Yesterday, I saw my oncologist for one of my every-three-month follow-up visits. As always, I went armed with my list of questions -- which is really my list of worries -- and one by one, I rattled them off. On a little sticky note, I had written:

• Lymph node
  
• Digital mammogram
  
• Next MRI
  
• Heart
  
• Colonoscopy

And this is what my doctor had to say about my concerns of the day:

Patients with this disease have a decreased quality of life due to symptoms such as shortness of breath, cough, pain, fatigue, and the inability to eat. One of the scariest parts about this disease is that it can be resistant to most therapies, including surgery, chemotherapy and radiation.

A press release from Alfacell Corporation says that the addition of a drug called Onconase (ranpirnase) to Adriamycin improves survival over Adriamycin alone in patients that have operable mesothelioma. Onconase targets cancer cells while sparing healthy cells. It is taken into the cancerous cell where it kills the cell through various processes. Onconase is not yet proved by the FDA in the United States.

A clinical trial was conducted to evaluate the addition of Onconase to Adriamycin compared to Adriamycin alone. The trial included a total of 143 patients. At one year 47 percent of patients treated with Onconase/Adriamycin were alive compared to 36 percent of patients treated with Adriamycin alone.

The researchers feel that the drug improves outcomes when given with Adriamycin. This trial was a Phase IIIb trial which means it could be up for FDA approval in the near future.

The second article that I read was recently published in the Journal of Thoracic Oncology. According to the article treatment with Alimta (pemetrixed) with or without Platinol (cisplatin) provides benefit with malignant mesothelioma who have received prior treatment therapies.

This research was focused on recurrent mesothelioma. Optimal treatment strategies that will improve long-term outcomes for patients with recurrent mesothelioma continue to be evaluated. A Phase III trial was conducted to evaluate treatment including Alimta or Alimta/cisplatin. The trial included 187 patients.

Anticancer responses were achieved in 32.5 percent of patients treated with Alimta/cisplatin compared with 5.5 percent for patients treated with Alimta alone.

The researchers conclude that this is a challenging disease. I bring this information in hopes that anyone diagnosed with is disease can have some information to bring to their physicians to discuss further.

Myocet is in its last clinical trial phase prior to FDA review. The trial is enrolling patients to evaluate the investigative chemotherapy agent Myocet (liposomal encapsulated doxorubicin) in addition to standard therapy for HER2-positive breast cancer.

Myocet is a chemotherapy agent that contains the active form of doxorubicin, you might better know it as Adriamycin. This chemotherapy drug is formulated to reduce the side effects associated with Adriamycin. Myocet allows for more of the active drug to be delivered directly to cancer cells, sparing healthy cells from being damaged.

This trial will directly compare the standard option of Herceptin and Taxol to the combination of Myocet, Herceptin and Taxol. Researchers are now enrolling patients with metastatic, HER2-positive breast cancer with a goal in mind to determine if the addition of Myocet to standard therapy can increase response to therapy or regression of cancer.

My new breast cancer friend recently sat through her second infusion of Adriamycin and Cytoxan -- the long-time traditional chemotherapy combination for breast cancer -- and all the while, listened to another breast cancer survivor share her thoughts on these two drugs.

This woman told my friend she opted to stray from these chemotherapy agents because of their toxic side effects, because of their combined potential for causing other cancers, like leukemia. She instead took another drug route and was happy for her decision. My friend, however, was scared.

My friend returned home from her treatment and found herself reading a Cancer Blog post reporting that Adriamycin and Cytoxan may no longer be the gold standard treatment for breast cancer, that Taxotere and Cytoxan may become the preferred, safer option.

Fear and panic set in, and my friend e-mailed me, in search of perspective from a recipient of the drugs she was starting to believe are both ineffective and cancer-causing.

I am not a doctor. I am not an expert. I am not qualified in any way to represent the facts about medical research. But I am surviving breast cancer. And I did spend eight difficult weeks under the influence of Adriamycin and Cytoxan, given every two weeks in a dose-dense fashion. So I have an opinion about these drugs -- and about most things breast cancer related.

I shared my opinion with my friend, who has since decided to proceed with her prescribed treatment plan. I told her that in rare cases, chemotherapy can cause a second cancer, like leukemia. But this is not common, and the unlikely risk does not outweigh the benefit of receiving chemotherapy to address the cancer at hand.

I also shared with my friend that we can only benefit from therapies that are available and effective at the time of our treatment. Studies prove that Adriamycin and Cytoxan work -- that's why so many women are treated with this accepted method. Drugs in the research pipeline may one day definitively replace what is available today. But we must be OK with what we receive -- because we have no control over what lies ahead. We must live in the here and now -- with the knowledge that should our cancers return, bigger and better options may await us.

Consider Herceptin. Once not even an option for women with aggressive HER2 positive breast cancer, this targeted drug may be the magic bullet in an attack against this disease. I received Herceptin. My friend will receive Herceptin. Timing was on our side for this medical breakthrough.

Timing may not have been on our side should a new gold-standard drug treatment emerge and replace Adriamycin and Cytoxan. But we can still trust these two drugs will do their jobs, will prevent a recurrence of a disease that is so much more treatable today than it was years ago. Lucky for us.

The results of a Phase III clinical trial, published in the Journal of Clinical Oncology, concluded that Taxotere (docetaxel) plus Cytoxan (cyclophosphamide) resulted in better cancer free survival than the treatment combination of Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide).

Adriamycin and Cytoxan, referred to as the AC chemotherapy regime, has been the gold standard for adjuvant therapy for those patients diagnosed with early stage breast cancer. This study was conducted on more than 1000 women who had Stage I to Stage III disease. Half of the women were given the AC regime and the other half given the Taxotere/Cytoxan (TC) regime.

The results of the study showed that cancer free survival was 86 percent for those treated with TC an 80 percent among women treated with AC. Overall survival was 90 percent among women treated with TC and 87 percent among women treated with AC. Nausea and vomiting were more common among women treated with AC. Muscle and joint pain, edema, and low white blood cell counts accompanied by fever were more common among patients treated with TC.

Anthracyclines are a type of chemotherapy that treat several different types of cancer including (but not limited to) leukemia, lymphomas, breast, uterine, ovarian, and lung cancers. Anthracyclines are technically antibiotics, although their high toxicity precludes their use as such. A major side effect from this type of chemotherapy is that it can lead to heart problems in some patients. The risk for heart problems can remain elevated long after cancer treatment is finished.

Researchers are looking to find ways to lower the risk of patients developing heart problems after treatment without sacrificing the effectiveness of the drugs. They reviewed information from six previously published clinical trials and found that if the infusion of anthracyclines are given slower, over a period of six hour or longer, it appears to reduce the risk of heart problems.

Available anthracyclines include:

• Daunorubicin
• Doxorubicin
• Epirubicin
• Idarubicin
• Mitoxantrone

I have a new friend who is a new breast cancer survivor. She is surviving a new diagnosis, a recent lumpectomy, and the moments leading up to another surgery to further investigate the margins surrounding the tumor removed from her breast. She is surviving the first phase of her breast cancer journey. A phase full of uncertainty and fear and panic. A phase so new and so fresh and so raw, her mind is whirling. A phase that has her grasping for any bit of direction she can find as she navigates a terrifying, unfamiliar road.

My friend is a young wife and mother whose worries are consuming her. She e-mailed me today and asked if I ever have moments when I look at my young children and worry that cancer will take me from them while they are young. She asked if I have always been so sure I will be okay. And so I replied with this candid cancer confession.

Cynthia Yousefi is a wife and mother of three living in Granada Hills, CA. She is 42 years old and works as an analyst for a Federal agency. She and her family enjoy trips to Harrah's Rincon Casino in San Diego -- and while the destination is a favorite, the sights along the way also bring them pleasure. Cynthia enjoys museums and amusement parks and swimming and evening walks. She enjoys a lot these days because she feels she's been given a second chance at life -- now that she is surviving breast cancer.

Since 1988, Wendy Chioji has been a reporter and anchorwoman for WESH 2 News in Orlando, Florida. She has covered news ranging from the pope's visit to Cuba in 1998 to the Olympic Winter Games in Salt Lake City in 2002. She continuously covered last year's hurricanes, and she has an Emmy award under her belt for a special news report on heroin use.

Wendy is a top notch athlete. She has run five marathons and competed in several triathlons and half-ironman races. She has ridden in parts of several stages of the Tour de France, and traveled across the country with Lance Armstrong in 2003 -- covering 550 miles -- with the Tour of Hope event to raise awareness for cancer research. Wendy has also made a tour with stage II breast cancer. Since 2001, she has been surviving this disease.

Kim Taylor is a 45-year-old single mother who lives in Suwannee County, Florida and is proud to have successfully raised one daughter -- a graduate of the University of Florida. Kim enjoys outdoor activities like camping as well as sewing, crafting, and carpentry projects. She is most at peace spending time with her family, working as a youth volunteer -- and raising awareness for breast cancer. It's a interest she acquired just two years ago, compliments of a personal encounter with the disease that has taught her to let the little things go, to appreciate every sunrise, to make every moment matter.

The breast cancer chemotherapy drug Adriamycin is often called The Red Devil. It's red in color and devilish in it's attack on both cancer cells and healthy cells. After her own personal attack by this drug, Katherine Russell Rich wrote a book, and she called it The Red Devil: To Hell with Cancer -- and Back. It's her account of how she got sick at the age of 32 with a relentless form of breast cancer. Although she was given just a short period of time to survive, Rich conquered cancer. And years later, she is alive and well. And she has discovered -- by mere coincidence -- that her book years ago inspired a group of women in Baltimore who are helping breast cancer patients through kind deeds. They foot the bill for transportation costs, housecleaning, and massage. They pick up and deliver medications. They gather and hug and eat. They take strolls. They call themselves The Red Devils.

Rich only found out about The Red Devils support group when a friend noticed a mention of the group in a newspaper. She informed Rich who visited the group's website. What she found took her breath away.

It seems a woman named Lark Schulze had at one time been desperate to learn about young women with stage IV breast cancer -- the same stage her 30-year-old daughter faced -- and she could not find any helpful resources. Until she came across Rich's book and poured herself into one woman's story. Moved by Rich's words, she tried to locate her, with no luck. So she took what she gathered from the book and after losing her daughter 19 months after diagnosis, became a founding member of a powerful support group -- The Red Devils -- in late 2002.

Despite failed attempts at finding Rich, Schulze says Rich changed her life. And now that the women have connected, Rich says Schulze has changed her life. At first Rich was afraid to be drawn into Schulze's world. But with a hunger to understand breast cancer from a mother's perspective, Rich took the plunge. She talked to Schulze, visited her, strolled with her, and soon the hard lump she'd carried in her stomach for so long began to soften as she connected in a deep and bizarre way with a woman she had inspired -- a woman she had never before known.

I feel fortunate to have received every cancer drug I needed to fight my breast cancer -- Adriamycin, Cytoxan, Herceptin, and every nausea pill, pain capsule, and anti-anxiety formula on the market. I got exactly what doctors thought I needed -- without worry about availability or funding or politics. I am lucky. Some in the UK are not so lucky.

Two targeted therapies for bowel cancer will not be used in Britain's state-run health system, according to NICE -- the National Institute for Health and Clinical Excellence. NICE, the country's financial watchdog, determined the high cost of the medicines meant their use was not compatible with the best use of resources. Patients are angry because these same two drugs -- Avastin and Erbitux -- are used widely in the United States and in much of Europe. And while neither drug offers a cure for bowel cancer, both treatments have been shown in clinical trials to extend life expectancy by four or five months in some patients.

Based on doses given during the trials, it is estimated that the average cost of treating one patient with Avastin would be around 16,800 pounds and with Erbitux -- about 11,700 pounds. Apparently, this is too much. But according to Hilary Whittaker of the charity Beating Bowel Cancer, the decision to deprive patients of this medication is a scandal. I agree. And for these patients, I am sad.

Just before my chemotherapy for breast cancer started -- when I was fantastically frightened by the toxic drugs that were about to drip into my veins -- I was told by doctors, nurses, survivors, friends that I would be just fine. I was young and strong and tough. I would easily tolerate the beating my body was about to take. This is what I was told and actually came to believe myself. I had no other choice really than to approach chemotherapy with a fighter mentality. And so I did. And I did pretty well for my first three doses of Adriamycin and Cytoxan -- given every two weeks instead of three in a dose-dense fashion -- followed by one injection of Neulasta 24 hours later to maintain normal blood counts. And then something happened. And I did not end up tolerating the chemotherapy my gut told me was a scary endeavor.

In the past year, I have had three severe skin reactions characterized by red, itchy, burning bumps that start on my chest and without fail climb over my shoulders and onto my back. They last for a few weeks, are irritated by the Florida heat, and have had no known cause -- until today when I visited my dermatologist for a skin cancer screening and briefed her on this bizarre condition that has kept me away from sunscreen and out of the swimming pool and in hiding from the sun. I have suspected that sunscreen, chlorine, the sun -- or some combination of the three -- have been my potential irritants. So I've been avoiding them altogether. But I learned today that the sunscreen and the chlorine are not to blame. That leaves the sun, which is the most likely culprit -- and only because I have received chemotherapy with one very toxic drug. Adriamycin.

My dermatologist told me about a phenomenon called UV Recall that is associated with Adriamycin. Apparently the toxicity of this drug, even though administered long ago, can be recalled, causing a reaction when the UV rays of the sun soak into my skin. Sunscreen may help, my doctor told me, but she cautioned me that it is just a screen -- it does not offer full protection. And she said the best suncreen option would include zinc oxide. I think for me, though, staying out of the sun is my best bet. It's not ideal -- it means I will remain on the fringe of the swimming pool, hiding in the shade, while my boys swim their little hearts out. And tropical vacations will be off my wish list. And I will seek outdoor fun mostly after the sun goes down. But this is okay -- I knew there were long-term side effects of chemotherapy drugs. I am just thankful for now that my heart has not been compromised -- a side effect of both Adriamycin and the drug Herceptin that I have also received. And it's also not a bad thing that the steps I must now take to prevent skin reactions are also the steps that protect me from skin cancer. So in some sort of round-about way, my inconvenient skin issues may just help me stay healthy. And that's just fine with me.

Herceptin -- a targeted breast cancer drug used to treat women who are Her2 positive -- has received rave reviews and has shown great promise in cutting down on recurrence of this aggressive form of breast cancer. Given over the course of 52 weeks, Herceptin is wondrous for its lack of short-term side effects. There is no hair loss, no compromise of blood counts, no significant sickness. For me, fatigue may have resulted from this treatment -- but it's unclear to me really whether it was the Herceptin or the two small boys I have living in my house that most contributed to my occasional exhaustion. Regardless, I functioned well while receiving Herceptin for the past year -- and I did not suffer anything more than a twinge of pain when my port was accessed for each treatment. In the short term, I have fared well. In the long term, the jury is still out.