Back To The Beginning

So the PET scan last September showed 2 lymph nodes in my retro peritoneum starting to exhibit signs of metabolic activity. In other words, the cancer was starting to grow there again. These lymph nodes are located about 2 inches below my sternum towards the back of my torso. The good news was they were not near any major arteries or organs. The bad news was these can’t be gotten to surgically. With my CEA also slowly rising- it was up to 2.4 at this point- my oncologist put me back on full chemo. This consisted of Vectibix with Irinotecan. My treatment schedule was 3 weeks on and one week off. This was brutal because the Irinotecan added a whole new set of side effects in addition to the Vectibix side effects. The biggest of these were GI complications and even greater fatigue. The three weeks in a row had me out of commission for 4-5 days each of those weeks. It was getting to be a bit much. On top of that my CEA was still slowly, but surely climbing. By the time it hit 3.0 in December, my oncologist ordered another PET scan. This time there was only one enlarged lymph node in my retro peritoneum, but it had grown and was fully metabolically active. Also, there was a new lesion on my liver. We immediately stopped the Vectibix and Irinotecan and went full Vizzini from The Princess Bride; when things wrong, you go back to the beginning. For me, that meant going back on Folfox (Oxaliplatin, Leucovorin and 5FU).

In the good news/bad news reality that is chemotherapy, the rash, splitting skin on my fingers and infected nails would go away since I’m off the Vectibix, but constipation, greater nausea, thinning hair and cold sensitivity were next up from the Folfox. I still had to be on the steroids and antibiotics that were helping with the Vectibix side effects for another 6 weeks, but then I could stop the antibiotics, and start to wean my way off the steroids; that should lead to me losing some of the 20 lbs. I put on while taking them. Of course losing weight as a cancer patient can be unsettling because it’s a good indicator that the cancer is growing. My oncologist told me that I should lose the weight I gained while on the steroids and be back at my old weight with no worries. If I got below my weight prior to the steroids, then it would be time to worry.

This new treatment meant the return of the hated 5FU pump. After my infusion in the office I was sent home with a pump attached to the port in my chest that has the 5FU in it for 46 hours. Then I went back to the office to get disconnected. The disconnection has the effect of air being let out of a tire. The physical exhaustion can be overwhelming. Another “plus” of Folfox is that the treatments are every other week, so I hope I’d have more time and energy to do things. I was scheduled to get 4 sessions of this treatment, and then have a CT scan to see if the lymph node and liver lesion had shrunk, or hopefully, been eradicated. If it worked, we would keep going with either more treatment (if it only worked partially), or maintenance, if the cancer were eradicated.

I didn’t make it to the fourth session. By the third treatment, my CEA had gone up to 6.8. Seeing this my oncologist ordered the CT scan early. Again we had good news/bad news. Good news- the lesion in my liver was gone. Bad news, there were more lymph nodes that had grown in my abdomen and now there were 3 nodules in my lungs. Here’s some irony; they could get rid of the lesions in my lungs with RFA like they did a while back for one in my liver, but, in order to do it the lesions have to be at least 1 cm, where the biggest one was only 7mm. The lymph nodes in my abdomen are bigger than 1 cm, but they’re in a place where they can’t get to them. er’s some ironySo for them to help me with the nodules in my lungs my cancer has to get worse.

All this was incredibly disappointing. I didn’t stop Folfox four years ago because it stopped working, I stopped it because I became NED and we wanted to have this in my back pocket so when all other chemo options stopped working I could go back to it. Unfortunately the latest recurrence was resistant to my back-up plan. Pretty devastating news. My oncologist said I should try Lonsurf, which is a chemo pill. I am wary of chemo pills since my Adventures in Xeloda in 2015. However, I was assured that Lonsurf doesn’t have the same side effects as Xeloda, and from what I’ve heard it’s supposed to be one of the “easier” of the chemo regiments as far as side effects go. I hope so. I also hope it works, because with each new chemo treatment I don’t know if it’s going to be effective or not, and I’m running out of options. I’ll be on these pills for 3 months and then another scan. The oncologist told me that I shouldn’t expect to see any positive results for 2 months. Time to get serious about looking for clinical trials. First up, an appointment at Moffitt Cancer Center in Tampa this Friday to see what they have to offer. It’s all a lot of wait and see. 

Houston, Do We Have A Problem?

After two months more of Folfiri & Vectibix I had a PET scan. The lymph node that had been enlarged and metabolically active (cancerous) shrunk to 1.5 cm and showed as metabolically inactive. That and my CEA still being <.5 put me squarely back as NED (No Evidence of Disease) for the third time. This was on May 25^th. May 30^th was my next treatment (just Vectibix as maintenance) and my CEA was up to .6. The next month it was .9, and the month after that 1.2. Great, now the number was going up- but there was that clean scan so nothing to panic about… yet. You try having stage IV colon cancer, watching your number go up and try not to panic. It ain’t easy. As I’ve said before, I’ve been lucky in an unlucky situation, as I’ve responded well to every treatment prescribed so far. Of course the cancer eventually builds up resistance to these treatments and I move on to the next one. The problem with that is, I’ll eventually run out of treatment options. I talked to my oncologist about looking at what other treatment options might be out there for me, including clinical trials. He agreed that now would be a good time to start looking and told me I should go to MD Anderson in Houston, TX. - the top cancer treatment hospital in the country.

I called MD Anderson and made arrangements for them to get all my medical records from my local oncologist. They told me that after they checked out my records, if they thought there was something they could do, they would schedule an appointment for me. That appointment was scheduled for August 10^th. This had me both excited and nervous. It was around this time my CEA was going up and hit the aforementioned 1.2, which made me nervous, but I was excited that they might have something that could help me. They have an online portal for patients and I could see that they already had a full morning of appointments for me lined up: 8:30 AM: Registration, 9:00 AM: Meeting with the Dr., 10:00 AM: Blood work, 10:25 AM: CAT scan with contrast, and then I would have a follow-up appointment with the Dr. the next Monday. My family is in Texas north of Dallas, so I planned to drive up and spend a couple of days with them and to drive back in time to make that appointment.

I got to my appointment only to be informed that I had missed part of the online “paperwork”- eight pages of medical history questions that I had to answer before going in. This put me behind schedule. When I saw the Dr. (who was running behind as well) he told me there wasn’t going to be much he could tell me until he saw the blood work and CAT scan results; a little frustrating, but understandable I guess. So on I went to get my blood drawn (one of the best sticks I’ve ever had), and the CAT scan. MD Anderson is huge. To get from phlebotomy to the CAT scan there was an indoor shuttle, and it still took about 10 minutes to get there! With the delays, I didn’t get to the CAT scan until 12:30, and they didn’t scan me until 3:00. The contrast I had to drink was different than the contrast I got back home. At home I have the “delicious” barium smoothies to drink (I go for the banana flavor). Here they gave me options for drinking the contrast in 32 ounces of water, Crystal Light, orange juice, or Sprite (what movie theaters call a medium drink). I picked Sprite. Almost two hours later as I was lying down for the CAT scan, the radiologist asked me if they explained the rectal contrast to me. I told her they neglected to mention the rectal contrast. She started to explain that she was going to “take a tube and insert it…” at which point I cut her off and politely told her that I was going to decline the rectal contrast. She said no problem, and we proceeded without it. I looked at it this way; I’m scanned and tested regularly, and I know there’s nothing back there anymore. Also, I was going to be driving 5 hours north right after, and wanted to have a comfortable time sitting for that long. The scan went well, though they inject the contrast at a quicker rate than I’ve had before. The iodine-based contrast they infuse creates a warm feeling and the urge to pee. The ones I’ve had in the past only made my torso and pelvis get warm, but this faster rate had the warmth expand all the way up to my face and down my arms. It was surprising, but went away as quickly as it started, and I was done with my appointment. I was now free to leave, go visit my family, and come back on Monday.

I spent the next couple of days having a nice visit with my family ( eating fresh chocolate chip cookies and getting beat at Flux by my nephew). I drove back to Houston on Sunday evening to get in for my follow-up on Monday, after which I was flying home. When I saw the Dr. he told me my CEA was 3.1, at which point I started to panic. He said that their lab results are usually on the high side, and it’s better to use the same lab consistently to get a more accurate result (something my oncologist has said as well). The other reason not to panic was that my CAT scan came back clean. However, when I saw the report I saw that wasn’t completely true; the lymph node that we had spent time shrinking had grown from 1.1mm x 1.5mm to 1.2mm x 1.9mm. The CAT scan can’t tell if it’s just enlarged or if it’s enlarged and “metabolically active”. That would take a PET scan. My oncologist at home has me scheduled for that.

The Dr. then told me that there was really nothing they could do that I was not doing already. He told me that since there was no active cancer that trials were a no-go at this time, and I should stay on the Vectibix until my cancer was resistant to it, and then go back on Folfox (the Howitzer of chemo that I started on when I was first diagnosed), and then call him and look for clinical trials when the cancer started advancing while on that. I asked about Lonsurf, which while it doesn’t usually decrease the cancer, it could keep it stable for a period of time. He dismissed the drug out of hand (I was so shocked by this and his saying there was nothing else to do, that I forgot to ask why). Also, I was getting pissed off. Why dismiss any course of action that could help prolong my life? I don’t want to die. I’m not ready to die. I am fighting to live, and will use whatever means necessary to do so. Another reason I was angry was because when I contacted MD Anderson they said they would look at my records and would only see me if they felt they could help me. My records showed that I had no “active” cancer. Why did they have me fly in, wasting my time, energy and money when there was nothing they could do? It’s both a good and bad thing when you’re seeing a doctor in a hospital in Texas and the smartest person in the room is back in Tamarac, Florida. So here I sit, in cancer no-man’s land; I have stage IV colon cancer but I’m NED, waiting to get sicker (my latest CEA was up to 1.9) so there’s something more that can be done. Yet another “new normal.” For now I’ll just wait and see what the PET scan shows…

Part 12: Give Me A Break!

          February 15^th, 2017 was my last maintenance chemo. I was officially in remission and NED (No Evidence of Disease). A brief note about being “NED”; there is no cure for Stage IV colon cancer, it’s considered treatable, not curable, and is treated like a chronic disease. Even though there is “no evidence of disease”, since the cancer spread from my colon to another organ (my liver) there would always be cancer cells in my blood that will eventually land somewhere and start growing again.  So while there is no “evidence” of disease, there are still cancer cells floating around my body. Once again I’m lucky in an unlucky situation as it’s rare to get to be NED, and rarer still to stay there. At that time my CEA was 1.2, my scans were clean and my oncologist gave me the best news since my diagnosis- I was getting a break from chemo! This was my first break from treatment since I started chemo back on April 21, 2014. From now on I would have blood drawn to check my CEA and my port flushed every six weeks, with scans to get an updated look every three months. As long as my CEA stayed below 2.5 and nothing new showed up on the scans, I would continue to not need chemo. I had been in remission before, but my numbers started rising while doing maintenance chemo and I never got to have a break. Obviously I was looking forward to this!  I was hoping to have surgery for an incisional hernia I had developed in my stomach where I had my colon resection and then start exercising and get back into some semblance of (better) shape.

            
          About a week into my break I started having pressure and severe pain in my chest. When I called and asked, my oncologist assured me that this was not a side effect from the chemo, and said I should check it out with a regular Dr. I have Gastroesophageal reflux disease (GERD) from before I had colon cancer (ah the good old days when migraines, GERD, and flat feet were my biggest medical worries!), and the pain and pressure felt similar to those I had when I was first diagnosed with GERD so I made an appointment with my GI Dr. He said this wasn’t anything associate with the GERD and I should go see a cardiologist. So off I went to see a cardiologist. The cardiologist immediately sent me to get a CAT scan of my heart to make sure I was in no danger of having a heart attack. The results came back negative, and he told me the chance of me having a heart attack was 1 in a million.  I was very happy to hear that because the pain was so intense at times I thought I *was* having a heart attack. During this time, there were nights where I slept on the couch because I was afraid I would have a heart attack in my sleep and I didn’t want my wife to wake up next to a dead me. After a more complete exam the cardiologist told me I had an acute case of pericarditis; inflammation of the pericardium and build up of fluid around the heart. He put me on 2 types of medication and told me he wanted to schedule an echocardiogram to be thorough, and make sure there wasn’t anything else wrong. A week later I was back at his office, getting an echocardiogram by the Dr.’s assistant.

That evening at about 11:30, as I was driving home from a bi-weekly Dungeons & Dragons game I play in, I got a phone call. I didn’t recognize the number so I wasn’t going to answer it, but then I thought, “It’s late, I wonder who that is…” so I picked up. It was the cardiologist. Instantly I knew something was wrong- no Dr. calls you at that time of night with good news. He asked me if I was able to go to the ER immediately- and not just any ER, but a specific hospital that has a special cardiac unit. I asked him why, and he told me something looked suspicious on the echocardiogram. He said there was a chance my aorta was leaking, and that was causing the pericarditis. If that were the case I would have to have open chest surgery so they could close the leak- sew up my aorta. He wanted me to get another CAT scan of my heart- this one to specifically look at my aorta and see if it was actually leaking. If it were I’d be admitted to the hospital right then and there and be scheduled for surgery. I asked him what the chances were that my aorta was leaking, and he said 5%. This got my heart racing since he told me the week before that my chances of having a heart attack were 1 in a million. 1 in 20 does not feel as safe as 1 in a million!   To my own surprise I didn’t really panic. I guess after a couple of years of dealing with colon cancer and the fun times it provided on a daily basis, this was just one more thing. I got home, said hello to my wife, and then told her we have to go the ER. I told her why, and that’s when I had a 42 second breakdown. I cried, and cursed, and then we left for the hospital. My wife was (and continues to be) a rock.

We got to the hospital, and checked into the ER. Luckily we didn’t have to wait long for the scan, which was quicker than the scans I usually had. This makes sense since they were only looking at my heart this time, not my pelvis, abdomen and chest. The results of the scan showed that my aorta was fine, and I was told I could go home and relax. So we went home, and I was able to relax- with the help of Xanax.

I stayed on the pericarditis medications for another 5 weeks, and it slowly got better. I had to stay on the medication even after symptoms were gone because of the risk of it recurring. By the end of April I was finished with the drugs, and then it was time for me to get my incisional hernia repaired. I had developed it around September 2016, right above my belly button. It’s a strange thing to see your intestine bulging through your abdomen, and when you push it back inside it makes a gurgling sound and creates a strange sensation that is difficult to describe. So in the beginning of May I had my hernia repaired. The surgery was successfully done lapriscopically and the recovery was more painful than I thought it would be. The week following the surgery it was time to get my CEA checked. It had gone up the last 2 times, from .7 to 1.2. to 3. When they checked it this time it was up to 8.2. The oncologist ordered a scan and wanted me to start full chemo again the next week. When I told him I had surgery the week before, he begrudgingly put off the treatment for an extra week. The chemo I was going back on lowers your platelet count, weakens your immune system, and causes you to heal slower, so you need 2 weeks off after surgery. When the scan results came back I had 2 new lesions in lymph nodes that were behind my stomach. Another recurrence. Seems I couldn’t really get a break after all…

Part 9: Adventures With Xeloda

After I got back from the trip to Paris and Amsterdam, it was time for me to try the oral Chemotherapy called Xeoloda. My Oncologist wanted to wait for me to return from my trip because of its possible side effects. Taking the oral medication would change my visits to the Oncologist to just once every 3 weeks (instead of every two weeks) for an infusion of just Avastin, which would be 30 minutes, instead of 3 1/2 hours for the previous regiment. The procedure for the pills would be to take 8 pills a day- 4 in the morning and 4 at night, two weeks on the pills and one week off. I was looking forward to it because it meant no more pump (as I’ve said, I hate that thing), fewer trips to the Dr, and less time off work. Up until that point, outside of treatment days and pump removal days where I had to take a half-day off for each, I had only missed work twice until the surgery when I was out for 6 weeks. First the insurance had to approve the oral meds, which they did. Then a pharmacy called me, and I had to answer questions from 3 different people. Once I finished that, the drugs were shipped directly to my house. Very convenient. They came with a bunch of papers and warnings, as well as arriving in a bag with a biochemical hazard logo on it. Part of the cautions was not to let it touch my skin at all. My enthusiasm for the pills slowed a bit right about then.

So I started taking the Xeloda without much of an issue- I was tired but it was endurable. The first two weeks went pretty well with only minor side effects. The problems started after the week off when I was midway through the second round of pills. I started getting mouth sores, and hand and foot syndrome. The mouth sores made it hard to talk and almost impossible to eat. I started living on mac and cheese and mashed potatoes. The “Magic Mouthwash” I had did nothing, and the Lidocaine they gave me worked for a short period of time- sometimes just long enough for me to eat something more substantial. The hand and mouth syndrome consisted of pain in my hands and feet; the skin feels like it’s been pulled too tight over your fingers, and they start to crack and peel. It’s an odd combination of numbness, and pain. That happened to my feet too, it just took longer for them to peel. The nurses suggested using lotion (Udder Butter was the most recommended) to try and alleviate the hand and foot pain. It didn’t work so well.  In addition to having a hard time talking because of the mouth sores, I was limping from the pain in my feet, and my hands hurt so much that tying my shoes was painful. The next side effect is where things really went south.

I want to insert a disclaimer here: the bad reaction I had to Xeloda is an extreme case. There are many people who take it and while they may have side effects (and usually do) they are nowhere near as bad as what I experienced. I also need to explain the difference between the Chemo pills and infusions and how the body absorbs each. In an infusion, the Chemo drugs are injected directly into the bloodstream and dispersed throughout the body to be absorbed through the blood; a very direct method for getting the medication into the bloodstream. The medication is then secreted through the mucus membranes and skin (hence the mouth sores, neuropathy, and itching when I get hot). For the pills the Chemo is absorbed through the body from ingestion. In order to get the same dose of the Chemo from the pills into your bloodstream you have to take 3 times the amount of the drug as in the infusion in order for it to be absorbed into your body. It’s then secreted the same way, but there’s more of it, kicking the side effects into hyper drive.

By the middle of the second week of the second round of taking the pills, it started to hurt when I was urinating. At first my fiancé and I thought it might be a bladder infection so I tried some over the counter AZO to counteract it. That did nothing but turn my urine orange. I went to the Oncologist’s office to pee in a cup and see what was wrong; that was a Monday. Before the test results even came back, on Wednesday at about 5:30 in the morning, my body refused to urinate anymore. Imagine 1,000 razor blades coming out while you’re trying to urinate. Now multiply that by 1,000. The oncologist told me that women who have had this issue have described it as a urinary tract infection on steroids. He told me I had mucositis of the urethra; the secretion of the Xeloda had destroyed the mucus membranes in my urethra, leaving no lining for anything that was going past, and causing the extreme pain. I was then told that I would need to get a catheter inserted to let the mucus membranes regenerate. I was not happy about this. After all, I had had one after surgery which was a not so good experience, and besides, who likes having a catheter? The Oncologist made an appointment for me that morning with a urologist, and my fiancé and I drove over there.

We got to the Urologist’s office where I filled out the usual paperwork and waited what ended up being over an hour. During this time I felt like I had to urinate, but my body was still shut down. After examining me, the Urologist agreed that I would need a catheter. He was getting ready to insert it himself right there in the office, when I asked if I would be sedated for it. He said they normally don’t sedate someone to insert a catheter. I said, I’m in excruciating pain when anything comes through there, and you want to stick something up there while I’m conscious? No thank you. I want to be out for this. He said if I wanted to be sedated I would have to go to the hospital. I said, no problem, I’ll go to the hospital. So the Urologist made me an appointment with his son, who also happened to be a Urologist for later that afternoon/early evening, and we went over to the hospital to get ready for the procedure, and to be there in case the son had an opening earlier.

The hospital is down the road from the Urologist’s office, and right next to the Oncologist’s office. We were told to enter through the Emergency Room, and they would take care of things from there- the Urologist had made arrangements with the hospital. We checked in, and they set me up in a bed, with the usual; IV, blood pressure and pulse monitor, and a lung X-Ray to make sure I was in good enough health for the anesthesia. I explained my situation to the nurse and Dr. that were there, and they too said it was unusual to be sedated for a catheter. I didn’t care. There was no way they were doing it with me conscious. After a while the ER Dr. said that if I were willing, he would sedate me and try it. If it didn’t work we could then wait for the urologist. The difference being that waiting for the urologist would mean being there for another few hours and they would then have to admit me to the hospital- more time and paperwork. This way I could be out of there much quicker- if it worked. He assured me that he’d done them before, so I figured I’d let him take a shot.

They got everyone together- a Dr, 2 nurses, and of course my fiancé was there as well. Nothing like having an audience for getting a catheter inserted. The nurse came over and injected something into my IV. I asked if that was the sedation (I didn’t feel anything happening), and she said “Yes, and this is to flush the IV.” My fiancé told me after that as soon as she said that my eyes rolled back in my head and I was out. When I awoke, about 5 minutes later, I had a catheter in me, and a tube that ran from my penis to a bag strapped to my leg where the urine would gather. I had to empty that a few times a day.

A short time after that we were on our way home. I had an appointment with the urologist to remove the catheter the following Monday. Those 5 days were some of the longest I’ve had since my diagnosis. I spent most of them on the couch trying to get into a comfortable position and staying there once I found it. Any little movement caused the catheter to shift and become painful. Our cat likes to use me as her favorite piece of furniture- she lies on my chest an nuzzles my beard- especially when I’m not feeling well, but I couldn’t have her jumping up on me, so I spent the time with a pillow on me as well. Before I left the hospital they gave me a tube of Lidocaine to apply to where the catheter entered me to help with the pain, and I used that quite a bit. One consequence of that, is sometimes the Lidocaine dried and stuck to the shorts I was wearing, and when I needed to do something it would pull- not a pleasant experience. I also used oral pain meds I had been given previously and Xanax to try and keep my head about me.

Monday finally came, and we went back to the Urologist’s office to have the catheter removed. When I got there, the Urologist informed me that he wouldn’t be removing it himself, but his two nurses would. This threw me for a bit. Not only had I had a bad experience in the hospital the first time I had a catheter removed, but I had been in so much pain this time that I wanted the Dr. to do it. I was told the nurses always did it. There was not enough insisting in the world that would have changed anything about that. It took me a good 30 minutes to gird up my courage to let the nurses remove it- even with my fiancé holding my hand I was scared. And it did hurt coming out- though it came out mercifully fast. I was then sent home, and told to come back in the afternoon- they wanted to make sure everything was working as it should. So I went home and waited to urinate again, afraid of what that would bring. The psychological impact of the pain, and anticipation of it still being there was still looming large. Eventually I had to go, and it still took me a while to let it happen. When I finally urinated it did it hurt a little, as they said it would from having the catheter in there for so long, but thankfully it was nowhere near what it was before. I returned to the Dr. in the afternoon, and told him it was better, and from there things slowly got back to normal physically. It was a highly traumatizing experience. The next week it was back to the old regiment of Chemo infusions every two weeks and the pump for 2 days after that, which all of a sudden didn’t seem so bad.

Part 3: Meeting the Dr.'s

When the appointment for the Surgeon was changed, it was a Friday. I honestly have no recollection of the weekend that followed. I’m sure there was crying, confusion, fear, and anger- there’s always anger after you’ve been told you have Cancer. So on Monday, my girlfriend and I went to see the surgeon. He said that we needed to see the Oncologist to get a better idea of what the best course of treatment was before talking about surgery. He did seem confident that the surgery would be a success, and give me the best chance for a longer life span than not having the surgery (at some point I will talk about how odd and unsettling it is to hear the words “ extend your life span” while in your 40’s). Still, we needed to see the Oncologist first. He asked us the name of the Oncologist we were seeing. When we told him, he said that if anyone in his family got Cancer, that’s who he would send them to. It’s always nice when you have one Dr. who can recommend another Dr. so highly- even before you meet him.

Two days later my girlfriend and I were in the Oncologist’s office. There’s a surreal quality to many of the things that have happened since my diagnosis. Walking into the Oncologists office for the first time is definitely one of those surreal moments that all to quickly become painfully real. Sitting in the waiting room, I felt like a cartoon cat who’s hanging from the ceiling by his claws. There’s paperwork to fill out as usual for a new Dr.; this time I (very wisely) made sure that my girlfriend was to be told anything medical that came up- I wasn’t making that mistake twice! Then my name was called and we were escorted to a room. The Dr.’s medical assistant asked some questions and then drew blood. Another thing you get used to, like it or not is that you become a human pin cushion- they draw enough blood to paint a Picasso.

Enter the Oncologist. Again, I have a hard time remembering exactly what happened in what order. It’s been a while, and there is so much information that was thrown at us, it was overwhelming- as if having Cancer isn’t overwhelming enough. I was told not only had the tumor on my colon spread to my liver, but there were multiple legions there. When I asked how many, he told me the amount doesn’t matter, only that there were multiple legions, and that I needed to get a biopsy of my liver to confirm the diagnosis. He said there was an 80% chance that the legions were Cancer- the biopsy would confirm that. He told me I also had to have a port surgically implanted (in my upper chest) to deliver the Chemotherapy I would need. The port is connected to my jugular vein, and it makes it easier to take blood, and have treatment every two weeks. He did tell us there was a small chance that the legions were just granuloma or something else.

I perked up a bit at that and told him that if there was a chance that it wasn’t Cancer I wanted to postpone implanting the port until the diagnosis was confirmed. I was desperately grasping at straws for any little indication that it might not be Cancer, so I could stop worrying that I was going to die. He explained to me that they were as sure as they could be that it was Cancer; the biopsy was just a confirmation, and I needed to get the port as soon as possible to start treatment (Chemotherapy). In addition, the blood work they did was only good for a limited amount of time before the surgery, and if that time ran out they would have to draw blood again. That would delay treatment, and he wanted to get started as soon as possible. I asked about surgery before Chemotherapy. He said since the liver had been compromised, and is a vital organ, that took precedence over surgically getting rid of the tumor in my colon. We were told if I had a good response to the Chemotherapy it would not only reduce the legions in my liver, but shrink the tumor in my colon as well. After a brief discussion with my girlfriend, I agreed to have the port implanted, and have the biopsy on the same day. All in all, the Oncologist spent about 90 minutes with us, explaining things and answering any and all questions we had in a very calm manner. One of the other things I do remember him saying was “Don’t look at the internet”. I was good with this for about six months, then I had a moment of weakness and started surfing the net. That’s a mistake I’ll detail in a future post, let’s just say I learned to always listen to my Oncologist. After he left, I was given the first 2 of many prescriptions- to deal with the side effects of my treatment. One prescription was for mild nausea, and one was for severe nausea- an ominous sign of things to come. I had the port surgically implanted and the biopsy done within a week (which I will also go into detail about in the future). Next up was the beginning of my Chemotherapy.