"Our soul must perform two duties. The one is that we must reverently wonder and be surprised. The other is that we must gently let go and let be." Julian of Norwich

...Cancer teaches both!!!

Monday, May 23, 2011

Still Some Work to Do...

I have been enjoying a time of convalescence at home since my discharge from G.F. Strong in mid-April.  With the holiday of Easter and a delightful visit from Robyn, Brandon, and baby Jordan, not to mention the reading of copious quantities of fiction, I have hardly found a moment to do any "blogging".  I have also been waiting for some definitive direction to be determined with respect to my ongoing cancer journey.  With such direction now clear it seems like a good time to issue a "health update".

Surgical Recovery and Mobility

I have continued to make great strides in my recovery from February's surgery.  I am now walking comfortably with one cane and able to cover 1-2 km. in an outing.  The pace is somewhat slower than I would like but is improving.  I hope to be able to walk in the 5 km "Underwear Affair" walk in late-July.  Or at least half of it.

All wounds associated with the surgery are now well healed.  There was a pesky little portion on my lower back that was slow to heal but is now fully closed and looking good.  My general, neuro-spinal, and plastic surgeon's are all very well pleased with my recovery thus far.

Cancer Status

One of the big questions of course is "what of the cancer?"  Did they get it all?

I must preface the answer to this question with the sober realization that there is rarely any "unambiguously good news" for the metastatic colon cancer survivor.  Most of the great gains I have made in this 7 year journey have been tempered by the reality that stage 4 colon cancer is a very slippery and persistent disease, recurrences are common.  A "wait and see" attitude is often prescribed.

That being said, the news form my surgery is very good indeed.  The goal of the surgery was to achieve a complete "en bloc" resection of the sacral tumour and all of the associated soft-tissue cancer with clear margins all around.  The pathology reports do indicate that this was achieved.  YEAH!

HOWEVER... some of the sacral margins are only "marginally clear".  There is a section along the right side of the sacrum where the cancer was within a few millimetres of the surgical margin.  My spinal surgeon was concerned about this and referred me to the radiation department.  The radiation oncologist explained that they tend to treat such margins as though they were "not clear".  They reviewed my previous (Oct. 2009) radiation report, CT scanned my pelvis, and concluded that a program of radiation would help to reduce the possibility of recurrences along the surgical margin in question.  They further advised that this particular radiation treatment was made more effective by the concurrent administration of chemotherapy with capcitabine (aka Xeloda).  My own oncologist has concurred with the recommendation of this approach.

Radiation and Chemo 

SO... I will begin a 5 week program of radiation and chemo this coming Wednesday, May 25.  The radiation will be the same dose I received back in 2009, administered over 25 treatment sessions rather than 15,  meaning a much lower daily dose.  Side-effects will include fatigue.

The chemo program is intended to augment the radiation.  Xeloda is an orally administered version of the standard colon cancer chemo drug fluorouracil or 5FU. I had this same drug back in 2007.  Side-effects include the standard nausea,  fatigue, and reduced blood counts as well hand/foot rashes and mouth sores with prolonged usage.

With both the radiation and the chemo, the side-effects are cumulative and tend to be worse in the later stages of the program.  If the chemo side-effects become too bad we will reduce or eliminate the chemo dose.

So basically I am hunkering down for 5 weeks of a daily grind of radiation and chemo.  With luck I will be finished before the July 1st, Canada Day weekend and free from there on to enjoy the great Canadian summer!

After that... we will "wait and see"...

TTFN... Rob; in Vancouver

"The dream of wellness sustained me throughout the reality of the treatment."
Vickie Girard