In an absurdly Pollyanna-esque way I’m considering myself lucky to have bone mets rather than distant spread to visceral organs (bar some small spots on my lungs; my liver and brain scans have been clear—so far so good). Compared with when I was treated first time around, therapeutic intervention (how they try to fix and/or halt things) has come a long way – mainly in the form of hormonal drugs and bisphosphonates.
But there’s a down side to everything: not to mention a yard and a half of side-effects. Whilst the bisphosphonates (which I’ve not started yet) are great news for my bones, there’s a rare side effect called bisphosphonate induced osteonecrosis of the jaw, or BONJ. Rare, I’m told, but to be avoided at all costs as not curable, hardly treatable and above all not nice. Rare if you take the drugs orally for osteoporosis (like my mother-in-law and possibly millions of women around the world). Much less rare if you’re going to take them intravenously every 3-4 weeks for advanced breast cancer. And much, much, much less rare if you have also happen to have advanced peridontal disease (commonly known as crap teeth & gums) – which, of course, yours truly has. Sometimes it’s not so hot to belong to a niche subset.
Hopefully BONJ can be avoided if you also avoid tooth extractions for the rest of your life (even if you stop the drugs they have a half life of some 10 years or so, helpfully hanging around in your bones – way above most advanced breast cancer life expectancies). So then I have to guess how long I’m going to live, how long I’m going to need my teeth for, and then have all remedial dental work for those next years done in advance of bisphosphonate treatment. Ah yes, the gambling aspect of cancer. Betting on a game where you’re not even sure what the sport is and who the players are, and where the odds are incalculable. If only the results were as clear as “if six cows could eat a bale of hay, how much could sixty eat?”
I recognise that my need for information, research and resultant calculations are vain attempts to create order and the illusion of control in an otherwise uncontrollable environment. But what the hell? It’s part of who I am.
I came into this latest relationship with breast cancer expecting to lose my left breast. Who would have known that five months on I would still be filling my bras but minus three of my much needed molars? Can you see what I mean in the gambling analogy about not even knowing what sport we’re playing? There was me thinking it was breast and cancer and lo and behold it’s all about bones and teeth.
Perhaps then not a case of eye for eye, tooth for tooth, but more a case of “if any mischief follow, then thou shalt give life for life, eye for eye, teeth for breast”.