zupton

I’ve got a brand new treatment plan. I think that it is much better than the single option that I had before, but I am anxious about the future.

Based on my response to the Gemcitabine and Cisplatin; the condition of my liver; and fear about doing a liver resection and whipple at the same time (from both the surgeon and me); my surgeon, my wife and I have agreed on a new treatment plan:

First, I will have Transarterial Chemoembolization on my liver. The hope is that this will further shrink the liver tumors. We’ll do three of these “procedures” over the next three months. I had a set of scans last week that indicated a new lesion on my left lobe. This was the healthy part of my liver…..

Assuming that the TACE works, we’ll take a few weeks off and then do the whipple procedure to remove the disease that is outside my liver. While he’s got me opened up, the surgeon plans to burn my liver tumors with microwave ablation.

Assuming that works, I’ll recover from surgery and then have a few more months of Gem/Cis.

Assuming nothing new and awful crops up, we’ll get ready for liver resection.

I’m not sure what to think about this plan. I’m optimistic, but there are a lot of “assumes” in there. It’s certainly better then flipping a coin with my life (they gave me a 50/50 shot at surviving the other surgery). One day at a time………

So, my first TACE treatment is tomorrow. I’m nervous about the procedure itself and pain and nausea that I’ll have in the 12-24 hours following the procedure. Wish me luck!

-Z

Jane,

There is a post down the line, I think on December 30, 2009 or something like that where I describe my progress. The bottom line is that I’ve been very lucky. The Gemcitabine (Gemzar) and Cisplatin combo have been very effective with my tumors. According to the docs the tumor in my liver is “dramatically” smaller.

Early on, the side effects that I felt with this cocktail were minimal. It was just a couple of days of tough fatigue. I shaved my head preemptively, but it turned out to be unnecessary. I’ve had a full beard the entire time. Now that I’ve had 4 1/2 cycles of this, the side effects are somewhat more pronounced. I’ve had no nausea, but I do have a great deal of bone pain. The docs think that this is a side effect of the Neulasta shots that I give myself after chemo and not the chemo itself, but who knows? The other side effects that I’ve had include increased tumor pain, longer-term fatigue, and some “chemo-brain.” My aunt, a breast cancer survivor, describes chemo-brain as a lot of short term memory loss…..I’m definitely there.

From what I understand, I’m lucky in both my response to the drugs and my overall lack of side effects. Don’t get me wrong, this hasn’t been a picnic for me or my family, but the results have been worthwhile.

Best of luck to you. I don’t know anything about your new treatment but would love to hear about the results.

Keep strong,

-Z

Murray,

Thanks. I was going to take part in a PARP inhibitor study at NIH, but alas I was disqualified because of my long-term and ongoing exposure to another chemotherapy agent, 6-mercaptopurine, for my Crohn’s diseaase.

My liver tumor is poorly differentiated, but all signs point to CC. However, I assume that the surgical result finding cancer in my distal bile duct is pretty definitive.

It’s not a bad idea to contact Mayo while I’m getting this current treatment.

Thanks for all the suggestions. I post this here so others with the Crohn’s/CC combo can be forewarned about 6-MP.

-Z

Julia,

Thanks for the note! I’m glad that I’m already helping…even when I don’t intend to!

I also had a an emotional week. However, a visit to my oncologist today led to one of those “Duh!” moments. I knew that I was getting a bunch of steroids as part of my anti-nausea routine. The connection that I failed to make was that I don’t do well physically or emotionally on steroids…especially when I come off of them. This might explain the fact that I haven’t been able to sleep, that I’ve been short-tempered, and that my emotions are pretty close to the surface!
The docs are going to change the steroid dosage a bit.

I grew up on a farm, riding horses and the resulting turns of phrase work for me!

I forgot about Zorro’s hat. I’ll need one of those black, flat-brimmed hats.

-Z

Thanks to everyone for the kind welcome! It’s nice to feel like I’m not alone.

In answer to Ashley’s question, I don’t know if I have PSC or not. The docs told me that they could do more tests to find out, but that it wouldn’t change anything about how they’d treat the cancer.

We’ll see how this Gem/Cis treatment works. After each of the infusions, I’ve felt better….In the meantime, I’m going back to work on Monday, and am excited to have something else to fill my mind.

My surgeon, in his ever-optimistic tones, has told me to plan for a long life. So, I’m setting my goal on dancing at both of my daughter’s weddings. One of them is 4 years-old and the other is 21 months old! There’s nothing like setting those goals high, right?

-Z