Ring the Bell

OK. I’ll be brief (famous last words). Today was the day of my 6th course of Chemotherapy.  Starting Wednesday, this week will suck like the 5 previous Chemo weeks ones. This completed the Chemo phase of addressing my lung cancer. As my last note indicated, the lung tumor has responded well, but we found a new trouble spot on my tailbone.  After much deliberation between doctors (and me, of course) we have decided to put off radiation until my next PET/CT scan in late January, early February.  If the bone shows no improvement we can radiate then with very little lost.

If a real pain in the ass develops before then (and I know plenty of them) I can start radiating sooner.  I’m looking forward to having the holiday season to celebrate with family and friends and focus on them instead of treatment.  The consensus is that there is little downside risk in waiting till February vs. mid-December.

I’ll still need to go every 3 weeks for Avastin (tumor preventer) and Zometa (bone helper) but it will only be for 1 ½ hours as opposed to 7 now. The key is to keep the lung tumor at bay and watch it closely.  Can do, will do.

Thanks to an idea from my new friend JJ (not Mr.Tibbs), Justin Johnson, I built a bell on a mount and donated it to my Oncology Lab.  I’ve attached a picture.  It is intended for people to ring on their last day of a Chemo regimen. Today was my day, so I rang the bell. It felt great. Hugs all around. The label says “Ring the Bell and Celebrate Together, What You Hope to be Your Last Chemo Ever”. Catchy, huh?

So it’s another week of crappy health, then hopefully an upward swing that takes me out of this forgetful year and into a new decade of good health, happiness and a re-opened Intermediate school (couldn’t resist).

As always, I thank every one of you for your prayers, support, food, kind words, empathy, funny e-mails, news and web articles, books, kid rides, etc. This ride is much easier with all of you.

I’ll check back again soon

Bone Scan Update

So the Bone Scan results are in and they confirm the findings in the PET/CT Scan. There is definitely observed bone activity and uptake (disease) activity in the same area at the very end of the tailbone.  The doctors consulted each other and presented my case to a panel of Oncologists, who all feel the same way. That is the area should be treated with radiation and likely represents a new metastatic tumor too small to show on the CT/MRI scans (<5mm). 

Considering the size of the area, where I am in the Chemo regimen (5 out of 6) and the fact Meri and I are going on vacation in mid December, the consensus is that I finish out Chemo on 11/29, get set for radiation prior to leaving on vacation, then begin radiating when we return.

The explanation for how this emerged during Chemo is that my Chemo meds are not particularly good at penetrating bone.  The saving grace is that had I never known about the cancer this area may have grown similar to the way the hip did.  It is quite likely that this area has been brewing for some time, as may be the case for other future appearances.  The doctors feel confident that we have hit this so early in the growth cycle that it is OK to wait a month, and then hit it with 15-20 doses of radiation. Getting that treatment AFTER Chemo will mitigate the risk of lowering White Blood Cell Counts, thereby threatening future Chemo treatments.  There is a chance it can aggravate my bladder or trigger a Crohn's flare-up, but that is the risk I must take.

To me, the key is to keep the lung quiet and to attack any metastases in a timely manner. So last week's test results were as good as I could have hoped, with this one wrinkle.  As a guy who plays the stats, I'm glad to have hit good numbers. 85% of lung cancers are non-small cell versions. Check.  60% of those respond favorably to Chemo. Check. Radiation treats spread to bones. Check.  I'll take any victory I can get.

So I get to look forward to a good holiday season. Thanksgiving with the big family.  Last round of Chemo.  Vacation in the Dominican Republic.  X-mas and New Years with friends and family. Just a little radiation sprinkled in for good measure to keep me honest.

I'll take it.

Trick of the Tail

It’s been a few weeks since I’ve written, and I’m lucid enough after the 5th course of Chemo to provide you all with an update.  I moved this treatment up to last Friday so I can feel good on my birthday this Saturday and to celebrate Tim and Marian’s wedding Sunday.  It was worth it. I couldn’t make it for the whole Giants game at Tex’s house Sunday, but with a half like that, there was no need to see the 2nd half.  I’m starting to believe the Giants are for real again. Enough about them.  Back to me.

I’m now 5/6 through my Chemo regimen with the final course happening the week after Thanksgiving.  My body is surviving (barely), and I’m grateful for that. I need White Blood Cell Booster shots to keep my counts up, but they are working.  Looks like I will limp to the Chemo finish line.

I had my first PET/CT scan since being diagnosed in July, and the results were mostly good.  The surgically repaired hip looks good.  The lung tumor is smaller (20% of original volume, and 60% of original diameter), and more importantly shows no uptake of sugar.  This is the key measure of activity of malignant tumors.

Too bad that was not the whole story. There is a small area of uptake activity at the end of my tailbone. This creates some confusion amongst the doctors as there is no clear evidence of a tumor (from the CT scan) and the other tumor(s) responded favorably to the Chemo. Hence the trick of the tail (for all you Genesis fans).

After further review, my team of oncologists has decided to do some more testing to see just what that little pain in the ass is.  Today I had a Bone Scan, and plan to review it with the doctors tomorrow.  First glance at the CD says I’ve got more work to do, as there is definitely something there.  It looks like the treatment options are to radiate it and/or remove it.  Last I checked, our tails were not all that useful.  We’ll see what they say.

Anyway, as we head into the holiday season, I can say I am satisfied with the progress I am making and am thankful for my doctors, my family and my friends, all of whom have helped me stay confident throughout this ordeal.  I know it is the early innings of a long game, but I’m glad to have put a few runs on the board in the first inning to give my team a lead to work with.

Go Giants.