Saturday, November 11, 2006

It's all about the statistics...

... as the oncologist said, when laying before me the options for treatment. One of the mixed blessings about having a disease such as breast cancer which is being so intensively researched is that there are a number of possible options after surgery. There are no promises to be made at this stage, just the stacking up of statistics and probabilities about going for ten years without a regrowth of cancer cells (when, I guess, I am pronounced 'cured'). If I do nothing, I have an 80% chance of getting that far: chemotherapy, radiation and hormone therapy of various kinds all have the potential to raise that percentile (as do exercise, diet, attitude, etc. but these are harder to quantify).

Mitchell drew a rough graph and sketched out the choices, or 'arms' of a clinical trial he says I am a candidate for, giving me the information brochure, the consent form, and the website of the trial. I won't go on, just yet, about the intricacies of these possibilities, but I have been interested to see how long it has taken me to understand the document and the meaning of the choices before me. 'You're an academic,' he and Suzanne have both said to me at different stages, 'you'll understand about statistics'. Well, yes and no. Which is the best way to see this? My own chances of recurrence? Or my chances of remaining among the majority of the 100 women setting out at this stage who will be given the all-clear ten years from now?

Given that I am an educated women with the equivalent of ten years' tertiary education in textual analysis, literary criticism, philosophy and social theory, I wondered why it was taking me so long to get my head around the details of the choices before me. I started thinking about the ethics applications I had read in my department. It was odd to see myself giving consent to take part in a trial and approving the storage and analysis of tissue samples, the anonymity of results, and so on, when I have assessed a dozen or more ethics applications and their 'plain language statements', all seeking to make sense of research projects in communications and cultural theory to an unsuspecting public.

And then I started thinking, 'What about the women without the benefit of my education? How could they possibly make sense of these booklets and leaflets and websites?' But then I remembered Suzanne's comments about Kylie Minogue, another Melbourne girl with breast cancer. I had read about her dismay at her original diagnosis, and her account of writhing in tears on the bathroom floor during her chemotherapy. While I have had a few bad nights and some anxious moments, I haven't experienced anything like this drama. Was I missing out on something? Suzanne just laughed and said, 'Of course she is! She's a performer; she's not analysing things the way you will.' And of course it's so, that different women will experience the disease differently, and need and want different levels of explanation when it comes to assessing treatment options. I make this comparison not out of disrespect to Miss Kylie; but mostly to make the point to myself that there are no normative responses to cancer and its treatments. That is, I don't need to start planning a dramatic comeback tour of my own (new haircut! more sequins! more feathers! a new theory about historicism and ritual practice!); it's ok just to keep going on quietly and peacefully as I am, and as I will now plan to do for a year or so.

That said, I'm still finding it difficult to chart this new course where I don't juggle a hundred committees and tasks each day, as I seem to have been doing over the last few years. It took me the best part of an hour to write the email to my Dean, explaining that I wasn't going to let my name go forward in contention for one of the big associate deanships for 2007, as we had discussed. It took her about five minutes to write back graciously saying that would be fine.

I'll see the oncologist again on Tuesday, and expect to sign up for the trial of different regimes of hormone therapy (in addition to the radiotherapy that is standard). One of the great things about this is that it means I won't, in fact, have to undergo the rigours of chemotherapy. I still reserve the right to as many tears as I need, though.

Warmest thanks, too, to all who've written, from near and far, from the present, and from the past. It's great to hear from everyone, and I'll write back soon...

1 comment:

earnest said...

» International Trial Of Novel Breast Cancer Drug
14/12/06 07:03 from Breast cancer blog from medicineworld.org
-------------------------------------------------------------
A clinical trial of a new targeted breast cancer drug, led by
physicians at Massachusetts General Hospital (MGH) Cancer
Center, has begun enrolling patients. The TEACH (Tykerb
Evaluation After CHemotherapy) trial will investigate ...


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