One More Hurdle To Jump Over

Hi there, been too long since my last update, and there's been a few developments within the last couple days.  Long post incoming!

On Monday I had my CT scan at SCCA.  I had gone into the office to meet with Dr. Back to get the results, and when the nurse printed out the report of the scan, I had caught a glimpse of a fairly technical report that mentioned that the tumors had increased, but didn't want to say anything until hearing it from Dr. Back.  He then had the nurse come back into the room telling me that he's printing something out that I will be interested in, another indicator that there was news.

When Dr. Back entered, he mentioned there was something to discuss.  He stated that the CT scan wasn't as clean as we had hoped, and the tumors on the lungs have grown (still less than 1cm in size).  Also, my previous CT scan in March showed that there were no spots on the liver, but now there were some in the area that I had my ablation/surgery, that are now up to 1.5cm in size.  It was also mentioned that typically I won't feel any side effects from the tumors until they are 10x the current size, so we're still a ways away from any symptoms.

This means that the current treatment plan of Xeloda and Avastin have run their course, and it's time to try something else.  Dr. Back's strategy is to go back on irinotecan, a chemo that I took last year as part of my first line chemo, and add in Cetuximab, a chemo that I haven't taken yet.  The side effects of these two will be more intense than what I was taking the last few months, with a new possibility for a skin rash thanks to the Cetuximab, which hopefully won't show on my face.  Also, the irinotecan will likely cause hair loss again, so my luscious locks may be thinning once again.

Additionally, Dr. Back wanted me to enroll into a clinical trial performed at UW that uses a drug, Vemurafenib, that has been FDA approved for melanoma (skin cancer), and has been proven to attack a specific mutation of the b-RAF gene, which may be found in some colon cancer patients.  UW will biopsy the liver sample removed during my surgery last September to determine whether I have this specific mutation in the b-RAF gene, and if so, will put me in the pool of possible individuals to go on the trial (because it's randomized).  The assumed numbers of individuals getting into the trial are about 80 out of 440 individuals that get screened, so we'll see what happens.  The flip-side to this is that I read that individuals who have this specific mutation typically have a poor response to most other chemo drugs, so I'm mixed on whether I want the results to be positive for the mutation or not.  If I don't get on this trial, there's another trial Dr. Back wants me to get on that uses radiation beads that will be implanted in my liver to attack those cells.  This strategy of an overall approach to attacking the cancer is preferred prior to begin discussions on a follow-up liver surgery, which may be required within the near term.

Lastly, I have been feeling a scratch in my throat the last few months that doesn't seem to be going away and seems to be getting worse.  I mentioned this to Dr. Back, and he said I will have an upper endoscopy to look at my throat for abnormalities.  This is a procedure were they sedate me, and use a thin tube to look down my throat.  Either way it would be nice to have this closure on this, and if there is something there, I'd prefer to get at it early. All of this seems to overshadow my clean colonoscopy a few weeks ago, but I'm glad that the polyp found and removed was non-cancerous.

While the future is uncertain regarding the associated side effects of going back on this stronger chemo, I have informed my work, and as always they have shown nothing but support which makes all this much more tolerable, and one less thing to worry about.  I plan on continuing to work as long as possible, and will take it easy if I find that the side effects are a bit much, but again my manager and team have been nothing short of great.

Despite this, I remain upbeat, not worrying about what I can't control, and playing the cards I'm dealt with as best as possible.  I hope to start this new regime sooner rather than later, and hopefully start my infusions next week.  We were in Hawaii last week and had a wonderful time, and I'm glad we were able to enjoy that to this hurdle.  

As always, I'm thankful to have access to the best doctors, the best medicine, a great supportive workplace and have wonderful family and friends.  Thanks for reading, and as soon as I learn more I'll share it here, and I hope you enjoy the beautiful summer weather!