COLONOSCOPY – POLYP GARDEN

Fresh from the colonoscopy 2 weeks ago, I received results: two polyps… 

Benign adenomas, precancerous, come back in a year… *Sigh*…

It was disappointing learning of the polyps since it has been only one year since the last colonoscopy and my results were clean then, so I was hoping for a repeat of that. But instead two tiny polyps still sounded alright, I could live with that. They would be biopsied and results would arrive in a few days. So my results today showed the polyps were “benign adenomas”, or precancerous polyps. That is not good, and what the heck does “precancerous polyp” mean anyway?

Polyp Phases

Phases of a polyp

polyp-phases-2

I’m guessing mine was at “severe dysplasia” stage, as it was benign, yet still precancerous.

 

 

 

 

 

 

Everything I’ve read about adenomas is that it will take between 2-10 years for one to develop into cancer. For a polyp to form and become precancerous within one year tells me that my polyps were under unusual conditions to become precancerous so early. This year has been unusually stressful, and unfortunately I have an unusually poor way of handling stress, ie. I hold it in. I convince myself it could be worse, I can handle it. This explains my “polyp garden” colon and why my resistance to growing these little guys is so low. This also explains why for survivors of colon cancer we have to stay on top of our maintenance exams (scans, colonoscopies, blood tests). I need to stay on top of my tests, I need to manage stress better. I’ve been doing the former exceedingly well, yet there’s more progress to be done on the latter.

In May 2016 my oncologist noted on my CT scan results a spot in my liver that he wanted to watch, and told me to have another scan done in three months. No worries, I thought, it’s too soon after chemo treatments, it must be something else. I did not worry. During the summer we started a new business, had Matt’s daughter and her fiancé move in with us, we had a series of financial difficulties and some personal issues come up all at once. I began losing sleep and obsessing over order in my house, an effort to keep some sort of control over a huge period of change. I (all of us) began feeling overwhelmed and out of control. We all worked from the moment we woke to bedtime every day for months straight with no breaks just to keep ahead of bills. I was on top of everything, I felt I was handling it, but was exhausted all the time. It was a miserable, stressful time for me and my family, and I began to worry about my health. I’d had a tickle in my chest for months. Thinking back about what my oncologist said about the spot in my liver, I could not let go of the fear that cancer had come back and settled in my lungs and my liver. I had no money to get the follow-up scan, and decided it would not hurt to put it off for a month or two until we could figure out our finances.

The fear overwhelmed me and I believed I was sick again. I worried for Matt, my parents, my friends, I dreaded telling them I was going to die. I worried about going through all of the diagnosis, treatments, months of uncertainty and sickness again. If this disease could come back so quickly twice, it must want me; I must be doomed. Things got extremely desperate and I could not shake the fear of not knowing. So I scheduled the scan and results came back clear.

I celebrated the good news, as did everyone around me. I had not made my concerns public, but my family knew. And yet the fear came back. The tickle in my lungs was still there, and I began to wonder how much of my chest the CT scan covered? I had not had a blood test in a while, and realized it was time. I was only a week or so off my schedule, so I scheduled the blood test and met with my oncologist. The blood test came back clear, the oncologist hypothesized that the tickle was coming from a new allergy. Again I felt better, but there was still an insecurity in my mind. No spots in my liver, no sign of disease in my blood,… the colonoscopy should turn out healthy too, right? With all the stress over the summer, what would it take for the cancer to come back? Where would it? After the first occurrence of cancer in 2012, it was only 2 1/2 years until the second occurrence in 2014. It has been about that long again, and I was inconsolably worried.

The colon prep this time around was miserable because I had a cold, too. Ugh… no fun. Coming off of the anesthetic the first thing the GI said to me was he found two small polyps. He did not think they would be problematic, but they would be biopsied all the same. The fact that the results came back precancerous is a red flag that I am not doing enough to manage stress.

The moral of the story is, I’m glad that I am being so closely monitored, that I have great health insurance (thank you Obamacare), I’m glad that at this stage the polyps could be removed with no incident. I am safe again, for now, thank goodness. I will continue practicing stress management, continue getting enough rest, exercise, good nutrition, laughter, and

I will continue with my maintenance exams.

polyp_colonoscopy

How polyps are removed, a retractable wire loop severs the neck of the polyp.

polyp_colonoscopy

Little bastard

CHEMO – FINAL ROUND 12 OF 12

Monday began the final round of chemo. That makes 12 in all! Whew! Remarkable!

champagne_toast

Monday morning I went in to meet with my oncologist, Dr. Look, get bloodwork, take vitals, chemo infusion and IV fluids, like usual. The primary thing I wanted to know, a conundrum we had discussed last meeting, was what the partners said about my case. Dr. Look was confident that my case was unique because of how well the cancer responded to the treatments and surgery. He felt I may not need to go through a maintenance chemo regimen, which would have gone on indefinitely, same routine with fewer chemical ingredients.

To review:

  • My cancer tumor markers (aka Carcinoembryonoic Antogen or CEA for short) came down to normal range before my surgery in early January (hallelujah!)
  • The surgery was a neat success with clear margins (no cancer cells found in the margin of tissue removed along with the tumors)
  • I went through 6 more rounds of chemo post-surgery after I was declared NED (no evidence of disease)

I should be pretty squeaky clean. Therefore there is no baseline disease to monitor new cancer activity, and Dr. Look felt it would be of no benefit and possibly cause more discomfort and harm than good. The partners at Compass Oncology agreed. THAT, dear readers, is the best news all year.

Coming up, I will have a baseline CT scan in three weeks to compare with subsequent scans in the coming years. I will have bloodwork done quarterly, colonoscopies done annually and scans probably annually or maybe 6 months.

So with caution, I will be celebrating in the coming weeks as this final round wears off. I’m not much on celebrating my own achievements. Although I like the idea, I always feel that things could change at any time, so I feel better mushing my celebrations in with other celebrations happening around the same time, ie. holidays, birthdays, housewarming parties… just not my own celebration – I prefer just hitting the hiking trails, the kayaking, making art, just playing for a while. What to do without all those pesky doctor appointments all the time!

Although I was already drinking tiny amounts of wine between treatments (hey, when in Rome, right? And I’m always in proverbial Rome with my family), I felt that a glass would be helpful mentally and do little harm in my already struggling liver. After about a week of no alcohol, I do moderately miss it. But I have to say, I have some simple virgin drinks which I drink at night that I do love. Recipes may be shared! And from my lovely friend Bettina, now in Dusseldorf Germany, mailed some lovely, refreshing tea mixes that I binge on daily. Don’t ask what’s in them unless you want a photograph of the label, because it’s all in German.

The Tempest is over, the laundry list of complaints left over are all annoying ones. Drippy nose; bloody mucous; mild sinus congestion; unpredictable, urgent, frequent bowel movements; constipation (all chemo-driven); shingles are still numb, but only scars now; neuropathy in the souls of my feet; dry skin. What else? It all blends together, but I’m still functional!

I feel I’ve been pretty blessed in spite of this cancer event. I keep telling people that I aught to be sicker than I am, but I’ve had such good complementary care from my naturopathic doctor team, my medical doctors have been so on the ball in my case, I’ve been able to do most anything that I want, with exception of some side effect discomfort, fatigue and so on, I feel pretty energetic most of the time. Life for Matt and I has been on a good track, and we are very happy with what we have and who we hang out with! Can you believe all this can happen in the face of a devastating disease? I absolutely cannot, yet here we are. We are very grateful for the benefits life has for us right now. And I am so truly thankful for my family and friendships and all the love I feel from around the world! Even making new friends and reacquainting with old friends who are going through similar trials as me has given me new resolve to get through my own.

I cannot ask for more after this final round 12, except for a permanent state of NED!

HAPPY NEW YEAR UPDATE

Hello All!

I haven’t updated publicly on where I am in the cancer treatments in a really long time. Sorry. I’ve been avoiding the FB rabbit hole while maniacally getting Hollarday preparations done. Tee hee.

Trust me, although I’ve had the month off from chemo, I’m still dealing with some medical stuff, nothing serious, just some discomforts and inconveniences!

By all accounts (family, friends, doctors) I am doing really well. I feel well; exercising, healthy appetite, seeing friends and celebrating *most* holiday events. Woohoo!

Right now I’m looking at surgery preps given by my complementary care oncologist – 4 pages of diets, supplements, etc, before and after surgery. Whoa… well it’s all good for me at least! Starting to think about what I will need after surgery.

The surgery is scheduled for Jan 8. No anxiety yet (that should come a day or two prior). Actually, it’s all going according to my plan, so I am very comfortable as things are. Wednesday, the 7th I sit down with the surgeon and finalize things. That’s it! It’s up to him after that! No pressure, Dr. Billngsley!

I’m expecting the very finest surgical work and exemplary follow-up care! I am doing my best, after all.

happy new year

Happy New Year and Ald Lang Syne

POUR SOME CHEMO ON ME*

*Just a little ‘80’s metal mood. 

First of all, let me tell ya –

Don't get sick in the Fall

Don’t get sick in the Fall

Don’t get sick in the Fall. Everyone you need help from is on vacation then. Just FYI.

Gawd. It’s taken way too long since the diagnosis of the cancer recurrence (Aug 25th-ish) to get a surgeon chosen, get an oncologist and to get started on the treatments. Although I was waiting a whole two weeks for appointments with the oncologists I wanted to meet due to lengthy September vacations (and who can blame them?), luck happened and late last Friday afternoon Dr. Look (my original Portland onc) called to make sure I am getting my needs met. Turns out that HE is NOT on vacation and IS available to start my treatments after an appointment the following Monday.

So today I met Dr. Look for the outlay. He says chemo will be the same treatment no matter which oncologist I opt for. He is also open to collaborating with a complimentary care physician (naturopath).

Regimen:

The combination therapy he described is 3-4 different drugs, Oxaliplatin, 5FU pump, Leucovorin, and I think FOLFOX, too. To infuse all of these, they will install a port, a small device set underneath the skin on my upper chest with a catheter that connects to a vein where all intravenous chemicals/fluids can go in and blood samples can be drawn as needed. I will wear a pump for two days after each infusion (talk about a ball-and-chain), then have it removed for the remainder of the two week cycles. At about 2 months, I take a break from the infusions, and have the surgery, then resume chemo after a healing period. The remaining duration of the infusions will be determined by results from CT scans.

Side Effects:

The first treatment is likely to be the worst, and the first few days, especially, for nausea, neuropathy (tingling and cold sensitivity in extremities, mouth), some hair loss (but not necessarily all of it), diarrhea, anemia, other unpleasantness.

When will I begin:

This Wednesday they will install the port at the hospital, I will go home the same day. Wednesday night I take a class on chemotherapy (!!) – and it’s 2 hours! Ugh, I hope they make it fun, especially since it’s the same day I have the port surgery. Then the very next morning, Thursday, I get a pump hooked up and the first of the infusions at the oncology clinic. Saturday I will have it removed for the remaining two weeks until the next infusion.

I am working out a meeting with the complimentary care physician now, and will post an update on that soon.

So, here goes!get-the-ball-rolling

I KICKED CANCER’S ASS

Kicking cancer’s ass

Wow, I’m still swimming in glee after the visit with my medical oncologist, Dr. Fischer! The news that my cancer is in remission, and there is no statistical benefit to follow-up with chemo, leaves Matt & I emotional and ecstatic!

Whew! That was big news. Matt & I both expected the doctor to say, “Here are your statistics for survival. Now you get to choose whether or not to go ahead with more chemo!”. I wasn’t looking forward to that decision, and we were both feeling a little anxious about this meeting. In spite of the potential life-saving benefits, the possible medication side effects of sickness, hair loss, neuropathy (numbing and tingling) by months of harsh medications.

My case was relatively clear cut.

The tumor was a standard stage II adenocarcinoma. The radio-chemo treatments successfully shrank the tumor, and Dr. Childs skillfully removed it and surrounding lymph nodes. The pathology tests were very extensive, and all came back in the low-risk category. The most important tests for my layman’s knowledge are:

Depth of Invasion – referring to how far the tumor grew through the rectal wall. Mine penetrated only the innermost layer, but did not emerge on the outside of the wall where blood vessels and lymph nodes are likely to pick up and spread it to other organs.

Lymph nodes – 21 of my nodes were removed and tested (standard removal is approximately 12 nodes), and all tested negative for cancerous cells.

The doctor also said, testing revealed that this was not a hereditary condition, known as Lynch Syndrome, that it was a freak occurrence… Not so comforting to me because there is still a question mark in my mind about what the heck started the tumor. I already thought I was doing the right things. But I guess I’ve got the rest of my LIFE to ponder that!
So I am proceeding with the planned course of surgery coming up in a few weeks (July 11), plus follow-up quarterly blood tests for the first year, every 5-6 months for years 2-3, then once per year through year 5. If, by year 5, test results consistently come back normal, then cancer recurrence is unlikely.

Wooooo! Matt & I did good!

And I must not forget to credit you, my friends, for the support, prayers and chants sent my way since the diagnosis. I believe a network of community support is the framework for successful recovery. Take care of yourselves and doing the right things for your own cancer prevention. Then we can all grow old together and party till we drop!

Now for the final recovery and the financial landslide… Right now I have a horrendously high out-of-pocket fee to pay plus extras insurance doesn’t cover. My days are filled with long hours of paperwork and research on financial assistance for patients. Wish me luck!

Thanks again for helping me kick cancer’s ass, and for your powerful, strong-arm prayers! They worked!

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