Day 99

Chemo No. 5

Too beautiful a day to spend it hooked up and this puts me in a funk.  The bay is looking amazing as the train pulls out of Pz station, super still water and the sky just one little white cloud.

In the Haematology Department Siobhan is there and I get weighed and blood tested.  It’s busy here today being an ordinary clinic day.  I’ve moved to Mondays for chemo instead of Tuesdays, but I get called through to see Dr Kruger pretty quickly.  He’s seen the CT scan which shows a partial response which is what he’d expect but he needs to see the PET/CT scan before he he’s happy to let me progress to the next round of chemo today.  So now we wait while he gets someone to chase the results.

I go into see Dr K and he’s brisk and to the point.  The PET/CT scan isn’t simple to interpret which is why there’s concern.  There are two main issues.

Firstly the scans show a strong new hot spot in my chest and what appears to be a fractured rib.  I knew this would be an issue.  Everyone’s asking the same thing – what broken rib?  Ok, I managed to injure myself crawling into the front compartment of the boat a month ago, at a bad angle on my side and felt something go.  It’s been sore ever since and I after a while could feel the rib clicking when I moved certain ways.  I knew what I’d done and it’s been pretty painful sometimes but I know also there’s nothing to be done for a cracked rib, just let nature run it’s course, and I think it’s healing finally.  I’d also read recently that chemo can interfere with bone healing because it attacks the fast body’s natural healing inflammation and fast cell growth as if it were cancerous.  Great.  I’d been ignoring the rib to be honest, and hadn’t a fessed up before, but was going to discuss it this time.  Anyway, the fact that I can account for the broken rib by my own actions appears to the a relief to Dr K who can now dismiss is as a further cancer show, and unrelated to the chest pain I’d experienced before.  I can’t actually fix the dates of these events without my diary, but think the rib injury happened after the chest pain episode.  Anyway they’re not related, but I feel like a naughty schoolboy.

The second concern is potentially more serious.  It appears that there is uptake of the radioactive sugar solution by a spot in my liver.  This could be several things.  The radiologist has pointed it out and the concern is that it might be a new cancer growth, albeit very small, about 5mm diameter.

If Dr K decided today that this was the case then it would appear that the cancer in one small place has mutated and is outwitting the chemo drugs. This would be a serious set back, indicating that I was not fully responding to the current chemo regime, resulting in me being taken off the trial and put onto a more aggressive high-dose chemo regime with stem cell transplant to counter the new cancer.  We talk briefly about transplants – it’s not a good place to go, high risk and tricky.  My heart sinks on hearing this.

But without this small hot spot the rest of the cancer appear to be on the retreat.  Dr K explained that they had all gone negative in terms of uptake of the radioactive sugar solution – they are assessed on a scale of 1-5 with 5 being high uptake, 3 no new uptake, 2 reduced uptake etc and my previous cancer shows are all at level 2.

In the face of this and the fact that I am seemingly responding well with surface symptoms retreating he is inclined to interpret the liver show as being a vascular abnormality, something that is not significant and is likely to come and go, showing erratically on the scans.  He decides we can proceed with today’s chemo.  I didn’t expect to feel grateful to receive those drugs today, feeling grouchy about it all this morning, but right now I’m very relieved.  I believe I’m getting better and want to see this trial drug through.  As Dr K explained, if I fail to respond in the end the options are the same; high dose chemo and stem cell transplant, so why not give the new drug a proper chance?

He explained his responsibility to both me and the the drug trial, and that in the end it’s his interpretation of the scans that count. He wants me to continue, and so do I, but he’ll order another interim PET/CT scan for 4 weeks time to double check.

I head over to the Disclosures Office again to order copies of the latest scans.  Francis remembers me and makes it all easy this time. They’ll be ready for me on Wednesday, and she’ll try to get a copy of the Echocardiogram too.

Back to the Headland Unit where it’s not too busy in the waiting room, but the mixing of my chemo cocktail is going to be delayed so I manage to persuade the nurse to let me wait elsewhere – maybe in Haematology where they have broadband but actually outside under some big trees I’ve found, almost a park with tables and grass.  Sitting in dappled light the air feels good.  It’s been a bit of a scare this morning; the thought of the trial chemo not working, of the cancer mutating, of a worsening treatment regime, the hazards of stem cell transplant.  It’s a fine balancing act going on here and things feel a bit precarious.  But I have faith in the team here, and if anything it will make me focus more on doing what I can to rid myself of this.

Well, that’s my morning.  I’ve enjoyed my big salad lunch and having some outside sunshine time, and I’d better go now and get my fix…

Been in the waiting room for an hour now. The TV’s on loud – everyone’s facing it but no ones watching.  I move seats, but soon get called through.

No suprises but a long session.  I’ve downloaded some classic 70’s videos from U-Tube which cheer me up no end.  Here’s Mungo Jerry and ‘In the Summertime’ – its such a sunny song maybe you’d like to give a listen:

 

I’m not out until 6.45pm.  Ali has just arrived and we drive back to take a walk in the still warm sun at Marazion, paddling in the sea, playing ball with Milli.  I feel dizzy with the drugs and the day, but alright.