I called yesterday and left a message with the thoracic surgeon asking for him to contact me to answer a few questions. I spoke with him today and asked him about his interpretation of the PET scan results. Like my medical oncologist, he also mentioned that the tumor was located in the bronchial tube at a place in the lung that is integral to providing air to the entire lung itself. This is not good. I asked him his thoughts about a surgical intervention and he stated that normally they would not do surgery on metastatic colorectal cancer in this situation, but that I was not a normal case (age and health status) and that it would be considered as an option. The bad part is that he stated that I would be facing the reality of losing at least half of my left lung with the potential of them taking the entire lung. Yes, you can live with only one lung and some live with parts of one lung, but I would have severe pulmonary functioning difficulties. For the time being I will continue with the chemo followed by another PET scan and bronchoscopy.
It really sucks to think about for a few reasons. If they normally do not do surgery on metastatic disease like this then that clouds my decision making process. For if a surgical intervention will only postpone further metastasis then do I want to choose another invasive procedure as a route of treatment? There will be no evidence available to inform me about whether I will prolong my life by any substantial amount versus not intervening at all. More than likely (although not gauranteed) the tumor will respond to treatment and potentially decrease in size. This will have me leaning towards surgical intervention. Again, however, if metastasis is to follow then is the pain and recooperation from surgery coupled with decreased pulmonary functioning advantageous to no surgical intervention at all. I will have to postpone chemotherapy to undergo a surgical intervention only to resume it after the fact. Not choosing surgery and continuing with chemotherapy may afford me the same amount of time that a surgical intervention presents. Fuck cancer!!!!
Josh
Thursday, April 16, 2009
Wednesday, April 15, 2009
Break-Down
I met with my medical oncologist about 2 hours ago. The PET scan results indicate that the most active area was in the left lung. Blood tests results indicate that organ functions are normal, as well as, normal red and white blood cell counts. There were two other spots on the scan that "lit-up," one under the right arm pit and the other in my sinuses. Although these "lit-up" there was do definitive evidence that they are malignant. That does not mean that they are not, but the doctor cited other reasons why there may be up-taking glucose cells involved other than cancer. The final conclusion will be whether or not the spots respond once therapy has been initiated.
That brings me to treatment. I will start chemotherapy on the 27th. I will be taking two drugs this go around. The good news is that neither one of them will be Oxylaplatin. Although I will not avoid getting sick or feeling cruddy, hopefully I will not "spew from all ends" or experience muscle cramps and spasms. I will be on one drug that I previously took which is 5-FU, or Flouracacil. Last time I had this medication in pill form, Xeloda; but this time I will receive it intravenously. This medication will have me on a take-home pump which will entail me also getting a port. The port will make my life easier for receiving medication and also for them drawing blood. The other medication that I will take will be Avastin, which assists by retarding the growth of blood vessels to the tumor.
The surgical and radiation option are still in the balance. My medical oncologist will discuss this with the other doctors and we will proceed from there. One issue noted in the PET scan was that the tumor is located in the bronchial tube rather than on the lung tissue itself. Although he is not a surgeon, the doctor noted that this can present difficulty for surgical intervention. Hopefully I will know more about these options in the near future.
I guess with all said, this is better news than it could have been. There are still unanswered questions and there is the hope of treatment. There is no cure for cancer, only treatment; and until a cure is invented I will stick with treatment. I don't want it, but I can do it. I am only looking at 3 rounds of chemo at first and then we will go from there following another PET scan.
Keep the thoughts and prayers coming. I will need strength to get through the chemo.
Josh
That brings me to treatment. I will start chemotherapy on the 27th. I will be taking two drugs this go around. The good news is that neither one of them will be Oxylaplatin. Although I will not avoid getting sick or feeling cruddy, hopefully I will not "spew from all ends" or experience muscle cramps and spasms. I will be on one drug that I previously took which is 5-FU, or Flouracacil. Last time I had this medication in pill form, Xeloda; but this time I will receive it intravenously. This medication will have me on a take-home pump which will entail me also getting a port. The port will make my life easier for receiving medication and also for them drawing blood. The other medication that I will take will be Avastin, which assists by retarding the growth of blood vessels to the tumor.
The surgical and radiation option are still in the balance. My medical oncologist will discuss this with the other doctors and we will proceed from there. One issue noted in the PET scan was that the tumor is located in the bronchial tube rather than on the lung tissue itself. Although he is not a surgeon, the doctor noted that this can present difficulty for surgical intervention. Hopefully I will know more about these options in the near future.
I guess with all said, this is better news than it could have been. There are still unanswered questions and there is the hope of treatment. There is no cure for cancer, only treatment; and until a cure is invented I will stick with treatment. I don't want it, but I can do it. I am only looking at 3 rounds of chemo at first and then we will go from there following another PET scan.
Keep the thoughts and prayers coming. I will need strength to get through the chemo.
Josh
No Word
Thought I would post and mention that I have not heard anything about my PET scan results. With that said, I will probably find out today at my 11:00 doctor's appointment. Surprisingly, I was able to get some good sleep last night.
In another note, I read a book The Anatomy Of Hope by Jerome Groopman. The author is a hemotologist/oncologist and he writes about the idea of hope and partly about its biological foundations. I have spent many years facing hopelessness with others as a social worker. I have been mentored by researchers, whom a large portion of their academic work is devoted to the origins of hopelessness. I finally asked one day how someone could devote such a large cognitive portion of their time on earth to such a difficult area. The response was that understanding hopelessness gives us a corresponding understanding of its obverse, hope. Anyway, the book came recommended by a friend who is also a colon cancer survivor. The book was able to put some things in perspective for me. Mostly, however, it has provided me solace against the feelings by some people that I have been pessimistic, cynical, or negative about my cancer experience. In a few instances I have become angry, but I usually allude to the fact that most people, despite their good intentions, have an incomplete understanding of what it means to face a terminal illness head-on. Anyway, I wanted to share an excerpt from the book:
Many of us confuse hope with optimism, a prevailing attitude that "things turn out for the best." But hope differs from optimism. Hope does not arise from being told to "think positively," or from hearing an overly rosy forecast. Hope, unlike optimism, is rooted in unalloyed reality....Hope is the elevating feeling we experience when we see - in the mind's eye - a path to a better future. Hope acknowledges the significant obstacles and deep pitfalls along that path. True hope has no room for delusion.
If you have a chance, take time to get a copy of this book. It is a great journey into the biological realm of hope, rather than the psycho-social dimension.
Josh
In another note, I read a book The Anatomy Of Hope by Jerome Groopman. The author is a hemotologist/oncologist and he writes about the idea of hope and partly about its biological foundations. I have spent many years facing hopelessness with others as a social worker. I have been mentored by researchers, whom a large portion of their academic work is devoted to the origins of hopelessness. I finally asked one day how someone could devote such a large cognitive portion of their time on earth to such a difficult area. The response was that understanding hopelessness gives us a corresponding understanding of its obverse, hope. Anyway, the book came recommended by a friend who is also a colon cancer survivor. The book was able to put some things in perspective for me. Mostly, however, it has provided me solace against the feelings by some people that I have been pessimistic, cynical, or negative about my cancer experience. In a few instances I have become angry, but I usually allude to the fact that most people, despite their good intentions, have an incomplete understanding of what it means to face a terminal illness head-on. Anyway, I wanted to share an excerpt from the book:
Many of us confuse hope with optimism, a prevailing attitude that "things turn out for the best." But hope differs from optimism. Hope does not arise from being told to "think positively," or from hearing an overly rosy forecast. Hope, unlike optimism, is rooted in unalloyed reality....Hope is the elevating feeling we experience when we see - in the mind's eye - a path to a better future. Hope acknowledges the significant obstacles and deep pitfalls along that path. True hope has no room for delusion.
If you have a chance, take time to get a copy of this book. It is a great journey into the biological realm of hope, rather than the psycho-social dimension.
Josh
Tuesday, April 14, 2009
Nervous Waiting
I completed the PET scan this morning. It was not bad at all. They injected me with a radioactive glucose based dye which bonds itself to cancer throughout your body which then turns up on the scan. Once they injected me with the dye I had to sit quiet in a recliner for about 45 minutes. Then I proceeded to the PET scan machine. I placed my arms above my head and waited about 30 minutes while the machine did its thing. The only bad part was that my arms got really tired being held above my head. After about 15 minutes they came in and placed my arms across my chest which was a huge relief. Honestly, sitting still allowed me to really concentrate on my breathing and practice some meditation and prayer. I felt extremely at peace once the scan was complete...although really hungry since I had not eaten any breakfast.
One moment of humor came to me in between prayers when I was just thinking about things. I had to fight off laughter and bite my lip and tongue (you have to be real still) because I could not get a recent picture out of my head of one of my friend's children crying at the Easter Bunny. For a moment I really thought I was going to lose it and blow that portion of the scan.
Anyway, now I am waiting nervously for results. I arranged to have one of my doctors take a look to see if results were posted this afternoon. The radiologist folks are given 24 hours to post results, but sometimes they are up sooner. Most likely I will know something this afternoon, but it is not promised. I requested this so I could know what we are looking at before meeting my medical oncologist. I know that if I were to receive the results from him then I would potentially be floored and sit in shock while not remembering what my questions are and what we need to talk about. I will post more information as it develops.
Josh
One moment of humor came to me in between prayers when I was just thinking about things. I had to fight off laughter and bite my lip and tongue (you have to be real still) because I could not get a recent picture out of my head of one of my friend's children crying at the Easter Bunny. For a moment I really thought I was going to lose it and blow that portion of the scan.
Anyway, now I am waiting nervously for results. I arranged to have one of my doctors take a look to see if results were posted this afternoon. The radiologist folks are given 24 hours to post results, but sometimes they are up sooner. Most likely I will know something this afternoon, but it is not promised. I requested this so I could know what we are looking at before meeting my medical oncologist. I know that if I were to receive the results from him then I would potentially be floored and sit in shock while not remembering what my questions are and what we need to talk about. I will post more information as it develops.
Josh
Monday, April 13, 2009
Pulmonary Funtioning....Check
I had a visit with another new doctor this morning. I had to complete a pulmonary function test. I basically had to breath into a tube and complete many different types of breathing exercises. For an asthmatic, I passed with flying colors!!! I was in normal range for every test which was some good news in this sea of dread here lately. I was able to talk with him about how the lung handles surgery. He stated that the lung actully does really well in regards to being cut. He mentioned that the lung has overcapacity for oxygen absorbtion. Of course it is never good to cut a piece off, but it is not the end of the world. As far as pulmonary functioning, I would potentially complete another test post-surgery to have an idea of how surgery (if I have it) has affected lung function.
I am slowly getting myself psyched-up for chemo (Game On!). I am hoping with all my might that this tumor is all alone. If it is, then I am going to kick its ass with some poison! I am really scared, but I know that I have the faith and strength to accomplish it again. It is not impossible. Yes, it is hell on earth; but not impossible. I have been trying to fatten myself up a little lately thinking that I may need some extra pounds prior to getting started with the medicine.
I reflected upon suffering yesterday and was reminded that someone suffered for me. That was all I needed to know for the belief that I can make it if I get a chance. Believe me, I am realistic that there are other dreaded possibilities here; however, its my turn to throw a few punches again!
Josh
I am slowly getting myself psyched-up for chemo (Game On!). I am hoping with all my might that this tumor is all alone. If it is, then I am going to kick its ass with some poison! I am really scared, but I know that I have the faith and strength to accomplish it again. It is not impossible. Yes, it is hell on earth; but not impossible. I have been trying to fatten myself up a little lately thinking that I may need some extra pounds prior to getting started with the medicine.
I reflected upon suffering yesterday and was reminded that someone suffered for me. That was all I needed to know for the belief that I can make it if I get a chance. Believe me, I am realistic that there are other dreaded possibilities here; however, its my turn to throw a few punches again!
Josh
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