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.