Chemo week 6 – uno mas

I saw my oncologist this morning and he remarked about how well I was tolerating chemo. My white cell count had dropped a little from the previous week, but nothing to worry about. I had been feeling more fatigued during the past week especially the past weekend. I spent most of Saturday either sleeping in bed or dozing in my recliner. Sunday morning wasn’t much better, but I started feeling better later that afternoon. Yesterday started out okay at work. However, around 11:00 AM things started to deteriorate quickly. I continued working a couple of more hours, but I had to throw in the towel around 1:30 PM and went home. That’s the odd thing about being on treatment; you never know when fatigue is going to hit you.

I hadn’t experienced shortness of breath until this week. It just happened a couple of times, once on Thursday and again on Saturday and only last a few moments. My oncologist wasn’t too concerned as I didn’t have any chest pain and the episodes were very short. Shortness of breath can be a concern if the episodes are frequent and or prolonged, which can result in hypoxia (low oxygen). It’s important that the tumor tissue does not become hypoxic because it could cause up regulation of hypoxia inducible factors, e.g. HIF-1 alpha, which in turn can stimulate vascular endothelial cell growth factor (VEGF), thus triggering angiogenesis, i.e. formation of new blood vessels. This must be avoided, as it will interfere with success of treatment. The idea is to fly under the radar and kill tumor cells slowly using radiation and a continuous low dose chemotherapeutic agent, e.g. 5-FU. Placing the tumor in a hypoxic state would cause it to mount a strong defense by triggering angiogenesis, which could increase the risk of metastasis. So the upshot is tumor hypoxia es no bueno.

This afternoon I went back to the oncology office for my last chemo exchange. I have to wear my European carry-all just one more week and then I’ll be done with neoadjuvant therapy.  My last day of radiation is tomorrow and it will be so nice to put that part of the treatment behind me.

Chemo week 5 - Free at last? Not so fast.

I didn’t receive my weekly chemogram from Coram on Friday and thought my oncologist had decided to stick to the original 5 week plan. However, when I went into the oncology office this afternoon they apologized and said that there was a miscommunication and that my oncologist did want me to continue chemo for two more weeks, but the instructions were never communicated to Coram. They removed my IV line for the evening, but I needed to come back tomorrow at 1:30 PM so they could hook me up again, which was fine with me. I  was so happy to get rid of that boat anchor around my neck even if it was just overnight. It felt great walking out of the office without my European carry-all and I was really looking forward to taking a long hot shower!

Chemo week 4

My oncologist is pleased with how well I’ve been able to tolerate chemo. Many people on 5-FU have problems with nausea, appetite or taste change, severe diarrhea, etc. I hadn’t exhibited any signs of nausea to speak of, my appetite was still good and the only taste change I had noticed was coffee tasted bitter and I had to switch to tea (Celestial Cinnamon Apple Spice is now my fav), but that was it. He said that if I continued doing well he might consider extending chemo out another week or so beyond the typical 5 week period.

Chemo week 3 - dancing the quick step

I really began to feel the effects of chemo and radiation by the third week of treatment. Up to this point I had just been dealing with chronic fatigue and intermittent dry mouth. The opiate in the Vicodin I was taking to help get me through the radiation treatments during the week was also slowing down my GI tract, which helped to counteract diarrhea caused from chemo. However, when I stopped taking Vicodin on the weekend let’s just say I got pretty good at dancing the quick step. I modified my diet right away by abandoning the high fiber content and replacing it with a low fiber alternatives, e.g. bananas, applesauce, white rice, white bread, etc. I had been eating whole wheat bread for years and was amazed at how tasteless my sandwich was with Wonder white. It was light, white and just not right. While changing my diet helped to slow things down a bit I was battling yet another problem. The simple starches in the low fiber diet caused my blood sugar to skyrocket, which exacerbated the fatigue I had been feeling. It wasn’t long before I had to switch back to my higher fiber diet of beans, brown rice and whole wheat. Imodium was a big help especially on the weekends when I wasn’t taking Vicodin.

Dick Clark’s Snoozin’ Eve

While I had every intention of staying awake until midnight to bring in the New Year, the effects of chemo and radiation conspired against me. I slept through the last hour or so of 2010 in my recliner and woke up in 2011 after the ball had been dropped and there was nothing left except confetti to clean up. How pathetic is that? It’s just as well, I was ready to put 2010 behind me and frankly I’m wanting to put the treatment of 2011 behind me too so I can get on with my life. I’m hopeful that 2012 will be a better year and that the Mayan calendar is wrong.

Chemo week 2

The second week of chemo also went smoothly, but I’ve noticed that I’m very tired especially in the evenings. I met with my oncologist this afternoon and he was pleased with my progress and lack of side effects. My blood work looked good with the exception of my CEA level, which had jumped from 11 to 22. He said that treatment can sometimes throw off the CEA level and he wasn’t too concerned, but he would order a repeat test later in the week.

God rest ye weary gentlemen

Instead of standing in line at the store to purchase last minute gifts I was standing in line at the hospital waiting to get my blood drawn. You wouldn’t think there would be that many people needing to get blood work done on Christmas Eve, but apparently the lab is the place to be for the holidays. As I sat there waiting for my name to be called I though about all of the children who were spending Christmas in the hospital battling cancer instead of being at home with their families. It reminded me of a segment I saw recently on CBS Sunday Morning called “Beads of Courage” about a woman in Arizona who started making glass beads and distributing them to children in hospitals across the country who were undergoing cancer treatment. Each colored bead represented various aspects of the process including clinic visits, chemo, radiation, etc. Some of the children had hundreds of beads, each telling their own personal story. One child in particular had so many beads that her father had to wear them as he accompanied her to each visit or treatment. It’s interesting how something so small can have such a big impact.