What Are The Odds

Sometimes you don't get the hand you want, but you have to play the hand you're dealt. My recurrence score on the Oncotype Dx is a whopping 41.

For those readers who are just getting up to speed, the Oncotype Dx is a new breast cancer test in which scientists can examine a patient's tissue and numerically rate her 10-year risk of cancer recurrence or metastasis. The range is from zero to 100, with a low score meaning a lower chance of recurrence. However, a recurrence score of more than 50 is so rare that the scientists actually stop counting after 50.

My 41 definitely puts me in the high-risk group, which means that chemo will be beneficial. By undergoing a chemo regime, I gain almost 14 percentage points on the 10-year scale, which is a sizable number. Here's how it works: After chemo, there is a better than 80% chance that the cancer will not recur in 10 years. However, you also have to consider that there is a 4% chance that something else will happen, the proverbial getting struck by lighting. So at some point, the numbers become meaningless, and you just do what the doctors tell you.

I start the first cycle on Wednesday, which will be followed by three more cycles given at three week intervals. The side effects are all that you imagine -- bad, bad and bad. There is one upside to being in the high-risk group. The patients with the most aggressive cancers get the most benefit from the treatments. In some cases, the cancer doesn't look particularly threatening, but is actually quite sneaky and subtle. This is akin to the passive-aggressive kid who appears nice but steals your cookies from your lunchbag. The low-key cancers don't always respond to chemo because they avoid detection and mask their threat. In my case, the cancer is bold and outgoing, more like the bully kid who wins by intimidation. However, because bully cancers readily show their true colors, they're more vulnerable to a chemo-laden assault.

So the next phase is about to begin. Time to call the hairdresser and get a new, short cut -- what my mother used to refer to as a pixie cut. Looking forward.