Four Weeks Of Information Overload

As many of you know I was diagnosed with Stage II colon cancer in January 2008. Surgery was performed in February and all of the cancer was removed. Since then I have followed my quarterly CEA (Carcinoembryonic Antigen) blood work and my yearly colonoscopy. By 2009 by CEA markers were increasing but still below the normal level specified by the Ottawa Cancer Clinic. Only one cycle since 2008 jumped above the normal level and the following cycle was back in the normal range. To this day my markers are still in the normal range.

Even though my blood results were showing all regular signs, the steady increase and the one test that was above normal was enough for my general surgeon to explore the options of a biopsy on a node that was visible in 2007. Many CT scans were taken in 2008 and 2009 but this node was not aggressively growing which indicated it was unlikely to be cancer. The biopsy was performed at the Ottawa Hospital on February 24, 2010 and results were due within a week.

On March 4th the words you never want to hear were sent my way. "Sorry to say, your biopsy results tested positive for cancer cells". The general surgeon that had been my primary physician since 2008 informed me that I would be returning to the Ottawa Cancer Clinic to deal with these test results. This was also disappointing to me as this doctor is one in a million. He is always looking out for your best interests and genuinely cares for his patients. In hindsight I now understand why he wanted me to transfer back to the Cancer Clinic.

It felt like a long waiting game for an appointment with the Oncologist but eventually everything came together. Monday, March 22 was my first appointment with a Colorectal surgeon at the Cancer Assessment Center. During this visit I learned that I actually had two tumours, not just one. They are both inside lymph nodes along the main artery in my abdomen. One is 3cm and the other they call a "baby" is 1cm. Given the location of the tumours and their size, surgery was not a viable option at this point. The surgeon explained that the Oncologist would recommend chemotherapy to try and shrink the tumour so surgery could become an option.

On Tuesday, March 23 I had my first appointment with my Oncologist. The outcome of this meeting was not at all what I was expecting to hear. From my meeting the previous day with the surgeon I just assumed I would have chemotherapy until the tumour shrunk and then I would have surgery. Within the first 30 seconds of this appointment I was informed that my cancer was Stage IV, not curable by chemotherapy alone and surgical removal is the only chance I have. Obviously I shut down immediately but Scott was with me an able to absorb all information from that point forward. The doctor explained that there would be two options for chemotherapy and one would be a clinical trial cocktail combing four different chemo drugs. He felt this trial would be his recommendation but I could also choose to have standard treatment with a cocktail of two chemo drugs. Side affects of both are very similar with the exception of one drug in the trial program. We were sent home with a contract to review for the clinical trial as well as other information on therapy in general.

This same week I was scheduled for a PET scan on March 25 and booked with my oncologist to review the results on March 30. The scan was painless, I actually fell asleep in the machine!

March 30th arrived and I was nervous for the appointment but optimistic at the same time. The results of the PET scan were good and bad. The good news is that no other cancer cells were found anywhere in my body. Bad news was a few very small spots were visible on my liver but the test was inconclusive. If they are cancer, they are too small to be picked up but they may still be nothing. I will have a CT scan in late April and they will check to see if anything is visible on this scan. These results did not change the treatment strategy and the next steps are preparation for chemo.

Over the next two weeks I have an appointment for a port-a-cath to be installed in my upper chest. This will allow infusions of chemotherapy drugs and blood samples as required. This port remains embedded during your entire treatment which saves the nurse from trying to find a healthy vein at each appointment. I am also scheduled for a chemotherapy information session, CT scan and blood work by April 26th. I have a quick visit with the Oncologist on the 26th before I begin chemotherapy on the 27th.

All above tests and blood work need to be completed no more than 7 days in advance of your scheduled treatment. On the morning of April 27th I will learn if I qualify to start the clinical trial cocktail that day or if I will be receiving standard treatment. The trial cocktail is a three week cycle with 1 day of IV drugs, 13 days of pills and a 1 week rest period. The standard treatment would be 1 day of IV drugs, the next 2 days of an IV pump at home and then an 11 day rest period. Time will tell which treatment I receive but I do hope to participate in the clinical trial as this cocktail has shown positive signs of shrinking tumours.

One last note...I had a 22% chance of a cancer re-occurance, 20-25% chance of curing this cancer so I truly believe my life is all about the 20's. Sticking with that theory, if/when my hair falls out I will be purchasing a long blond wig that makes me look 20. Here's to the twenties!

Take care and I will be in touch again.
Karen