I met with the Johns Hopkins oncologist on Friday, in Baltimore. He agreed with the
treatment plan posited by our local oncologist, saying that it presented the best option at this point. As he explained, when one has stage IV cancer (labeled so because it has spread outside of the initial tumor region - in this case, in several lymph nodes for me), it's not common to aggressively pursue chemo treatments at the level they're suggesting for me; it becomes more of a monitor and make comfortable. But...since I am "younger" (most of his patients are 70+) and don't have other physical/medical battles (like heart and/or lung issues), and because the cancer has not metastasized into any bones or organs, he felt that this was a good way to go: chemo, plus immunotherapy.
It's interesting that cancer apparently has a way of masking itself from the body so that the immune system cannot attack it. Immunotherapy takes away that "cloaking," so that the body's own immune system can also fight back against the invading cancer. The chemo drugs this time around will be different than what I had the first time. The first time around they were intended to work with the radiation, to make that more effective. This time, there will be no radiation and these chemo drugs bring a slew of potential new side effects with them. I have no idea how they're going to make me feel, or how effective they'll be. We'll have to wait 2-3 months until they do another scan to see the impact/effect. But at the same time, Jess and I don't want me going through this, suffering, if it's really a moot point. We were quite direct with the doctors and they were equally forthright. This offers the best opportunity right now to 1) reduce the cancer 2) make sure it does not spread and 3) prolong my life.
I know I've talked a lot about surgery, and how I'm not a surgical candidate (and very likely never will be), but in hearing more, and learning more, about the surgery, I'm not so sure that would be ideal anyway. Besides the fact that it's dangerous, and the recovery is long and painful, the quality of life afterwards is also drastically changed. Think about it - they remove the majority of your esophagus and pull your stomach up to connect. They rearrange your whole insides and your digestive system is now completely different as far as what kinds of foods you can eat, how much, when, etc. But even more surprising is the fact that in about 50% of patients who have this surgery, the cancer comes back any way; either in the same spot, or in another organ. So, you go through this mega surgery and for what?
Treatments should begin soon. The oncologist called yesterday to get things rolling on that front. I believe he said that it'll be every three weeks. In the meantime, I'm trying to handle and deal with the many ways in which my body struggles with the cancer: eating, keeping things down, aches and pain, soreness, weakness, constantly being uncomfortable, warm then cold then warm, tiredness. And mentally I'm trying to understand the reality of my situation, to really wrap my noggin around it. How long do I have? And what is that life going to look like? That's pretty damned sobering. You have all these plans, these ideas and designs, and then you're turned upside down and shaken like a snow globe. That life you thought you were going to have? No....this is your new direction. And somewhere up ahead, the bridge is out.
That's not me giving up, or not being positive. That's me being honest with myself, and the situation. One can be both honest and remain positive. Well, that's all I have for now. Thanks for tuning in and checking in and, as always, for your support, friendship, thoughts, energy, universal vibes and heavenly petitions. I appreciate you.
- j