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Wednesday, March 08, 2017

Battle Fatigue in the War on Cancer

It's been almost two years since I first received the diagnosis that I had rectal cancer and that it had metastasized to my liver, making it the dreaded stage four. Once upon a time, a stage  four diagnosis of rectal cancer was an imminent death sentence but new  advances in treatment have changed that. Although the long term survival statistics are still not all that good, there are  many people who have survived longer than five years and who enjoy an active lifestyle. Although my cancer is not considered "curable" we plan to "manage" it as though it's a chronic  disease, fight it and keep it too weak  to fight back and spread its tentacles into other organs.

So my body has become a war zone in the war against cancer. I am the head of  my own little kingdom that has been invaded by a formidable enemy and have had to call in some troops from outside to help wage this war. The surgeons,  radiologists, oncologist, and I discuss and plan the strategies; the nurses, medical techs, phlebotomists, pharmacists and  others behind the scenes prepare and administer the weapons.

There have been advances, retreats, skirmishes and all out battles as different chemo combinations have been tried out. I received a surgically implanted port that could be used to infuse the drugs and also the contrast dye for CT scans. I  received eight  chemo treatments using a combination of FOLFOX and Avastin.  Although these drugs  can cause some nasty side effects, I was very fortunate to have escaped the worst of them and  they did seem to  work on shrinking the tumors.  Next I went to 28 radiation treatments while simultaneously hooked up  to a 5-FU chemo pump that delivered chemo 24 hours a day 5 days a week. That shrank the rectal tumor but the liver tumor was growing, and was joined by several tiny spots that were too small to diagnose as  cancerous. Emphasis  shifted to the liver and another chemo combination was tried with limited success. Finally, we began using a targeted therapy of Irinotecan (Camptosar) and Cetuximab (Erbitux) that has been shown to be effective in stage four  colorectal cancer.  Finally,the  liver tumor was small enough to be treated with radio frequency ablation.  The liver surgeon performed the ablation in August.  I came away  from the procedure with  five little incisions and was told he had gone in eight times and had also burned out the small lesions, just to be on the safe side. The procedure left me quite sore; it took a couple of days at home before I was able to stand completely upright!

Meanwhile, a fibrin sheaf had formed around the port's catheter and it had to be removed.  The new port was  implanted  on Tuesday, two days before Thanksgiving, by a vascular surgeon, who ran the catheter from the port, over my collarbone and directly into my jugular vein. In the process, my lung got nicked resulting in a pneumothorax, or  partially collapsed lung, so a chest tube was inserted and I was admitted to the hospital and told I would probably be there a few days. Determined not to spend Thanksgiving in the hospital, I worked like crazy with my yoga breathing exercises to try to  assist the chest tube in re-inflating  my lung.  It all seemed to work, the tube was removed the next day and I was discharged on Wednesday night at 7PM so we were able to spend Thanksgiving day   with our son, daughter-in-law and granddaughter at their house as  planned.

Since then,  I've been back on the cycle of receiving an infusion of the Erbitux and  Camptosar every other Wednesday.  Before those drugs are infused I receive several other drugs, including steroids, antihistamines, anti diarrhea drugs  and a couple more to  prevent  side-effects. Today was one of those Wednesdays and I received the 18th  treatment with this  combination. After three or four hours in the infusion chair, I definitely feel the battle fatigue almost as soon as the nurses unhook me and tell me I'm good to go. My speech is slurred, I'm wobbly on my feet. I hit the bed as soon as we get home and sleep off and on all afternoon, waking up to eat a little, drink fluids and suck on ice chips to prevent dehydration. Other than that, I'm pretty much useless all day and poor Mr. G  acts as my minion. 😄 I hope these drugs are continuing to work.  We'll know more after next Wednesday, when a CT scan  is scheduled. Whatever shows up on the scan will determine  whether to continue the current regimen or to develop a new strategy. Cancer is wily and relentless, and may win in the end, but we've kept  the enemy at bay for nearly two years and I have no intention of going down without a fight, battle weariness notwithstanding!

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