No, it won't set off metal detectors - it's plastic

Yesterday involved a long day at the hospital giving swabs, bloods and generally preparing for the main show - surgery !

... hold on, I wasn't having surgery, was I ?...

Well, I'm still not having liver surgery, and instead I am resuming chemotherapy starting this coming Monday. But the pain the drugs were putting my arms through was getting highly unpleasant, so my oncologist and I agreed that a portacath was the way to go.

This is a small plastic bump that sits under my skin on the upper chest. The bump has a silicone membrane that allows needles to penetrate and remove bloods or inject fluids. From the bump, there is a long tube that goes down a main artery and to the main blood flow into my heart. The pain in my arms was coming from the arm veins only moving 10ml blood / minute. This meant it took a long while for the chemo drugs to dilute around the body, and the concentrated dose in my arm was causing the pain. As the main arteries move around 3 litres of blood / minute (e.g. 300 times faster) this should remove this localised pain - one of my least favorite part of the oxaliplatin injections.

The operation to put this in took around 1 hour and was a complete success so far. But for the next 7-10 days, I need to be careful with the stiches, as there is a 2-3 inch incision where the portacath was fitted. It's also quite painful, like a very nasty bruise on my chest, but also one I need to be careful not to suddenly jerk or move around too much. A few over the counter pain killers are keeping it quite manageable, but I hope it's feeling significantly better by next Monday for it's trail run !

The surgery has been cut

Took a long lazy day today just relaxing and getting my thoughts together. One of these thoughts, around 4pm, was that I'd left my phone in the other room, and when I went to fetch it I realised I had missed a call from my liver surgeon relating to yesterday's scan !

The message was that there was nothing distinctive on the CT scan to operate on - the lesions or "metastasis" on the liver were unclear which indicated the chemo was having a good effect on reducing them.

So it is the opinion of the surgeon that no operation should be attempted at this time, I should resume my treatment, and only if things reappear on a later scan should we attempt surgery. My thoughts are that this might mean I only delay a needed operation, potentially prolonging the time I am affect by this condition, but on a more positive note, it may be that no surgery will ever be required and the drugs can cure the liver metastasis all by themselves - which would be excellent.

I have had my month off chemotherapy, a break to allow myself some time to get my head together and be reminded what life is like outside of the drugs. I feel I am ready for another 3 months of treatment now, and hope future scans continue to offer the positive news that yesterday's scan did.

A surprising start to 2009

One month out of Chemotherapy and I'm ready for surgery. Except I'm not sure I'm getting any...

It has been nice to be off the drugs. I have been a little bit more able and awake - certainly energetic enough to get some good snowboard time on my recent 4 day trip to Austria. There was a plague of spots from the Cetuximab over xmas, which was very unpleasant esp. where they caused my scalp to itch madly. But again, being able to deal with that without any other side-effects flaring up was a blessing.

So I went to see my liver surgeon on Friday, expecting a date for surgery, but after seeing the latest MRI scans he wants to take another Liver CT scan (due tonight) before going ahead with any operation. I have mixed reports on what the surgery might be; "only small, simple, surgery" seems contrary to "it will take two procedures to remove the lobe" ! But equally if we decide we are not going for surgery, this means I am back onto the chemo ASAP and relying on it doing the job. And I get the impression that surgery has the highest "win" rate. Ok, so if the chemo only approach fails, perhaps I will simply have surgery later on this year instead - but I am keen to get rid of this disease ASAP.

Practically though, cancer is a long-term thing. Even after getting rid of the tumors, there are still going to be months of uncertainty and scans ahead before I am "free" of it. So a "get rid of ASAP" approach is not neccassarily the best here. In any case, I should get the results of the CT scan tomorrow, so later this week I'll know what is going on for sure. Stay tuned...