Good morning folks!
Almost as if by clockwork, another month has passed, and I've had another visit with kindly Dr. Ho, the oncologist. This time around we had lots of good news on most every front:
Earlier in the week, I went for a PET scan to determine how much progress we'd made in knocking back the cancer. I'm really pleased to report that the scan shows cancer only at the primary site at the esophagus/stomach juncture, and that tumor has gone from its original intensity of 12 (on the PET scale) down to a 7 for the July scan, and is now at a 5 -- so we've cut that baby by more than half, with chemo alone. The other sites that were lit up in previous scans show no activity (the adrenal glands and lymph node near the primary site).
I asked Dr. Ho what the significance of the scan being clear for sites that had previously lit up -- and the answer is a bit complicated. The PET scan is a great tool, but doesn't light up only for cancer cells -- basically any cells that are metabolically active can cause it to light up. That includes infection, injury/surgery sites, and certain organs like the brain and heart naturally absorb the radioactive sugar and appear bright on the scan. In the case of the clavicle node, we have a biopsy that confirmed cancer cells there -- hence, he said if we did another biopsy it would probably still reveal some cancer cells, albeit a much smaller population than previously. Simply put, that site is now below the PET scan's threshold of recognition. Still, it's fantastic progress, and the symptoms (sore neck, etc) have gone away completely.
So, you ask, "what ya gonna do about those remaining cells?"
"Good question," I says. Here's the answer:
The next step is to start radiation therapy in late August -- that's at least a month ahead of the optimistic estimate he gave us in May, so I think that's a good indication that we're still kicking ass and taking names. The bad news is that I'll still be doing chemo, and I'll have the 5-FU pump (also known semi-affectionately as "The Pimp" or "Betsy"), every week, M-F for radiation on a daily basis for a total of 28 treatments. As it turns out the 5-FU chemical is a "radiosensitizer" -- meaning that the cancer cells are more susceptible to damage in its presence, therefore this is sort of a two-pronged approach to obliterating the little bastards. The other bad news is that radiation will probably add to my fatigue, on top of the chemo, and as it progresses through the 6 week course, my esophagus will get progressively more irritated and eating will get more difficult, not easier. These effects should be transient, though, so once I stop, my body will begin to heal the radiation "sunburn" effects. As Mother used to say "ain't no step for a stepper -- we'll get through it." The next couple of months are probably going to suck, but it beats the alternative ;-}
Once I'm done with radiation, I'll have a 4-6 week rest period, and then we'll re-stage. Hopefully all the secondary sites will be quiet at that point, and then we will reassess. Most likely, more waiting will ensue, with periodic scans. Assuming things stay quiet, then we can contemplate the removal of the primary tumor. Unfortunately, as any of you who've battled this beast in the past know, there's no quick fix, no fixed path to getting rid of it, and a whole lot of waiting.
We're still a long way from "cured" but honestly, what he told us yesterday was at or beyond my best expectations. So, today, I'm home with the Pimp -- Pimpin' the Plantation, so to speak. I feel pretty good, considering it was a late night, and hope to get out a bit today.
Thanks again to all of your for your interest, encouragement, thoughts, positive energy, prayers, playful jabs, voodoo dolls, books, and most of all, staying in contact. You have no idea how much it helps to know that my army is with me -- clearly it's working.
Take care, and much love to you all,
J
PS I'm still kinda fightin the GMail dist list, so if someone gets excluded or duped it's not intentional. Just let me know if there's an alternate email address to which you'd prefer I send this.
Almost as if by clockwork, another month has passed, and I've had another visit with kindly Dr. Ho, the oncologist. This time around we had lots of good news on most every front:
Earlier in the week, I went for a PET scan to determine how much progress we'd made in knocking back the cancer. I'm really pleased to report that the scan shows cancer only at the primary site at the esophagus/stomach juncture, and that tumor has gone from its original intensity of 12 (on the PET scale) down to a 7 for the July scan, and is now at a 5 -- so we've cut that baby by more than half, with chemo alone. The other sites that were lit up in previous scans show no activity (the adrenal glands and lymph node near the primary site).
I asked Dr. Ho what the significance of the scan being clear for sites that had previously lit up -- and the answer is a bit complicated. The PET scan is a great tool, but doesn't light up only for cancer cells -- basically any cells that are metabolically active can cause it to light up. That includes infection, injury/surgery sites, and certain organs like the brain and heart naturally absorb the radioactive sugar and appear bright on the scan. In the case of the clavicle node, we have a biopsy that confirmed cancer cells there -- hence, he said if we did another biopsy it would probably still reveal some cancer cells, albeit a much smaller population than previously. Simply put, that site is now below the PET scan's threshold of recognition. Still, it's fantastic progress, and the symptoms (sore neck, etc) have gone away completely.
So, you ask, "what ya gonna do about those remaining cells?"
"Good question," I says. Here's the answer:
The next step is to start radiation therapy in late August -- that's at least a month ahead of the optimistic estimate he gave us in May, so I think that's a good indication that we're still kicking ass and taking names. The bad news is that I'll still be doing chemo, and I'll have the 5-FU pump (also known semi-affectionately as "The Pimp" or "Betsy"), every week, M-F for radiation on a daily basis for a total of 28 treatments. As it turns out the 5-FU chemical is a "radiosensitizer" -- meaning that the cancer cells are more susceptible to damage in its presence, therefore this is sort of a two-pronged approach to obliterating the little bastards. The other bad news is that radiation will probably add to my fatigue, on top of the chemo, and as it progresses through the 6 week course, my esophagus will get progressively more irritated and eating will get more difficult, not easier. These effects should be transient, though, so once I stop, my body will begin to heal the radiation "sunburn" effects. As Mother used to say "ain't no step for a stepper -- we'll get through it." The next couple of months are probably going to suck, but it beats the alternative ;-}
Once I'm done with radiation, I'll have a 4-6 week rest period, and then we'll re-stage. Hopefully all the secondary sites will be quiet at that point, and then we will reassess. Most likely, more waiting will ensue, with periodic scans. Assuming things stay quiet, then we can contemplate the removal of the primary tumor. Unfortunately, as any of you who've battled this beast in the past know, there's no quick fix, no fixed path to getting rid of it, and a whole lot of waiting.
We're still a long way from "cured" but honestly, what he told us yesterday was at or beyond my best expectations. So, today, I'm home with the Pimp -- Pimpin' the Plantation, so to speak. I feel pretty good, considering it was a late night, and hope to get out a bit today.
Thanks again to all of your for your interest, encouragement, thoughts, positive energy, prayers, playful jabs, voodoo dolls, books, and most of all, staying in contact. You have no idea how much it helps to know that my army is with me -- clearly it's working.
Take care, and much love to you all,
J
PS I'm still kinda fightin the GMail dist list, so if someone gets excluded or duped it's not intentional. Just let me know if there's an alternate email address to which you'd prefer I send this.
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