It’s more of a gray area

I met with my radiation oncologist and we talked about my progress. The problem I had been experiencing with painful urination went away just a couple of days prior to my appointment. He said that painful urination is a typical side effect from radiation treatment to the pelvis and that most of the time it’s only temporary and just lasts a few days/weeks. He said that most of the apoptosis (cell death) within the tumor should take place in the few weeks following treatment. He wanted to schedule another PET scan about a week or so prior to surgery to see just how much of the tumor was left. He thought that I would have very good response and would not be surprised if the tumor had shrunk by half. I asked him how rads I received with each dose of radiation. He said that the scale was measured in grays (gy) instead rads and that I had been receiving a dose of 1.8 gy with each treatment and the form of radiation was just below that of gamma waves on the spectrum.

Setting the date

I met with my surgeon this this morning to schedule a date for surgery and March 23^rd would be the big day. We talked about the laparoscopic procedure and he said that I would be in the hospital for 3-5 days following surgery. He wanted me to stay home for at least two weeks after surgery and said it would take about 6 weeks before I was completely healed. He gave me a prep kit containing a McMargarita (bottle of magnesium citrate) several doses antibiotics (erythromycin and metronidazole) and a set of instructions. Now it was time to hurry up and wait.

Go with the flow

A few days after my last radiation treatment I began to experience a fair amount of pain while urinating and wondered if I had a bladder infection.  I felt like Tom Hanks in the Green Mile and I was wishing John Coffey would appear to help “take it back”.  Finally, I asked my oncologist to run a urinalysis and some cultures to see if it was indeed a bladder infection. The results were negative. It turned out that the painful burning sensation was a side effect of the radiation treatments. I had experienced some mild discomfort toward the end of my treatments, but nothing quite like this. Oddly enough, when I had to empty a full bladder it didn’t hurt as bad as when the volume was low. Using any abdominal muscles only made matters worse. I had to totally relax and just go with the flow.

All in the family

My sister, Patti had her first colonoscopy on MLK day and a sizable polyp was found during the procedure. It was now official; polyps had been found in all four siblings.

Last day of neoadjuvant therapy

This afternoon I went to the oncology office to have my portable IV pump, a.k.a. European carry-all disconnected The nursing staff gathered round to congratulate me on making it through treatment and gave me a bottle of sparkling cider to celebrate.  I thanked them, left the office and it felt wonderful to finally be free after being tethered to the portable IV, 24/7 for 7 weeks.

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!