Penultimate Postoperative Poisoning - Playing the Percentages
Welcome to my penultimate poisoning! I'm sitting in the windowless infusion room getting my next-to-last dose of chemotherapy. They're playing Christmas music. It seems like they should be able to poison me OR play Christmas music before Thanksgiving, but not both. First 🦃, then 🎄
This chemo is the same stuff I took back in March and April and it still sucks. 🤢 Today is the hookup day for dose four out of five. I will be disconnected from my last dose in 16 days! 😮 But who's counting? 🙄
The hardest part of post-op chemo is that it's probably not doing anything. I'll explain in bit.
When researchers examine thousands and thousands of patients with rectal cancer, more patients survive longer with postoperative chemo than without. Those extra survivors were the few patients with stray tumor cells that got killed off by the post-op chemo. Because medicine is all about playing the odds, everyone gets post-op chemo.
Most people won't have a metastasis in the narrow window from chemo to surgery. Consequently, the post-op round is only going to be useful for a small number of patients. I bet those extra survivors are appreciative and if you're one of those patients, great! If you aren't, then you're putting yourself through 10 weeks of chemotherapy for nothing.
By the way, there's no way to tell which kind of patient you are.
Just to make things harder, I could walk away from chemo at any time. Disconnect myself, drop off the pump and go back to work in a few weeks. Thanksgiving dinner wouldn't taste like a rusty muffler and I'd be normal 😜 by Christmas. But if a few months or years went by and a new tumor cropped up... I'd never forgive myself.
So I lie here, hooked up to my can of poison and I suck it up. Four down, one to go.
This chemo is the same stuff I took back in March and April and it still sucks. 🤢 Today is the hookup day for dose four out of five. I will be disconnected from my last dose in 16 days! 😮 But who's counting? 🙄
The hardest part of post-op chemo is that it's probably not doing anything. I'll explain in bit.
First, the pathology report from the big surgery in August was good and bad. I had "clean margins" which means that the entire rectal tumor was removed. Also, there was only one tumor in the removed liver lobe. According to the scans and surgeon, my cancer is gone. 👍
The bad news is that despite chemotherapy and radiation, 3 of 43 lymph nodes still had evidence of cancer. Unsurprisingly, the very large primary tumor did not 'completely respond' to radiation and chemo. Lastly, the very small liver tumor shrank, but it didn't have a complete response either. 👎 This means that despite being poisoned and irradiated from March to June, the cancer survived. The tumor cells share my DNA and this means they're stubborn as hell. Just like my daughters. 😆
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| Who you callin' stubborn!? Anna, August 2010 |
No matter how stubborn, any cancer cell can be killed. They're actually quite fragile. Bleach, sunlight, poison, fire, radiation all work. The tricky part is that the tumor is surrounded by fragile, non-tumor cells. Kill off too many of those cells and the person made of them will be in trouble. It turns out humans are quite fragile as well. What's worse, cancer cells can mutate to be tougher than non-tumor cells. When that happens anything that will kill the tumor, will kill the person first.
Wait a minute... if the cancer is out, why the hell am I getting chemo?
Because my team is playing the odds.
The PET scan I had in March confirmed the rectal and liver tumors. It also showed no other tumors in my body. Once I started chemotherapy, any cells which broke off (metastasized) from a tumor would've landed in a poison environment and died. After that came the Eye of the Storm. It's possible, but unlikely, that something metastasized during that stretch or during surgery. That possibility is what we're treating now.
My chemotherapy felt like it was killing me, but it wasn't. Unfortunately, it didn't kill the cancer either. We both got beat up pretty badly, but survived. The problem now is that any remaining cancer cells are the toughest ones. A recurrence would be more resistant and harder to kill. Good thing the scans and surgeon say that all the cancer is out!
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| Stubborn? I don't know what you're talking about. Lydia, August 2017 |
Because my team is playing the odds.
The PET scan I had in March confirmed the rectal and liver tumors. It also showed no other tumors in my body. Once I started chemotherapy, any cells which broke off (metastasized) from a tumor would've landed in a poison environment and died. After that came the Eye of the Storm. It's possible, but unlikely, that something metastasized during that stretch or during surgery. That possibility is what we're treating now.
When researchers examine thousands and thousands of patients with rectal cancer, more patients survive longer with postoperative chemo than without. Those extra survivors were the few patients with stray tumor cells that got killed off by the post-op chemo. Because medicine is all about playing the odds, everyone gets post-op chemo.
 |
| I'm not stubborn and I have no idea what happened to this wall. Ella, October 2014 |
Most people won't have a metastasis in the narrow window from chemo to surgery. Consequently, the post-op round is only going to be useful for a small number of patients. I bet those extra survivors are appreciative and if you're one of those patients, great! If you aren't, then you're putting yourself through 10 weeks of chemotherapy for nothing.
By the way, there's no way to tell which kind of patient you are.
Just to make things harder, I could walk away from chemo at any time. Disconnect myself, drop off the pump and go back to work in a few weeks. Thanksgiving dinner wouldn't taste like a rusty muffler and I'd be normal 😜 by Christmas. But if a few months or years went by and a new tumor cropped up... I'd never forgive myself.
So I lie here, hooked up to my can of poison and I suck it up. Four down, one to go.
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