Friday, 3 October 2014

An interim update

When Katie and I met my oncologist yesterday we were expecting to get the results from my latest CT scans, unfortunately the consultant radiologist has not yet written the scan reports so we'll have to wait a few more days. We've only experienced delays like this once before but given how vital scan results are to people in my situation I do think this is twice too often.
In the absence of an expert radiological opinion my oncologist has taken a look at the scans and feels that they show the cancer progressing. This view is consistent with both the symptoms that I've been experiencing and with a decline in my liver function that  my recent blood tests indicate. Assuming my oncologist's interpretation of the scans is confirmed I will have to move to a new treatment.
We've agreed that the treatment most likely to benefit me is a course of chemotherapy using the combination of drugs gemcitabine and docetaxel. This would be a repeat of the first chemotherapy regime I had following my diagnosis back in April 2011. The drugs caused the cancer to shrink slightly and then halted any growth for several months. I only had six cycles before switching to another drug and there was no indication that my cancer had begun to develop immunity to gemcitabine/docetaxel during the short time I was using it. This gives us hope that the treatment will shrink or stop the growth of the disease for a while.   
Unfortunately gemcitabine/docetaxel is the chemotherapy regime that has caused me the most problematic side effects. I had extensive fluid retention that got progressively worse with each cycle and I was reduced to spending most of my time sitting with my feet up on the sofa. For those who have never experienced it, fluid retention may sound like an inconvenience rather than a serious problem, however it can be very uncomfortable and if the fluid is retained around the chest it can contribute to heart failure. I've already had some issues with heart failure back in 2013 so I may be prone to it. In addition to fluid retention I also had a wide range of additional side effects including reductions in the strength of my immune system, constipation, nausea, muscle weakness and flu like symptoms. Not surprisingly I'm finding the prospect of this treatment  rather grim and am currently looking hard to find some enthusiasm for progressing with it!  
We haven't taken any definite decisions at this stage as we need the radiology reports and my oncologist also has to confirm that my liver function is within the parameters permitted for receiving these drugs. We should have this information and a confirmed way ahead next week and I'll post a further update then.
I'll end with some colour, I photographed these flowers in the wild flower field at Hartley Farm in Winsley, near Bath (click or double click for larger versions).


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