Thursday, September 6, 2012

Cancer on My Mind - September 6, 2012

Part 4 - Financial Costs... and other Things

I have amassed a short stack of medical statements in the last three months. They total $21, 290 to date. More are coming. This is twenty-one thousand dollars just to find out what’s wrong with me. I started treatment, the “cure”, on August 13th, but haven’t, as yet, received any of those statements. I expect the total cost to dramatically climb.

I’m one of the lucky ones in that I have grown old enough to have Medicare and the State of Alaska offers supplemental insurance, so my out-of-pocket costs each year is limited to $800. I have enough reserves that I could have paid the bills to date, but doubt that my resources run deep enough to cover that which is coming. Many in the country do not have that peace of mind. I don’t know exactly how many are without insurance, but they count in the millions, and showing up at Emergency will not get them the serous treatment they need for catastrophic illnesses. Most bankruptcies and financial ruin are a result of the enormous bills that pile up when an “unexpected” illness befalls a family that lacks adequate coverage. The financial burden and emotional anguish must be overwhelming.

And then there is the “cure”: Chemo, Radiation, and Surgery - two poisons and a dagger. Granted, the radiation machinery is impressively sophisticated, and the chemicals are refined and targeted. But the best modern medicine can presently deliver is, in a way, indistinguishable from the tools of a medieval alchemist. I have to get sick before I can get well. The radiation is to shrink the tumor - the chemo to kill any wandering cancer cells. I may be free of the cancer after that.


I feel fine now but it’s an irony that when the first two stages of therapy conclude in another month I may be weak, nauseas, bald (more so), somewhat emaciated, and need to recover before I can go under the knife. The surgeons will remove a good portion of my stomach and esophagus in hope of preventing the cancer from returning, but there are no guarantees.

I have a blood draw on Tuesday and am injected with two Chemo drugs on Wednesdays. I sit in a comfortable leather recliner for Chemo, in a room with eight other patients, all reclining in theirs – some reading or on their computers, some sleeping, and a few eating snacks.


The nurse puts a warm bean bag on my arm and then hunts for a large vein in which to insert the needle. The larger the vein the larger the needle can be, and the faster I get the dosage. I’m going to be there two and a half to three hours. A saline solution is first to flow, then a pain killer, and then the first drug, Paclitaxel (trade name: Taxol). Paclitaxel functions by causing abnormal microtubule formation in cells. That inhibits cellular replication and causes cell death.

When that bag empties it is replaced with one of Carboplatin. (trade name: Paraplatin). This one produces its anti-cancer effects by binding with DNA, damaging it, and killing the cell. I am told they kill healthy cells along with the cancerous, but fewer cancer cells survive each week. I completed the fourth of five treatments this week – one to go. So far, I cannot claim any ill effects from Chemo. I continue to have plenty of energy – cut the grass, cleaned the rain gutters (on an extension ladder), and varnished the front door recently. Mary has had to take over the dog and cat poop as the doctors say I need to avoid such things.

I go to radiation every weekday at 3:30pm, and am scheduled for 28 treatments. It’s in the same hospital complex as oncology so I have just a short walk.
 The spacious radiation facility congers images of a medical temple with a sacrificial alter centered in the middle of the room. It is the Siemens Oncor Impression Plus Linear accelerator, an external cone beam radiation device coupled with a CT scanner. I remove my clothes from the waist up and lay down bare chested, and am offered a warm towel which I always decline. They tattooed several reference points on my abdomen and sides (not really noticeable) which are used to ensure I’m properly aligned when I lay down on the alter, my head resting in a cup. X-rays are taken at the beginning of each week to ensure nothing has moved around. The machine then rotates around me, stopping to beam radation at my tumor from seven different angles. The procedure takes only about 15 minutes. I’ve had sixteen treatments so far – twelve to go. So far, so good - no ill effects that I can claim.
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