My First Treatment Plan

Robbie and I met with four oncologists to get a range of opinions and see what treatment options are available. We met with a local oncologist at Morristown Memorial, one at Cornell Weill Medical Center in NYC and two at Memorial Sloan Kettering (one in NJ and one in NY). They gave similar opinions (which is a good thing) although they weren't identical. In the end, I decided to go with Sloan Kettering (MSK) in NYC because the doctor there (Dr. S) is one of the top experts in colon cancer - so I think I'll have my best shot with him.

I no longer have colon cancer in my colon since that was all removed during the colonectomy. My issue now is that the colon cancer spread to my liver. I have about 15 lesions in my liver, spread out over both lobes (who knew livers had lobes?). If I had fewer lesions or if they were located in a small area, I would be a candidate for a liver resection in which a surgeon removes the bad area. Unfortunately, because my lesions are spread out, I am not a candidate for surgery and the doctors do not think it's likely that I will be in the future (although anything is possible). Therefore, the goal of my treatment will be to keep the cancer from growing or, if I respond well, to get the lesions to shrink. Maybe some of them will even disappear.

The plan for me will be chemotherapy. As Dr. S at MSK said "Think of this as an open-ended commitment to chemo". So, I should expect to be on chemo for 6 to 9 months to start and we will monitor how I do. There are a number of chemo formulas so the mix can be adjusted as we go along. Every few months, they will do a CAT scan to see if the lesions are shrinking (or at least not getting bigger). If I do well, I could potentially have "chemo holidays" in the future where I come off chemo for a while to give my body a rest.

The current treatments still have side effects - fatigue, hair loss, nausea, mouth sores - but evidently they are not as bad as they were in the past and there are some things the docs can do to help lessen them. Some of the side effects, like fatigue, are evidently cumulative so that early on in treatment, it's not that bad but over time you get worn down. We'll see how it goes.

So, my plan is to return to work - scheduled now for 11/17. I will get chemo every other week at MSK in NYC (the office is only a few blocks away from mine so I can walk over). The chemo is administered over 48 hours - I will receive a dose at the office over a couple of hours and then stay hooked up to a little pump in a "fanny pack" that will give me a slow infusion. I will remove the needle myself on the second day. (They'll train me on how to do this).

In order to get chemo, they need to install a "port" in my chest. The port is just a catheter that goes into one of the arteries in your heart. It has a rubber receptor just under the skin which heals over it. When you take the meds, they can put the needle through the skin into the port rather than trying to find a vein each time. Then on the second day, I just pull the needle out. I will have my port installed on 11/12 - it's outpatient surgery.

OK, so that's it - my first treatment plan. Sounds like fun, eh? We'll see how it goes. But I am happy that I'll be able to go back to work and try to lead as normal a life as possible....BB