Thursday, August 28, 2008
Who is this lean and fiery orator?
Now that's how you do it. I guess JK had himself an espresso shot sometime in these past four years.
Wednesday, July 30, 2008
Is it ...? Could it be ...? REMISSION??
If you're still here, hi. I'm still here, too. I've been getting back to normal things like going to work and walking around and being seen in public, which accounts for the radio silence on this blog. But I thought an update would be in order, so here goes:
Well, I have been out of the chemo for a few weeks now. In that time, I have had a couple of tests to gauge the effectiveness of my treatment. Let's run 'em down, shall we?
1) There was a CT scan to check on my lymph nodes. The size of your retroperitoneal lymph nodes after chemotherapy for TC is pretty crucial information, obviously. Nonseminomous testicular cancer (what I have) has a nasty habit of leaving behind a benign mass called teratoma. Teratoma is not itself dangerous but a) it can grow, putting pressure on your organs, and b) it can become cancerous later down the line, creating a recurrence of TC -- and cancer is always much more dangerous the second time around.
Before this CT scan, I had to drink one of those loathsome barium sulfate "smoothies" that coats your stomach a provides better image quality. Fortunately, I had been so fully briefed on how disgusting this stuff would be that the actual taste, while horrible, was miles better than I expected. (In fact, I think it's the mucus-y consistency as much as taste that really grosses people out.)
Anyhow, the scan revealed that my lymph nodes had shrunk significantly from the chemo, returning to their normal sizes. There is one node, however, that is still inflamed to about one centimeter. This poses a bit of a problem, as some oncologists would recommend surgery in my situation (in fact, would recommend it for any residual lymph node swelling whatsoever) while others would advocate surveillance. Dr. Hellerstedt is in the latter camp.
Post-chemotherapy RPLND surgery is a pretty intense and difficult procedure. Only a few surgeons in the country have done more than a handful of these procedures. Frequently, nothing more than scar tissue is found in the affected nodes. Nevertheless, the surgery does offer some peace of mind by (in all likelihood) revealing that there is definitely no active cancer in the nodes and removing any teratoma that is discovered.
On the other hand, it's certainly preferable not to get the surgery if you don't have to. And Dr. H seems confident that I don't have to right now. (The story will change if we see my one lymph node growing in a subsequent CT scan rather than shrinking back.)
I'm torn. I've done my homework, and I know that many TC specialists think the post-chemo RPLND should be done in any case of residual node inflammation for the the slight increase in statistical long-term survival that is possible. However, surgery carries risks, and these must be weighed against the slightly increased risk of recurrence that comes with not doing the surgery.
I hope I'm laying this stuff out clearly. It's pretty late as I write.
Given Dr. H's confidence, I am pretty comfortable in moving forward with surveillance for now. That'll be CT scans and blood tests every three months for the first year, with less frequent tests in subsequent years. If something happens during surveillance that makes us think surgery is necessary, then we will we move forward with that.
Just to put my mind at ease, though, I am going to ask Dr. H to put in a call with Dr. Lawrence Einhorn at Indiana University. Dr. Einhorn literally wrote the book on modern TC treatment and is famously helpful in answering calls to consult with oncologists around the world who are dealing with TC patients. If Dr. Einhorn concurs with our current plan, then I will move forward with surveillance and consider myself unreservedly in remission from testicular cancer. (Hoot, hoot.)
So! Keep your fingers crossed.
Oh yes. There was another test used to check out my lymph nodes.
2) A PET scan. (If you have any interest, click that link, because this scan actually works in a pretty interesting way that involves injection with radioactive material.) This was done to look for any "active cancer" in my inflamed lymph node -- cancer that the chemo just plain failed to kill. This scan is not really super useful for patients in my position; it is known to produce a significant number of false negatives, and it does not reveal the presence of teratoma. However, Dr. H thought we should go ahead with it because a) my insurance agreed to pay for it and b) if it was positive for activity in the node, we would definitely think about doing the surgery rather than surveillance. Fortunately, the scan was negative, as we expected.
OK. That is all for now, cats. I will continue to post as things develop ... and may even start posting about non-cancerous subjects as I return to normal life.
Thank you to everyone who has taken a moment to express concern and send good wishes. It was all very much appreciated, and I apologize to anyone who I failed to respond to individually. I am in much better energy now and have no excuses, so drop me another line if you like.
Well, I have been out of the chemo for a few weeks now. In that time, I have had a couple of tests to gauge the effectiveness of my treatment. Let's run 'em down, shall we?
1) There was a CT scan to check on my lymph nodes. The size of your retroperitoneal lymph nodes after chemotherapy for TC is pretty crucial information, obviously. Nonseminomous testicular cancer (what I have) has a nasty habit of leaving behind a benign mass called teratoma. Teratoma is not itself dangerous but a) it can grow, putting pressure on your organs, and b) it can become cancerous later down the line, creating a recurrence of TC -- and cancer is always much more dangerous the second time around.
Before this CT scan, I had to drink one of those loathsome barium sulfate "smoothies" that coats your stomach a provides better image quality. Fortunately, I had been so fully briefed on how disgusting this stuff would be that the actual taste, while horrible, was miles better than I expected. (In fact, I think it's the mucus-y consistency as much as taste that really grosses people out.)
Anyhow, the scan revealed that my lymph nodes had shrunk significantly from the chemo, returning to their normal sizes. There is one node, however, that is still inflamed to about one centimeter. This poses a bit of a problem, as some oncologists would recommend surgery in my situation (in fact, would recommend it for any residual lymph node swelling whatsoever) while others would advocate surveillance. Dr. Hellerstedt is in the latter camp.
Post-chemotherapy RPLND surgery is a pretty intense and difficult procedure. Only a few surgeons in the country have done more than a handful of these procedures. Frequently, nothing more than scar tissue is found in the affected nodes. Nevertheless, the surgery does offer some peace of mind by (in all likelihood) revealing that there is definitely no active cancer in the nodes and removing any teratoma that is discovered.
On the other hand, it's certainly preferable not to get the surgery if you don't have to. And Dr. H seems confident that I don't have to right now. (The story will change if we see my one lymph node growing in a subsequent CT scan rather than shrinking back.)
I'm torn. I've done my homework, and I know that many TC specialists think the post-chemo RPLND should be done in any case of residual node inflammation for the the slight increase in statistical long-term survival that is possible. However, surgery carries risks, and these must be weighed against the slightly increased risk of recurrence that comes with not doing the surgery.
I hope I'm laying this stuff out clearly. It's pretty late as I write.
Given Dr. H's confidence, I am pretty comfortable in moving forward with surveillance for now. That'll be CT scans and blood tests every three months for the first year, with less frequent tests in subsequent years. If something happens during surveillance that makes us think surgery is necessary, then we will we move forward with that.
Just to put my mind at ease, though, I am going to ask Dr. H to put in a call with Dr. Lawrence Einhorn at Indiana University. Dr. Einhorn literally wrote the book on modern TC treatment and is famously helpful in answering calls to consult with oncologists around the world who are dealing with TC patients. If Dr. Einhorn concurs with our current plan, then I will move forward with surveillance and consider myself unreservedly in remission from testicular cancer. (Hoot, hoot.)
So! Keep your fingers crossed.
Oh yes. There was another test used to check out my lymph nodes.
2) A PET scan. (If you have any interest, click that link, because this scan actually works in a pretty interesting way that involves injection with radioactive material.) This was done to look for any "active cancer" in my inflamed lymph node -- cancer that the chemo just plain failed to kill. This scan is not really super useful for patients in my position; it is known to produce a significant number of false negatives, and it does not reveal the presence of teratoma. However, Dr. H thought we should go ahead with it because a) my insurance agreed to pay for it and b) if it was positive for activity in the node, we would definitely think about doing the surgery rather than surveillance. Fortunately, the scan was negative, as we expected.
OK. That is all for now, cats. I will continue to post as things develop ... and may even start posting about non-cancerous subjects as I return to normal life.
Thank you to everyone who has taken a moment to express concern and send good wishes. It was all very much appreciated, and I apologize to anyone who I failed to respond to individually. I am in much better energy now and have no excuses, so drop me another line if you like.
Thursday, June 26, 2008
George Carlin is Fucking Dead
Obviously, I am behind the curve on this one, but I thought I should throw a nod in the direction of George Carlin's passing, since the guy was a not-insignificant shaper of my thought and attitude back in my teenage years.
My favorite Carlin was the one who strove to knock the human race off its high horse. We're nothing particularly special -- just clever mammals, though not nearly clever enough. Here he is deconstructing one of the (many, many) lazy and false pieties we humans propped together to elevate ourselves over the muck and tide of the universe, the "sanctity of life":
My favorite Carlin was the one who strove to knock the human race off its high horse. We're nothing particularly special -- just clever mammals, though not nearly clever enough. Here he is deconstructing one of the (many, many) lazy and false pieties we humans propped together to elevate ourselves over the muck and tide of the universe, the "sanctity of life":
Wednesday, June 25, 2008
That's All, Folks (Sort Of)
Monday -- I received my final infusion of bleomycin. My final chemo treatment.
Tuesday -- As my hemoglobin was pretty low, I went into the hospital for a blood transfusion. I wasn't thrilled about the idea, but it seems to have paid off -- I am, at least for the moment, feeling like a million bucks, although I suspect the bleo will start to kick me around in the next day or so.
What's next -- Monday, I meet with Dr. Hellerstedt for what I imagine will be a brief assessment/review/discussion of my forthcoming surveillance schedule. Wednesday, July 9th, I have a CT scan, which will (hopefully) confirm that my lymph nodes have shrunk back down to their normal size. If so: I am officially in remission.
I can't even tell you how nice it feels to be done with this shit, and I am just waiting for my stomach to recover so that I can get fucking drunk.
And now, because I want to give back to everyone who has provided kind words/support/food/books/DVDs/etc. during this ordeal, here is a clip from the 2004 film Karate Dog. Yes, that is Jon Voight, formerly promising actor of the '60s and '70s, fighting the CGI karate dog. In 2004, Voight also appeared in Baby Geniuses 2: Super Babies.
Tuesday -- As my hemoglobin was pretty low, I went into the hospital for a blood transfusion. I wasn't thrilled about the idea, but it seems to have paid off -- I am, at least for the moment, feeling like a million bucks, although I suspect the bleo will start to kick me around in the next day or so.
What's next -- Monday, I meet with Dr. Hellerstedt for what I imagine will be a brief assessment/review/discussion of my forthcoming surveillance schedule. Wednesday, July 9th, I have a CT scan, which will (hopefully) confirm that my lymph nodes have shrunk back down to their normal size. If so: I am officially in remission.
I can't even tell you how nice it feels to be done with this shit, and I am just waiting for my stomach to recover so that I can get fucking drunk.
And now, because I want to give back to everyone who has provided kind words/support/food/books/DVDs/etc. during this ordeal, here is a clip from the 2004 film Karate Dog. Yes, that is Jon Voight, formerly promising actor of the '60s and '70s, fighting the CGI karate dog. In 2004, Voight also appeared in Baby Geniuses 2: Super Babies.
Tuesday, June 17, 2008
Bloooooood
Only one infusion left to go, kids, and then the road to recovery.
Yesterday I received my penultimate bleomycin infusion, and now I'm just lazing around waiting for it to whup my ass for a few days. My hemoglobin is down, which means my heart needs to work triple-time to get that good ol' oxygen to all my precious organs and extremities. Generally, I feel all right as long as I don't try to -- you know -- do anything. Moving, walking, picking stuff up -- stuff like that. Carrying a bag to the front door makes me feel like I spent a half-hour on a treadmill.
Don't get me wrong, I am exhilarated to be so close to done. But you have never seen such an exhilarated fellow so thoroughly immobile.
Yesterday I received my penultimate bleomycin infusion, and now I'm just lazing around waiting for it to whup my ass for a few days. My hemoglobin is down, which means my heart needs to work triple-time to get that good ol' oxygen to all my precious organs and extremities. Generally, I feel all right as long as I don't try to -- you know -- do anything. Moving, walking, picking stuff up -- stuff like that. Carrying a bag to the front door makes me feel like I spent a half-hour on a treadmill.
Don't get me wrong, I am exhilarated to be so close to done. But you have never seen such an exhilarated fellow so thoroughly immobile.
Sunday, June 8, 2008
All Hail The Swayz
As though playing Dalton in Roadhouse and Bodhi in Point Break didn't already eternally seal his place in the Badass Hall of Fame, Patrick Swayze has re-established his bona fides by delivering a roundhouse kick to cancer's stupid, ugly face.
Pancreatic cancer is as close to a guaranteed death sentence as you can get, and the fact that The Swayz has not only outlasted it for this long but now has his doctors' permission to get back to work is a huge deal.
I think we could all stand to take some words of wisdom from the man himself:
Be nice.
Until it's time to not be nice.
The Finish Line Comes Into Sight
Well, folks, let me first apologize for how sporadically I have updated this thing. The fact is that my life + chemo = boring, for the most part, and I don't really want to waste anyone's time with posts about how many hours I slept in a given day or how many episodes of Law & Order I watched while nailed to my couch.
This past week was the final week of cycle two, and it contained some of the crappiest days yet. My blood counts went waaay down, so I'd get dizzy while standing up and feel my pulse pounding after climbing a few steps. Not too much fun. But that was only for a few days, and now I am once again feeling something approaching normal.
Which is good news because tomorrow is the first day of my last chemo cycle! Meaning, knock on wood and cross your fingers, I could be three weeks away from getting back to regular life.
Once the chemo is over, I'll be CT-scanned once more to check whether my lymph nodes have shrunk back to their normal size. If they have, then booyah, it means remission and frequent surveillance. If not ... well, unfortunately, I'll have to have them out surgically (which was precisely the thing we were trying to avoid by doing chemo first, but you can't win them all), which is not a disaster, but a surefire pain in the ass.
Three more weeks! Mark it.
This past week was the final week of cycle two, and it contained some of the crappiest days yet. My blood counts went waaay down, so I'd get dizzy while standing up and feel my pulse pounding after climbing a few steps. Not too much fun. But that was only for a few days, and now I am once again feeling something approaching normal.
Which is good news because tomorrow is the first day of my last chemo cycle! Meaning, knock on wood and cross your fingers, I could be three weeks away from getting back to regular life.
Once the chemo is over, I'll be CT-scanned once more to check whether my lymph nodes have shrunk back to their normal size. If they have, then booyah, it means remission and frequent surveillance. If not ... well, unfortunately, I'll have to have them out surgically (which was precisely the thing we were trying to avoid by doing chemo first, but you can't win them all), which is not a disaster, but a surefire pain in the ass.
Three more weeks! Mark it.
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