Day Five: Decision

Friday, November 25

9:00 am

When Gilvania doesn’t arrive for work at 8:30, I wonder if she’s taken her first sick day since she began working with us a year and a half ago. When we call she is quiet and evasive. We ask her to come back to work only when she’s ready.

I get online and get to work. My first search is “anal cancer, prognosis.”

The most concise article is from the UK, and a quick scan provides the following:

• Anal cancer is an uncommon malignancy, accounting for only about 4% of all cancers of the lower alimentary tract.
• 80% of anal cancers are squamous cell carcinomas. (Check.)
• Radiation therapy alone may lead to a five-year survival rate in excess of 70%, although high doses may be required and cause necrosis or fibrosis.

Wait, what? Five year survival rate? That’s it?

I keep reading.

Under prognosis, I find the following:

• Anal cancer is usually curable. The three major prognostic factors are site (anal margin tumours are better differentiated and have a better prognosis than anal canal tumours), size (primary tumours less than 2 cm in size have better prognoses), and lymph node status.
• Radiation therapy, given as external-beam or brachytherapy, has a cure rate of 70-90% in selected patients. The cure rate is about 50% for those with tumours larger than 5 cm or if lymph nodes are involved.
• The reported five-year survival rate following surgery is 40-70%.

My heart sinks. Helena has an undifferentiated tumor and it’s larger than 5 cm. We won’t know about the lymph nodes until we get the results of next week’s MRI.

And what’s with this five year survival rate statistic?

What happens after five years?

Helena calls me from the dining room where she’s been doing her own research. She’s come across a support site for women with anal cancer. Of the members of the group who have had surgery, chemo and radiation, 100% of them will be using colostomy bags for the rest of their lives. They describe, in graphic detail, the effects of the radiation. One woman described that the walls of her vaginal and anal canals are now “fused,” and she is in constant pain.

Helena points to the screen and says, “Are you looking at this?”

I nod. “So basically you end up with a cu-ceta.” (In Portuguese, “cu” is slang for ass, and “buceta” is slang for vagina. I combined them to create one word.)

We laugh at my pun, but it’s not funny.

3:00 pm

We continue our research well into the afternoon until I finally call it off. Enough’s enough.

We make a late lunch but neither of us can eat, so we go to bed.

Helena cries, asking me, “What are we going to do?”

“I don’t know yet,” I respond. “We just need to keep asking for answers.”

When we wake, it’s dark outside. For about five hours we sit on the couch, alternating between crying and silence. This makes no sense. We always said that if either of us got sick, we’d never use traditional medicine…too barbaric, too medieval. We’ve always believed that if you give it what it needs, the body can heal itself.

But sometimes fear is stronger than reason.

“Maybe we should just do it,” Helena says. “Let’s just do the radiation and see if it works.”

We cry and cry, and cry some more, and then I agree. Yes. This is what we need to do. We will be aggressive about this.

9:00 pm

We make a big dinner, which neither of us eats, and then Helena goes to the bookshelf and pulls out a video that my father brought with him from the US when he visited 2 months ago: Healing Cancer From the Inside Out. When they visited we were in the middle of a series of back-to-back retreats, so we put it on the shelf and didn’t think of it again.

Within the first 10 minutes, we are looking at each other in disbelief:

It’s midnight when the film finishes, and we’re full of more energy than we’ve had in five days.

“This is what I’m doing,” she says. “There’s no question.”

I hold her hands and look into her eyes. She’s practically dancing with excitement.

“I believe this can work,” I tell her. “I know we can do this.”

“We WILL do this,” she corrects me. “I’m going to cure this!”

For the first time in five days, I feel hope.

Want more?

Listen to this interview with Mike Anderson, the director of Healing Cancer from the Inside Out. In it, he very clearly explains what the “five year survival rate” statistic means:

Related articles

• Day 1: Diagnosis (liveyourbliss.wordpress.com)
• Chemo Kills, Cancer Doesn’t! (mschaeferdc.wordpress.com)
• Helena’s Healing Circle (helenashealingcircle.wordpress.com)

Day 4: Third Opinion

Thursday, November 24

Hora de Madrugada

We barely sleep, taking turns listening to the sound of each other breathing. Although we’re back in the bed where we spent the first 3 months of our life in Brazil, the nighttime sounds of Copacabana are unsettling. I pray in 30 second bursts throughout the night.

7:00 am

I walk to a corner market to buy the massive amounts of Gatorade that Helena’s required to drink before the colonoscopy. We called the office and asked whether she could drink agua de coco instead (coconut water is also packed full of electrolytes), but they insist. Again, I ask myself: “Why are we doing this?”

It’s more information, that’s all.

2:00 pm

We arrive early for the appointment. The nurse tells me that the entire procedure will take about an hour and a half. I kiss Helena and hold her arms before she goes in, wishing her sweet dreams.

I sit down to wait. I ask for guidance for the doctor, calm for Helena, and I pray for the other anxious families, wishing them peace with whatever the results may be.

I look at my watch and only 3 minutes have passed. I jiggle my foot for another minute, then tell the receptionist that I’ll be back.

When I emerge from the cool building I am momentarily stunned by blinding sunlight. I feel the tears well, put on my sunglasses, and continue walking. A corner stand is selling the bitter Italian lemon ice that I loved as a kid, and I give in to the momentary comfort of the familiar flavor. There’s a large park across the street and I walk to the very center, where I sit at the base of a large statue to rest and wait.

That’s when I remember that it’s Thanksgiving Day in the US, and I’ve forgotten to call my parents. The tears come, and I struggle for about 20 seconds before pushing them back. If I let it all go, I’m afraid I won’t stop.

I pray and pray and pray, knowing that I will not make bargains with God. We chose this path— long before we ever met. One day we’ll understand.

I remove my glasses and squint up at the sun, waiting. There will be no answers today.

When I return to the office an hour later, they tell me that Helena is ready. They lead me to a recovery room where I find her looking remarkably radiant. “I finally got some rest!” she laughs. We wait and talk, and then the doctor calls us into his office to review the results.

I can see from his face that the results aren’t good. He is serious but kind as he tells us that the tumor is very large, and most certainly inoperable. I hold Helena’s hand and ask him if it’s spread. He shows us the photos and says, no, he doesn’t think that it’s spread to the intestines.

“So this is good news,” I comment, looking him directly in the eye.

“Yes,” he says, looking down. “It’s very treatable by radiotherapy if it’s contained to the site of the tumor.”

I squeeze Helena’s hand, and in her eyes, I see fear.

“It’s treatable,” I remind her. “This is good news.”

We ask a few more questions, but I can feel that there’s something the doctor isn’t saying.

6:00 pm

We make our way back up the mountain.

Related articles

• Day 1: Diagnosis (liveyourbliss.wordpress.com)