Part 6: Progress and the Road to Remission

Eventually I got into a routine with the treatment and it’s side effects. Certain weekends became “chemo weekends” where you know you’re not going to be able to do much. It’s inconsistent- some days I could do a couple of things, and others there was nothing I could do but become one with my couch- which is very comfortable. Time passes strangely and I learned to deal with the effects of the treatment on my life. There are times of despair, and anger, but as I fought through those, I got used to the grind of treatment and the knowledge that I was going to have days where I couldn’t do anything but lie on that comfortable couch and flip between ESPN and HGTV and nap. Those 2 networks may seem like an unlikely pair of places for respite, but they’re really not. I’ve found them to be the best escape for me on long “chemo days” as both rarely have any mention of Cancer on them (though when Stuart Scott died of Cancer I laid off ESPN for a few days). On other networks, there always seems to be Cancer somewhere. Just watch TV for a while and see how many shows have at least a mention of Cancer- and then there are commercials for Cancer treatment and treatment centers. Every time Cancer would come up, I’d turn to my girlfriend (if she was with me, if not I’d say it to myself) and say, “It’s always fucking Cancer.” Like I need another reminder of what’s trying to kill me.

When you have Cancer, they track your progress, and the success (or lack there of) of your treatment by blood tests and scans. The Carcinoembryonic Antigen (CEA) is a blood marker that determines the amount of Cancer in your system. In a healthy person the CEA is a number between .1 and 2.5. A smoker can have up to 5.0. A CEA number over 5.0 indicates Cancer. The first time they tested me my CEA was 354.4. I had CAT Scans on my pelvis, abdomen and chest done when I was first diagnosed as routine tests after they found the tumor in my colon. I had an additional CAT Scan with contrast (barium sulfate), which identified the size and number of legions prescribed by my Oncologist. The contrast comes in several different flavors, and I really didn’t mind the taste of them. I had to drink one (rather large) bottle of contrast 2 hours before, and another one hour before the scan (I had one banana smoothie and one vanilla smoothie flavor). You also have to fast for 4 hours before the test. When the time comes for the scan they inject iodine into you to contrast the barium sulfate. When they inject the iodine you feel like you have to urinate, and are warm all over (thankfully not from actually urinating on yourself). This first scan is used not only to identify size, number and placement of the legions, but it also serves as a baseline of comparison for future scans to again indicate the success (or lack there of) of the treatment you are getting. After beginning treatment I was told that at 3 months I’d get a PET Scan to see how the treatment was working. While a CAT Scan shows legions, they do not show whether those legions are cancerous. A PET Scan not only shows the legions, but they inject you with radioactive sugar that literally lights up a legion on the scan that is cancerous. My first PET Scan showed the Cancer in my colon and throughout my liver. My girlfriend and I epically miscalculated that getting to the PET Scan meant that I would be done at that time. Ignorance truly is bliss. My Oncologist would later tell me that in this first PET scan my liver “lit up like the sky”.

I got lucky in an unlucky situation with my response to the treatment. After one month of chemotherapy my CEA number dropped from 354.4 to 115.8. The next month was down to 37.7, then 25.4, and then magically, after 5 months I was under 5 at 4.2. Under 5.0 means remission, however remission doesn’t mean what most people think it does. For Stage IV Colon Cancer, remission means that the Cancer is now on a cellular level- there are Cancer cells floating through my body, but no tumors. The Oncologist also told me at this point that under 20% of Stage IV Colon Cancer patients get their number that low- reach remission. Around this time I had my second PET Scan, and that reinforced the CEA results, that I had no tumors. My Oncologist wanted my number below 2.5 to then do surgery to remove what was left of the tumor in my colon and the area around the tumor. The idea being that even if the tumor was mostly gone, the site of the original tumor could still be producing more Cancer cells that would circulate through my body and possibly attach themselves somewhere and grow into non-treatable tumors. They didn’t do surgery when I was first diagnosed because my liver was so compromised, and it’s a vital organ, so it was more important to try and get rid of the Cancer there through Chemotherapy, than remove the tumor in my colon. The Chemo would also shrink the tumor in my colon if everything went well, which it did. Two months later my CEA was down to 2.1, and I made the decision to have surgery.