Wednesday, January 7, 2009

Going on the Offensive

Greetings all! It's a New Year!
[2008 was tough. I won't say bad, but certainly challenging.]
For me, the turn of the page means shifting from December's focus on healing from my Whipple procedure to the underlying cause of all of this medical proceduring – my pancreatic cancer. Now that the presenting tumor has been removed, my attention turns to how to keep it away.
Today was my second of two appointments with medical oncologists – the doctors who will suggest and lead my adjuvant therapy (treatment given after the primary treatment to increase the chances of a cure). Going into this phase, I thought that they might suggest that I receive no further treatment – neither chemo nor radiation therapy. I had very mixed emotions about this. On the one hand, it could imply a confidence on their part that the evil tumor had been so thoroughly removed that I was clean. On the darker side, it could reflect the absence of effective treatments for pancreatic cancer. Thankfully, neither doc suggested that I do nothing.
They agreed that a combination of chemotherapy, followed by radiation, followed by more chemo was the way for me to go. This is consistent with what the Clinical Practice Guidelines in Oncology recommend. They differed only on how long the initial chemo before radiation ought to be. The very latest thinking suggests that more chemo early on might be more effective. The treatment will take about 6 months in total.
I will start two cycles of chemo with a drug called gemcitabine next week. Each cycle consists of three doses given once per week followed by one off week. After that (in two months), I will have 6 weeks of radiation therapy - daily treatment on weekdays. I will have a week or two of recovery time before undergoing the last two cycles of gemcitabine chemotherapy.
I ought to be able to work throughout this entire period – except maybe for the occasional day here or there. The gemcitabine is generally well-tolerated. I've been told to expect some fatigue, nausea, flu-like symptoms the evening of the treatment, and lowered blood counts. The radiation seems to be the more troublesome of the two. The effects are cumulative with about 5-10 lbs of weight loss, greater fatigue and upper abdominal soreness expected.
I am, of course, totally up for all of this – being prepared to do all that I can to live a long time. There's a three-part partnership at play here – (i) me and Jacquelyn, (ii) the medical professionals and (iii) God. I've been working with the others to the best of my abilities so far. Deferring and challenging as appropriate. Taking action gives me a sense of control. It's time to kick some cancer ass, baby.
Unbelievably – it's been nearly three months since all of this madness started. In the larger scheme of things, I trust that it is only the beginning.
Thanks for staying with me.


heidi said...

Dear Franco Jaqueline and Kids

We know its not easy thing to deal with you, dont know the outcome but believe in GOD, believe that all will be okay, it takes time but you will get thru this.

Best wishes always
Heidi & family

Tricie Higgins said...

Dear Franco and family,
I've been reading your blog and find your words so inspiring. Your faith in God and love for your family will get you through this. You are all in my prayers every day.

Tricie Higgins

Anonymous said...

Franco, It is a pleasure to stay with you and stand by you and support you as you document your journey. Your faith and love and positive approach to life motivate us to want to live every day with devotion to our families and love in our hearts. you are a true hero. Love, Amber, Bill, Brady and Jerz. said...

Best of luck in the next phase of your battle. I agree with you that you are going to kick cancer's ass.


Marie said...

It is great to read that you complete each phase of this journey sounding stronger than the each phase preceding. Your strength will carry you the challenging moguls of chemo and radiation. You sound like you have a good balance to your approach (mind, body and soul). Our daily prayers will continue to be part of your supporting network - like the Verizon commercial ;).

Love, Marie and Lou, Victoria, Nico and Louis

Gizmo said...
This comment has been removed by the author.
Gizmo said...


Keep up your positive spirit and forward looking attitude. We miss you on the Rahway campus and look forward to your return. May your family be your strength.

Pete Z