In Cancer Care, Cost Matters

An important article on the OP-ED page of today's New York Times regarding the cost of cancer drugs and how those costs are passed on to consumers. Bach, Saltz and Wittes from Sloan-Kettering Cancer Center authored this piece (link below) describing the decision of Sloan-Kettering to NOT offer a new drug --Zaltrap--for colorectal cancer.

Very interesting and maybe surprising to hear this from the preeminent cancer center in the world where you'd expect them to try everything no matter the cost. But these docs have decided that more expensive is not necessarily better. They also explain how monthly outlays for cancer fighting drugs have risen from $4,500 per month ten years ago to drug regimens that now cost $35,000 per month. Yes, per month.

This is a short piece and worth reading. Even if you have great health insurance or Medicare no one can afford this.

Here's the link:
http://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html?smid=pl-share

Fashion Tips for Caregivers at Chemo

The question arises: What should a caregiver wear to chemo? There is no official dress code but think again. My favorite look: Khakis with a black linen shirt worn over a black tank top (layers are good) black ballet flats (they signal a causal insouciance) and my new necklace—black pearls inserted among silver waves. This is the gift from John: subtle, stylish and very me.

Hospitals, doctor’s offices and even at chemo-Looking good makes a difference. Leave the sweat pants and polyester at home. Go for neutrals, polish and natural fibers. (There are enough chemicals in CancerLand for everyone.)

Diana Vreeland, the legendary editor of Vogue wrote, “The one presenting the most style has the most power.”  In this powerless situation, style is a consolation.

Chemo Love Therapy

Kisses that last at least ten seconds and hugs of at least six seconds increase the flow of oxytocin and serotonin. Oxytocin is the love chemical that promotes bonding, and serotonin, as we all know, is the happiness drug.

XOXOXOXOXO

Conversations at Chemo

It’s a funny thing. We end up having these important conversations while he is receiving chemotherapy. It’s a public setting and stressed in its own way. Surrounded by people who are sick or dying or getting well. Caregivers sit at the feet of their loved ones. There are several TV’s on and lots of chatting and joking and movement as nurses check machines and add bags of chemicals and insert IV lines and jam needles into patient’s chests. In the middle of that, almost accidentally, we fall into these profound conversations about our lives, our relationship and our love. Maybe, surrounded by all that living and dying it’s not surprising after all.

Chemo is Coming

Tomorrow is Chemo Day again. John will spend four hours at the oncology center then wear the infusion pump for the next 48 hours. I am nervous each time. What will the blood work say? He has been more tired and his mouth is sore more often now. The pain and tingling in his hands is more frequent so I think that means that the chemo is digging in. Does that mean it’s “working”? Killing cancer cells or just killing all of his fast reproducing cells?

I am recognizing my own unsettledness on this day before chemo. I have the logistics down: I pack the bag: we take books and magazines to read, I take extra magazines to leave at the chemo center (they have terrible magazines there—all about cancer) I also pack our I Pods and snacks for both of us, and take the Blue notebook for taking notes when we meet with the doctor. In this day before chemo I am also bracing myself. I lose him during these chemo weekends and the loss gets longer each time.

He’ll be distracted on Friday, and annoyed by the pump and side effects on Friday and Saturday. The tiredness will begin Saturday so he’ll take more naps and be more drowsy. It’s hard to feel connected in those days. I get needy and so I have learned to make plans for the weekend now.

Being at home watching him sleep on the couch or being aware that he has more pain makes me feel lonely and afraid. Each time I lose a bit more of him and each time I am reminded of how serious this is. I have to watch my own anger too. A couple of sessions ago I realized that in the pre-chemo days I get stirred up and angry. I’m mad at chemo and mad at cancer but it’s so easy to forget that cancer is the problem and instead think that John is being unkind or inattentive or to start to make a case that he is not committed to this relationship. My fears stir and I flail inside. My head starts to tell me that he doesn’t love me, that he will leave me. My heart knows that cancer and chemo are taking him away.