Remember when Monty Hall used to ask contestants on “Let’s Make A Deal” “Will it be Door #1, #2, or #3?” Sitting at home in the living room, I remember yelling my (always correct) choice at the T.V. (not that the ridiculous people dressed up like hippos or aliens ever listened).
After meeting with John’s local oncologist today, it feels a little like a “Let’s Make a Deal” choice for us at present. We’ve reached the place in his cancer journey where the doctors aren’t telling him what to do, but giving him options and leaving the choices up to him.
Radiation is a certainty and will start early next week and last only about two weeks. Five mega doses that will hopefully shrink the now huge (and growing about 1 1/2 cm a week) tumor on his leg to a size that’s easier for John to live with. The other certainty is that it won’t cure his cancer. That’s where our choices come in.
Door #1 is to keep walking down the road we’re on and hope that the quality of life John has left, for as long as he has left, is as positive and healthy as possible. No one is willing to speculate on (and no one really knows) how long that road might be. The CT scan he had on Tuesday is actually more promising than we thought it would be, and while there is definitely progression and growth in the existing areas they’ve been following since last May, there were no new areas and no mets in his bones or other major organs. That was truly a relief for both of us.
What’s behind door #2 is the anti PD-1 drug Keytruda. It’s the miracle drug that has the potential to cure his cancer if it doesn’t completely annihilate his pancreas and colon first. Worst case scenario, according to his doctor today, his pancreas completely dissolves (and he won’t survive that). Best case scenario, we wipe out the cancer and he has several more years (if not a whole lifetime). But (and this is a big but), his quality of life while he’s on that drug could be really, really bad because we have no doubt that he will have issues with his pancreas, which is already unhappy, and in order to stay on the drug he won’t be able to increase the Prednisone to heal it. His specialist at Seattle Cancer Care Alliance has advised against door #2. His local oncologist (who, by his own admission is NOT a Melanoma specialist) clearly thinks he should go for it based on the three patients who are currently experiencing “miraculous” results.
Monty, Monty, Monty…Which door do we choose?
We have a couple of weeks to figure that out. It feels like an overwhelming choice for me. I’m a planner and I like order. I like to know what’s happening, when it’s happening, and what I need to do to show up prepared. While I’ve gotten better at rolling with the cancer punches we’ve been through over the past 18 months, it’s still not something that comes at all naturally for me. And up until now, at least we’ve had an idea about what comes next. Someone was telling us which door to choose. Now it’s up to us.
We’ll talk it through together, but in the end, it’s John’s decision. It’s his life. Whatever he decides, I’m on board.
Plus, there’s always door #3. Behind that door? A miracle. I choose that one. Yes. Definitely door #3.