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[Cancer]

[cancer] Here we go again

I met with my oncologist this morning. I have a 35 mm diameter metastatic tumor in the right lobe of my liver. We are certain this is not a repeat of the false alarm of last year because the medical imaging is corroborated by the elevated CEA levels in my bloodstream, which in turn are highly indicative of liver metastases, among other things.

The proposed course of treatment is a chemo regimen of FOLFIRI interrupted by a liver resectioning. FOLFIRI’s side effects include significant hair loss, elevated fatigue (in comparison to FOLFOX) and more extreme lower GI symptoms.

The current plan is to start chemo on Friday, May 13th, continue for four sessions on a bi-weekly schedule, then interrupt chemo to conduct the surgery, around mid-July. Around late August I will return for eight more bi-weekly chemo sessions. The purpose of the interrupted chemo schedule to ascertain through direct observation of the re-sected tissue whether the chemo course is having an effect on my cancer. If it is not effective, we will resume chemo with a different regimen.

A review of the older CTs suggests this tumor was present prior to my FOLFOX course, but evaluated at the time as a malformation of the blood vessels in the liver. This is ironic for obvious reasons, but also good news, because it means the current metastasis isn’t a post-FOLFOX metastasis. Which is to say, the FOLFOX course may well have been effective.

Also, as this is a readily accessible, single-site metastasis, we continue to view my treatment goal as an eventual full cure. My oncologist has reclassed me back to 30%/5-year survival rate, and suggests that we’re about 50/50 on achieving full cure. I’m not sure I understand how those two statistics are compatible, but that’s how she put it. I would characterize her as neither particularly optimistic nor particularly resigned.

We did discuss the value of continue treatment, and life extension versus quality of life remaining. As we’re still aiming for a full cure, and even in the event of mortality we’re talking about years, not months, we have decided to proceed with the planned treatment. She indicates I’m not a candidate for clinical trials as I have not yet exhausted the core chemotherapy regimens, and my tumor is surgically addressable.

My own emotional picture is deeply mixed in very obvious ways. I recognize that of all the bad things this could be, what we’re facing is about the least-bad. At the same time, I’m about to lose another year of my life to this. My last round of chemo came at an incredibly high cost to me personally, emotionally and professionally. I do not expect this to go any more lightly on me.

Still, I will survive.

PS – Though given this news I do not expect to make any more convention appearances this year after Norwescon, JayCon will still be occurring June 4th. Please come celebrate my life if you can.

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