Archive for October, 2003

Going home

Posted in Writing, Cancer Journal on October 18th, 2003

Last night spoke to Emma about coming over between November 5th and 26th.Tried to allay her fears about my health. Eventually sorted it out and she is happy I am coming. Me too.

Not good news

Posted in Writing, Cancer Journal on October 16th, 2003

New and not good information has come to light after four bouts of chemo since July.

The level of shrinkage of the tumours was 50% arising from the first two or three chemos but since four it has remained static (stable). [Not 100% sure about this, but the CA125 levels had definitely dropped] The existing tumours remain on top of the organs and although the bowel looks “Sticky” (Dr’s term) there is no sign of invasion in the second scan taken on Friday 10th October. There was a ’shadow’ on the spleen, but the doc seemed fairly confident that this was an artefact and nothing to worry about, although obviously to keep an eye on.

It seems there are two types of cancer cells and the first chemo drugs (carboplatin and docetaxel) have been successful in attacking the first type. It looks as if the second type is resistant to those drugs. They might be actually a mutation as a result of the chemo (which alters the DNA of the cells) or were already there from the beginning. (Do they have names for these cells?) This second type of cell may now be growing or, at least not responding to the current therapy. None of her vital organs show signs of invasion i.e. spleen, bladder, bowel, and the ascites (fluid generated by the cancer) is not increasing. There is every possibility that next time it is tested her blood marker will increase: currently CA125 of 48. It is unlikely that the current flattening out is a blip but that is still a remote possibility. If so, that would mean a no change of current treatment.
The course of action proposed is: first, to continue with the current drugs for one more time (this was done on Wednesday last with a reduced dose), The reduced dose was to give the bone marrow a bit of respite before the next lot of drugs and then to change the drugs to either Topotecan or Calix. Both types of drugs are usually used for second line treatment and have more severe side effects. Calix, in particular, causes extreme sensitivity in the hands and both result on hair loss and nausea.

The favoured drug is Topetecan - newer but not sure if there are other reasons.

Emma is concerned that this change appears to mean second line treatment of less effectiveness (30%)30% is the figure when these drugs are compared to other drugs as first line treatments. The situation is different when used as second line treatments. The consultant thinks it is different in her case because the first line treatment has been successful for one type of cell and the drugs will be acting differently to the first line drugs . So he suggests a rate of 60% is more likely. In any case, the drugs will attack her immune system in no uncertain terms and she will be much more unwell than previously.

The next treatment is November 5th and B has offered to go with her.

Doctor dismiss

Posted in Writing, Cancer Journal on October 16th, 2003

Emma has been having a very difficult time in the last few days. She did not get to yoga because she could not find any energy to go after her scan on Friday. She was very anxious about the results of the scan and on Monday when she saw the doctor her fears proved to be well grounded. It was not that she believed it was all going wrong although she is not feeling very good. The problem was that the hospital had slipped up and did not have the comparative results available. To add to that the doctor was angry too and would not give Emma any answers to her questions. She was deeply traumatised by the whole experience.

The upshot is that she has changed her consultant who she found very dismissive and patronising (confirmed by others who have seen him in action). He does not seem to recognise just how vulnerable she feels. Now she faces the results of the scan. Her fear is that the chemo is not effective and she may have to go to second line treatment. The blood marker test is not as good as before. So we await the consultation.

Feeling exhausted…so took day off to tend my roof plants and steady myself.

Slip up

Posted in Writing, Cancer Journal on October 14th, 2003

Emma was angry on Monday. After her distress over the weekend it seemed inevitable that she would find it all very hard to bear and the situation certainly added to her difficulties. It seems as if the hospital slipped up badly by not having the comparative scan reports available. Added to that she did not know in advance- presumably because the consultant did not tell her - that the choice of chemo drugs was likely to be highly influenced by the scan comparison. And then he did not answer her questions and spoke to her inappropriately as he does. So it all blew up.

She is feeling more pain recently and that is making her even more worried. She is expecting to hear that the tumours have grown.

Whales surfaced just opposite the Opera house as I went to work on the ferry. Amazing! Three of them swimming gently in formation. The harbour people had a boat shepherding them against the rush of commuter ferries and curious water borne watchers.