New Trial Time!

Ok so I haven't been very good at keeping this thing up to date.  Last I left off we were doing Docetaxel for treatment and the only results we were getting were hair loss, nose bleeds, hiccups, and neutropenia.  Oh wait, those are side effects, not the results we were looking for.  A few weeks ago we scanned to see how things were going and the results weren't promising.  The lymph node had grown again to 40% what it was at the end of January to about the size of a baseball.  Good news was that it is still undetectable elsewhere.  This basically meant the drug wasn't cutting it so time to move on.  The options were Pemetrexed or a new trial drug.  Pemetrexed is a standard traditional chemotherapy drug and by traditional I mean the type that tries to kill the cancer before making you too sick.  The trial drug was one we had talked about before and targets a protein on the cancerous cells to deliver the chemotherapy drug and hopefully leave all your normal cells alone.  The catch however was that there was a waiting list that takes top 3 and I was number 4.  This would mean I would be at the top of the list when they accept more candidates in 10 weeks.  Ten weeks, seems like a long time to wait so I wondered what the other options were.  Can we do Pemetrexed in the meantime?  Should we shoot this thing with some radiation to stunt its growth?  Turns out my oncologist had one other item of news, my blood counts have been on a steady decline for the past couple months and aren't bouncing back as nicely as they used to.  This was even with the aid of a Neulasta shot to boost my white blood cells.  This was due to the amounts of chemo I have been receiving but the dangerous part is that the levels can become chronically low.  Traditional chemo drugs do have this side effect and you can imagine it is one to avoid.  Chronically low blood counts would be bad for day to day life but also exclude me from being accepted to any future drug trials. 

So here I am, sitting in the doctors office being told that my cancer is still growing, my blood work isn't looking good, and that as a result I should do nothing and wait the 10 weeks for the trial to open back up as doing Pemetrexed or radiation would very likely make me ineligible for this and future studies.  Not comforting news.  As a side note, my oncologist confided in me that he figured I had a 50% chance of getting into the study in just three weeks if one of the other three candidates became ineligible.  He happened to know a colleague that had a patient who wasn't doing so hot.  Great, so now I'm hoping somebody's condition gets worse so that I get on the trial faster?  That can't be good karma.  We left the doctors office a bit frustrated as you can imagine.  I decided to sleep on it for at least a week to make a decision on our next steps. 

A week later, after thinking about my options, I got a call from my oncologist with good news.  A patient had dropped out as a result of their lymph nodes being too small to be eligible.  So I was in!  And I didn't get in as a result of someone's bad results it was because the patient was getting better! 

This Wednesday was the first infusion.  Luckily it only takes 30 minutes but since it is a Phase 1 drug (first time in humans) there are a lot of blood draws, EKGs, and other tests to make sure I am ok and figure out how long it takes the drug to metabolize in the body.  As a result Wednesday's visit was a 9 hour ordeal.  Then there are draws on the following three days.  So I am pretty much living up in Seattle for the time being.  This only lasts for the first cycle so after three weeks it will be more manageable.  Side effects so far are non existent so I hope it is working on the cancer.  Next scan is in 8 weeks so expect an update at least around then (hopefully sooner).

On a lighter note, the hair is coming back.  Once again the beard is coming in nearly white and progressively getting darker.  I was getting used to the no shaving or haircuts.  It has been nice hanging out with the nephew who is obsessed with Thomas the train and RC helicopters.  Looking forward to heading over the mountains this weekend to visit the folks.  Should be 80degF and sunny, maybe time to open up the pool?  We will probably spend some time helping prep the place for my youngest sisters wedding which is this August.  She asked me to officiate which makes me excited and nervous.  This will be my second wedding I have performed but the first had like 6 people in attendance, this one will be more like 200.  Wish me luck!

Springtime!

It didn't quite feel like spring was here just yet when I was in Seattle a couple days ago and some form of icy sludge fell from the sky but yet today it is sunny and brisk and I see many things blooming (sorry allergy sufferers).  Enough about the weather, might as well get down to the details.

Had my CT scans done this week and the docs came back with what they call "stable disease".  Not exactly the most friendly of terms to hear but definitely not the worst.  Basically in the last six weeks with two doses of docetaxel we have slowed down the single tumor growth to a mere 15% increase in size.  At this point it is hard to say if we are keeping it at bay or the next data point will show some shrinkage.  The best news of course is that there is no evidence of the disease hanging out elsewhere in the body.  After some discussion of current options I decided to keep with the current treatment regiment for another six weeks.  If things are still looking "stable" or responding we will stick to the plan.  If not there are some other trials available that are showing promise that I can change to.

Good news is that this chemo is not nearly as harsh as some of the earlier stuff.  It has been two days since treatment and I feel pretty good.  Appetite came back pretty quick and the nausea is pretty harmless at this point.

In other news, I finally received my Employment Status Review and it looks like April 21, 2014 will be my last official HP employed day.  I know that my team would have me back in a heart beat and I am very glad to have their support but taking this time off is what I need to focus on recovery.  I know I will return when the time is right.

Now to go and enjoy some sunshine!

Beautiful Day

Should have posted earlier but I finally made it out of the hospital on Monday.  Ended up sleeping most of yesterday as it is hard to get some good shut eye with nurses bugging you every couple hours in an uncomfortable bed.  Immune system is back on line thanks to some help from a few nuepogen shots but I am still keeping a low profile. 

Today is bright warm and sunny and I am having a small bbq to celebrate getting older.  Still need to avoid large crowds for a few more days and really don't want to get ill again before the next round of treatment on the 19th.  I have a CT scan next week as well which will tell us if the docetaxel is working or not.  Keeping positive thoughts and fingers crossed until then.

Focus Time

So chemo has started, the job has been shelved, and I am focusing on my health.  I just completed the second round of chemo (Docetaxel on a three week cycle) and caught myself a nice head cold that started a week ago.  The cold seemed fairly benign besides the sinus headache but it was followed up with a slight fever Tuesday night.  For those who are unfamiliar, fevers during chemo are dealt with seriously.  Mine happened to start at midnight and the on call doc properly suggested I go to the nearest ER to get checked out.  Begrudgingly I followed the suggestion hoping that this wouldn't be a long ordeal.  Chemo drugs cause a drop in your immune system and a fever is a sure warning sign that you have an infection your body can't quite handle.  Sure enough, the blood work showed that my neutrophil counts were low enough to be considered neutropenic.  This means that my body is unable to deal with a bacterial infection by itself so they hooked me up to IV antibiotic drugs and admitted me to the hospital.  Luckily Lorri came along so I wasn't dealing with this alone. 

At this point I figured that I had just an overnight stay at the hospital.  Should be out of here by Thursday, right?  Guess not.  My neutrophil counts have actually been dropping for three straight days which is in the wrong direction.  I think I'll be lucky if I get back up to stable levels by Monday.  I guess it was a good thing I went to the ER when I did because that infection (which was likely a UTI but not detectable now) probably would have gotten much worse if left to my own self to resolve.  The IV antibiotics have cleaned up shop and all my lab tests show no infections and I feel good.  Now it is just a waiting game until those counts come back up to normal.  Until then I'll be attempting not to go stir crazy in here.

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.