Of all the possible side effects from chemotherapy, the one I wound up with following my first treatment was bone pain. The pain is caused by one of the chemical agents in the chemo, Taxotere, and an injection of a drug called Neupogen. The Neupogen shot boosts the white blood cell count so the patient is able to fight off infection. Interestingly, Neupogen is made using the bacteria E coli. I’d received two of the three scheduled injections following chemotherapy when I told my oncologist that the bone pain was debilitating. Thankfully, he cancelled the third shot before I received it last night.

Funnily enough, it was a story about cancer of the bone, told me by one of my sisters-in-law, that reinforced the wisdom of taking chemotherapy. A woman in my sister-in-law’s circle had not had chemo following her bout with breast cancer. The cancer returned to her bones. I know how painful that would be.

When the surgeon reports she got all of the tumor out, the lymph nodes are clear, and tests show no metastases elsewhere in the body, that does not mean the cancer is gone. When I met last week with Dr. Frank Stockdale, co-founder of Stanford University’s Combined Modalities Breast Cancer Program, he noted that the average woman with stage one breast cancer has a twenty-five percent chance of it recurring anywhere in the body. A woman with a high grade tumor such as mine (grade three), has a one-in-three chance of having it return within a ten-year period. That makes the case for chemotherapy. Period.

Dr. Stockdale noted that in Europe, surgery, radiation, and hormone treatment only would be given for a stage one tumor less than two centimeters in size. I asked what sort of results Europeans are getting with this. “They’re willing to accept a fifty percent reduction in risk of recurrence,” he said, “where in the U.S. we’re getting a seventy percent reduction in risk. So they’re willing to accept that. There are lots of reasons. Some are economic and some are philosophical.”

I asked Dr. Stockdale about long-term damage to the body from chemotherapy. “You have to realize,” he said, “you only get four treatments. Most of the toxicity that is long-term is in the cumulative phenomena. It’s total dose related. The cumulative doses for the treatment your doctor has recommended for you are tiny.”

Only four treatments. I wish they were already behind me.