Relapse, it's a bitch

Haven't updated in awhile.  Things were going really well up until a couple weeks ago.  I had returned to work last Fall and enjoyed a great week in Maui with family and my girlfriend in January.  Had a CT scan that showed a 4 x 4 cm lymph node in my groin region that didn't exist last September.  Nothing visible to a nearly 2 in x 2 in node is not great news, it is on the move again.  The best thing to do now is go back to chemo, bleh.

Good side of this, it is not congregating anywhere else besides this lymph node that is far away from vital organs.  There are also a number of drugs and trials coming up in the near future that we can throw at this.  Bad news is that this is bad news, recurrence at this rate of growth after the many weeks of chemo and extensive surgery I have gone through doesn't bode well.  However I am still in very good health otherwise and young and can power through this chemo crap.

I go in Wednesday February 5th to start up treatment again.  Hopefully the Seahawks parade allows me to get there on time :-)

Girlfriend and I on a sunset dinner cruise in Maui

On top of SilverStar in January

Blue Lake Sprint Tri

As some of you may know, I planned to do a Sprint Triathlon last weekend with some friends.  I was not able to participate but I was able to attend and cheer on those that did.  Mike got a great turnout and even some newbies to come out. I really wanted to be able to participate but considering it was 3 days after chemo and walking causes me pain, it would have been a bad idea.  It was really great seeing those who could make it to the "race".

Chemo is Over!!

Ok, I owed you all an update nearly a month ago.  Between rounds 2 and 3 I ran into some small complications which caused us to delay chemo for 2 more weeks.  Yesterday was the end of cycle 3 and I have no more chemo left to do!  This is good on multiple levels but I'm also wondering if my body was able to take much more.  The past couple months my nueropathy has increased to the soles of my feet and occasionally the fingertips.  The numbness should go away over time.  I have also started to have a Pavlov nausea response to the clinic at SCCA where just the smell of the place can make me puke.  I guess that's my body saying "what the hell did you come back here for?!".  My blood counts were also low but OK to do treatment just barely. 

I'm not quite out of the woods yet as the delay was caused by a hydrocele in my groin area.  We did a CT and MRI scan to double check that it was not any kind of occurrence and the results came back clean.  The hydrocele is nothing life threatening, just causes me enough pain to want to sit on the couch rather than go for a walk (in other words, beginning to drive me crazy).  Good thing the chemo this week has been knocking me out so I'm sleeping most of the day anyway.  I have yet to talk with my surgeon but it looks like it will need to be surgically removed.  It is likely a small complication from the previous surgery and will be minor.  Hoping to get that fixed soon so that I can fully enjoy summer and get back to some normal living. 

It was nice to have a concluding conversation with my oncologists yesterday.  We discussed pulling out the port and how we plan to do scans every 3 months for the first year to be certain things are going well.  After that it will be scans every 6 months until the 5 year mark. 

Thanks again everyone for the continued support. 

Choices

Round 2 Day 8 (not to mention 6 previous MVAC cycles) and the docs have finally found a small hiccup in my bloodwork.  Nothing that will prevent me from getting chemo this week but my creatinine did increase this cycle to a slightly concerned level.  The creatinine is a measure of kidney function and it seems that after 8 doses of Cisplatin my kidneys may be seeing some affects.  Or I'm just dehydrated.  I don't get Cisplatin on Day 8 so the docs believe my kidneys should bounce back in two weeks when I am scheduled to have it.  However it also begins to beg the question of whether there should even be a round 3 of this treatment.  I have been in uncharted territories for most of my treatment which is a curious spot to be in since the doctors do not have all the answers.  Don't get me wrong I love the team I work with at SCCA but there just is no data as to what to do with a 29 year old post chemo and surgery who had metastatic disease.  This of course bugs me because as an engineer, I thrive on data.  I'm currently scheduling round 3 treatment with the hopes that my kidneys will be back to good function and the rest of my body is hanging in there.  My doc has stated that I could stop after round 2 or he would support me going through a round 4 (eek!) but there really is no "correct" answer here.  At some point the chemo will stop and we will then enter the surveillance stage.  Sounds like we will scan every 3 months at first than every 6 for the first 2 years.  On most of the reports I have read, 2 years seems to be a bit of a magical number.  If you can make it that long without a relapse chances are you are home free.  At 5 years they call you cured and send you on your way.  Of course I'm planning on being here longer than that.

I'll let you know how it goes in two weeks if we start round 3 or not.

Summer is coming!

Sorry for the long delay since my last post, it has been over a month.  Let's see if I can fill you in on the current happenings.  I decided to go forward with the PGC treatment, might as well throw the kitchen sink at it.  Treatment started April 10th so I am already through 1.5 cycles.  So far it hasn't been as bad as the first regiment but it ain't no walk in the park.  For those of you who missed it, my hair did grow back between cycles.  It managed to come in with no pigment at first so it looked like I had frosted the tips of my beard.  Alas though it has fallen out again and I have gone back to the cue ball look.  I was feeling good enough to go on a run/walk for the first time in six months last weekend.  Probably ran a little over half of the two mile trek which made for some very sore legs for a few days.  Definitely got winded quickly but not nearly as bad as when I was in the last few treatment cycles of MVAC.  Hopefully that won't get worse and I will be able to train for the Blue Lake Sprint Tri.  I have also managed to start to put a little bit of weight on but the chemo still slows the appetite.  If all goes according to plan, my last dose of drugs will be at the end of May.  Definitely something I will be happy to be done with and hopefully the hard part of all of this will be behind me after that. 

I have been out enjoying the warmer weather and managed to get on the bicycle a little.  Like the running, the legs are weak but the riding is fun.  I am currently up in Seattle until the end of next week likely so if you're around and want to meet up drop me a line. 

Anybody got a hatchet?

Met with the oncologist this week.  Thankfully they got my case reviewed by the tumor board and they came back with a consensus, more chemo.  Yep, you read it right.  There is consensus that there is no detectable levels of cancer currently in my body but the pathology report from that single lymph node that had cancer had it on the exterior of the node.  As a result there is concern it could have flaked off some cells that are swimming around.  Considering that last time it took the cancer less than two years to spread to all those lymph nodes from an undetectable state, we want to go after while it's retreating.  The good news is we aren't talking of doing dose dense MVAC again, I'm done with that nastiness.  Instead I have a couple options: GC or PGC.  GC was one of the options we were looking to do at the start of treatment but decided to go for a little bigger gun.  The side effects shouldn't be as bad as the MVAC but the cocktail still has Cisplatin in it.  The PGC option adds another drug, Paclitaxel, which could aid in clearing out more of the possibly existing cancer.  I say could because the head to head trial between the two didn't quite meet the statistical requirements to show a valid advantage, but it was close.  The concern however is it is known to cause neuropathy, damage to nerves, and I am starting to already have a numbness in my toes due to the last treatment regiment.  Currently it isn't painful but it could progress to be so and some damage can become permanent.  There would only be 2-3 cycles of treatment and each cycle is 3 weeks so only a couple more months to push through.  I get to pick my starting date but we are planning to begin in 1-4 weeks, sooner the better but I want to see if I can add some pounds first.  The appetite is doing ok but the weight gain has not quite gotten traction.  I figure the body is using a lot of energy to mend my insides.  Recovery is still coming along slowly.  I have noticed I can walk at a decent pace now with less pain and the swelling has gone down significantly, almost non-existent in the mornings. 

As I've said, I have a couple decisions to make and I won't be returning to "normal" life for at least another two months.  I was anticipating that this would be one of the recommendations but it wasn't until I got in the car to leave the doctors office that it hit me, a part of me really wanted the surgery to be it and no more chemo.  It was definitely a torn feeling as I do believe more chemo is the right thing to do for the long run but knowing that I have to go through with poisoning my body again is tough.  So we're going to aim at a possibly existing mosquito with an hatchet and hopefully cleave that buzzer into pieces.

Recovering in the Valley

Well I'm making progress.  The wound area is not nearly as sore but I'm still not using any abdominal muscles, my sauntering is becoming more of a steady walk, and getting up and down from a lying position has become easier.  I've been staying at my parent's house since Friday and it's nice being home.  My grandparents have been dropping by to make me lunch and go for an afternoon walk which is a nice breakup to my day of reading, naps, video games, and netflix.  Next week will be follow up appointments with the oncologist and surgeon.  I expect to have a better idea as to next steps afterwards and if any more chemo is in the near future.  Part of me definitely doesn't want to go through with anymore of that and another part says lets kick this cancer while it's down.  There is no known cancer in my body at this time but there still may be concern of small sites due to the small amount of live cells found in one of the 24 lymph nodes.  Either way, recovery from the surgery is top priority so that's what I'm focused on. 

For those of you I haven't seen in awhile, my hair growing abilities have returned.  I'm sporting a decent beard and tuft of hair on top of my head.  It's all coming in full but the patch that my nephew pulled out, that area is a bit sparse.  I plan to be back in the 'couv in a couple weeks.