Chemo Five: Smooth Sailing

Tuesday, May 19th was the fifth chemo treatment. Tagged onto this one was the bone medicine. I’m pleased to report that the chemo session (as described in Chemo Four with the addition of the bone med went very smoothly). Because this past week brought some pain in the left shoulderblade, shoulder, arm, wrist, and hand, I had to have a very  small amount of morphine with the chemo push, since it was done in that hand. This made the whole procedure nearly totally painless, and considering the session administered for nearly four hours, this was a good thing.

The arm pain, muscle wasting, and dimensional changes had been going on for months. This was the first place really that I noticed significant body changes due to the cancer, and according to Harrison’s Principles of Internal Medicine, is not uncommon with cancer (p. 642 , 15th Edition) and since we aren’t sure of the etiology, the oncologist has me scheduled for an MRI of the cervical and upper thoracic area on the 22nd.

Overall, the oncologist and I am pleased with the treatment so far. I am feeling better, eating more, and sleeping better. Nausea and vomiting seem to be under control with the medications he’s prescribed. I did lose a few more pounds, at the morning weigh in I was 149, down from  155 last week. I went over this with him and got more suggestions on how to increase calorie intake. Basically anything goes at this point, and that includes any fast foods I want.  For once I am grateful that when this process started I was holding at 183 (age 60).  And grateful too for the years of bodybuilding, because in spite of the wastage, there is still muscle.

My hair is completely out now and in fact stubble is already growing in. I picked up a few cute knit caps at the Center, courtesy of the Bartlesville Fibre and Knitting Group to keep the pate warm and cozy, and my sister-in-law has a care package on the way, as well as my cousin.

The oncologist points out again that we have a lot of cancer to kill, and I know the disease is widespread in my body, however, I’m not afraid of it. We have numbers for the two biggest tumors, 736 and 1006, and he’ll be checking those once this round of chemo ends. We can see the visible shrinkage at least at the tumor on my right neck axilla area, and many of the areas affected under the skin (like lymph nodes under my arms) have shrunk.  We’re using the PET scan as the major “map”.

At only five weeks in treatment, I am pleased that there have been palliative effects, in spite of the fact that chemo is very rough, and always difficult for each and every patient in some way or another.  It’s always a balancing act with cancer anyway — it translates out as try to do no further harm while trying to ameliorate the harm that’s already done by the disease process itself, especially tumor burden.

Tumor burden isn’t really talked about much, but that is the effect the tumor and it’s presence is having on the patient, the idea being that when it gets to be “too much” (defined in various number scales) the tumor kills the patient.  Most commonly talked about in lung cancers, tumor growth, invasion or obstruction of adjacent structures, growth in regional nodes through lymphatic spread, growth in distant metastatic sites after hematogenous dissemination, and remote effects of tumor products, are all areas the oncologist and patient need to address. In addition, peptide hormone secretion by the tumor, or immunologic cross-reaction between tumor and normal tissue can produce a variety of signs and symptoms. Cancer is a complex disease, and its byproducts and side-effects are numerous and dangerous. This, in part, is why combinations of therapies are used — chemo, radiation, surgery, etc.

In this chemo round, I have session six left next week, and then two weeks “off” in which we might do some repeat tests to check progress. This I am leaving up to the oncologist.

I’m working on increasing my energy levels by Chi Gung and meditation practices, and also more vitamins and food. Those are things I would normally do anyway when sick at this stage of the game.  Some good research papers were found by a friend on the benefits of remaining physically active during cancer. I believe this is a good thing to do, and also it is very important to maintain as stable an attitude as possible toward the disease, which is a long term problem and because of this is hard for most people to reckon with.

I have hopes that the records left in this blog will give some guidance to others who have to deal with advanced cancers, which have their own set of issues. Regardless of the time left to you, no one has imprinted a number on your feet… median prognosis of four to ten months for example, is a statistical measure, and when looking at the individual case, should not be taken as a death sentence. Various studies yeild various numbers but all of it, for the individual, will be dependent on individual factors, such as response to treatment and attitude.

My cousin Carol brought up the case of Farrah Fawcett this week on Facebook, I didn’t know she was suffering from cancer, but apparently has had quite a bit published in the media. I wish her well, she was always a favorite actress, and I hope her message will reach a lot of sufferers.

My message for the week is always remember to rest. Even if it’s just a forced rest, hanging out on a relaxing surface, no sleep involved — rest is important for the cells that have to rebuild. Chemo kills good cells as well as bad ones, so rest and proper nutrition are mainstays for the immune system and should be taken seriously. Keep up your sense of humor too, that helps a lot.


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