Happy Nuclear Holidays

Okay, I haven’t blogged in three months, so I guess I should provide a brief explanation as to why. The fact is that I was a bit too melancholy about the results of my August scan to find the right words. My late August scan was the first scan after starting Irinotecan, which I eased onto after getting my stent. Normally, a first scan will show that a drug is “effective” if the tumors shrink by 50% or more. That scan showed shrinkage of only about 10%, indicating that the drug wasn’t going to be very powerful for me.

Normally after getting a bad - or in this case not-so-good - medical report, it takes me a couple of days to regroup and focus on the positive path forward. But in August’s case, I just couldn’t seem to do it. I guess my reserve of emotional resilience had run a bit low. I just couldn’t shake off the feeling that the report was a harbinger of bad things to come. So, I kind of laid low all Fall – not being particularly social on a number of fronts. In the meantime, a few events passed without comment – the 4 year anniversary of my cancer diagnosis in early October, the Super Storm Sandy in late October and, most notably, my lovely wife’s 50th birthday! I know, how could I pass up the chance to write about my “old lady”??

But it was a nice Fall nonetheless, with Rob and the kids doing well.

Unfortunately, my premonition that things would get worse medically has been confirmed. I had a scan two weeks ago that shows significant tumor growth in my liver and new metastases to my lungs. The Irinotecan worked only as a brief stop-gap much as the Vectibix did earlier this year. As a result, I have now used up all of the available chemotherapies and am in the end-game.

But providence still gives me a couple of options. There is a newly approved drug for end-game patients with low side effects and some modest ability to prolong life. In addition, there is a radiation therapy which can be both harsher and riskier, but might also provide a more meaningful extension of life. After discussions with my oncologist and the Interventional Radiologist (the surgeon who would do the radiation procedure), we have decided to give the radiation a try.

Since time is not on my side, I will start the process this Friday with an angiogram to map my hepatic artery, close off the portions that go to other organs (outside the liver) and test that the only blood flow left goes towards my reachable tumors. If it can be sealed off as needed, I will return for another angiogram in early January to have radioactive “microspheres” injected, which should lodge themselves in the tumors. I will have that procedure again a couple of weeks later because the protocol is to treat one lobe of the liver at a time (livers have 2 lobes and I have cancer in both).

An angiogram, by the way, is a procedure where a catheter is inserted into an artery in the groin and then threaded up to the doctor’s “worksite”. Normally, I avoid any activity whose explanation starts with the sentence “We’ll insert a large needle into your ______”, if the blank is filled with a word like eyeball or groin. But in this case, I’m making an exception.

Since these procedures will play out over the next 6 to 8 weeks, and issues may or may not arise in innumerable ways, I can’t say how easy or hard it will be. I’ll just hope for the best and take it as it comes. But most importantly, I hope the radiation will work!

In the meantime, I wish you all a happy holiday season.