This has been a tough few days for Susan following her topotecan treatment on Thursday. We’re now in the middle of the sixth round of chemo following her last surgery, so it’s not surprising that the side effects are accumulating. The last few days have been queasy ones for her as she has tried various anti-nausea medications to fight the ickiness she feels.
Emotionally, we were hit with another challenge when we saw the oncologist on Thursday. The continued good news is that Susan remains in remission, as verified by the CT scan. However, the cisplatin is taking a toll on her hearing. She can barely hear high frequency sounds now, including such things as the oven alarm or certain women’s voices. The doctor says that this is irreversible, and if she continues the cisplatin she will eventually become deaf. He therefore gave us three choices: 1) continue the present treatment with its hearing consequences; 2) delete the cisplatin but continue the topotecan; 3) stop treatment altogether until the next recurrence. (Note, he didn’t say “if” you have a recurrence; rather, he said “when” indicating that he fully expects one.)
The doctor’s preference is choice 2. Yet he was frank with us: the medical literature is ambiguous when it comes to deciding whether ongoing chemo during remission delays recurrence. Some specialists give 4 treatments and then stop no matter what.
In making her decision Susan wants to consult with her surgeon—who is also a gynecological oncologist. We will appreciate your prayers for divine wisdom over the next two weeks as we sort through all the data and opinions. Likewise please pray for Susan’s hearing and its restoration. We know the Lord can accomplish all things even in spite of medical conclusions to the contrary.
If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. (James 1:5).