Patient receives uplifting news from oncologist
by Paula Levy
published: September 3, 2003
The first time we met Rosanne Himmelman on June 18, she was just beginning a regimen of chemotherapy to fight metastic colon cancer. Through periodic updates, Rosanne is sharing her experience. This is part three of her journey.
After only one round of chemotherapy, things are already starting to look up for Rosanne Himmelman.
The 36 year old was given only two weeks when she was diagnosed with metastic colon cancer nearly two years ago. This is the second time Rosanne has been on regular chemotherapy.
Each round of chemo consists of four IV treatments at South Shore Regional Hospital. After each series, Rosanne makes a trip to the Cancer Care Centre in Halifax to see oncologist Dr. Danny Rayson.
Barb Grant, an oncology nurse that works with Dr. Rayson, is the first to assess Rosanne. After checking Rosanne's weight and determining that she has only lost one pound, Ms Grant leads Rosanne to an examining room.
Ms Grant's job is to make note of symptoms that Rosanne is experiencing for Dr. Rayson.
Rosanne tells Ms Grant that although she had been experiencing some nausea, vomiting and tiredness the day of each chemo treatment, she felt it was more to do with the summer heat than chemotherapy. She said once a relative volunteered to rent her Broad Cove house to her for the summer, her symptoms began to disappear. Other symptoms that Rosanne experienced from the drugs included sores in the inside of her mouth, a minor rash on her chest, a little shedding of hair and tingling in her feet.
Since the side-effects from chemotherapy so far are manageable, there is no cause for concern.
"And, emotional. Are you doing okay?" asks Ms Grant.
"Yes. Well, you know me," laughs Rosanne. "I'm doing well and I'm grateful and thankful for that."
After Ms Grant leaves, Dr. Rayson comes in. The two discuss her symptoms from the chemo and the cancer in her body. Before Rosanne started chemotherapy, she was experiencing severe pain in her abdomen. Dr. Rayson says it was a result of the cancer in her liver becoming active.
"I'm managing the symptoms, like we did before," she tells Dr. Rayson, referring to the last time she was on chemotherapy nearly one year ago.
The biggest news for Rosanne is that the discomfort she felt in her abdomen before she began chemo is gone. She tells Dr. Rayson that four hours after the first chemo treatment, the pain in her liver disappeared.
||Rosanne talks with oncologist Dr. Danny Rayson after receiving news that after only one round of chemotherapy, her treatment seems to be working. Paula Levy photo
"The first indication of tumour response is the target symptom disappears," says Dr. Rayson, "which it has done."
Rosanne smiles, but she knew that anyway. Having already gone down this road and knowing her body, she is able to ascertain whether chemo is working.
Dr. Rayson says since Rosanne is tolerating the side-effects from the chemotherapy drugs, there is no reason to change Rosanne's current prescription of chemo drugs.
"There is no correlation between toxicity and benefit. A lot of people think that with chemotherapy you have to be suffering and miserable for it to be working," says Dr. Rayson. "You tolerate it well and we know that you responded in the past dramatically. We know it's still working so there's no sense pushing the program to toxicity. That counteracts what we're trying to do."
Dr. Rayson says the goal of chemo is to shrink the tumours as much as possible, eliminate any symptoms caused by cancer, ensure Rosanne is maintaining a good quality of life and prolong her quality and quantity of life for as long as possible.
After checking her liver from the outside of her abdomen, Dr. Rayson determined that since the pain has disappeared, Rosanne's chemo is indeed working. When he first met Rosanne, her liver occupied almost her entire abdomen.
"She's about the sickest I've ever treated," says Dr. Rayson. "As we went along and I saw how dramatically improved she was, how strong of a person she was and how well tolerated the chemo was, optimism started growing for all of us. At first all of us were scared because she was so sick," says Dr. Rayson.
Rosanne says even though a combination of things have contributed to her survival, Dr. Rayson plays a huge role. Before she met him, her hope was beginning to fade. But she says when Dr. Rayson put out his hand and said, "Hi, I'm Danny and I'm here to help you," her hope magnified.
Dr. Rayson says it's a team approach to Rosanne's care and her unwavering positive outlook that has played a huge role in her survival.
"We're a great team together but Rosanne has been pretty amazing throughout this whole thing," says Dr. Rayson. "Her attitude is crucial in terms of simply dealing with the hassles and toxicity of chemotherapy. Dealing with the challenges of colon cancer, and being able to live her life, has been really remarkable. Her attitude plays a huge role [in her survival], no doubt about it."
Rosanne's survival is testimony to her refusal to give up the fight against cancer. And, already it seems to be working.
"We suspect [the chemo is working] because her pain disappeared," says Dr. Rayson. However, the ultimate sign of the effectiveness of chemotherapy will be a CAT Scan. She will receive the results of that test on September 5.
Dr. Rayson says the scan will reveal just how effective the chemotherapy has been in reducing the tumours in her liver and eradicating the cancerous cells in her lungs.
Rosanne adds, "I would be surprised when I have my scan if we don't see a change in a positive way because I feel so good."
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