A visit to the Onc

Yes.. it was that time of the year again to stop in and see my Oncologist. See what is up, and how things are going.



Yea the good news is that my blood work is excellent. Gotta get a copy of my recent CT scan over to him, and then following that, I can make arrangements to have the port removed from my chest. Hmm.. Maybe before New Years? That will be another step towards putting this all behind me and moving on. I am lucky in a way. a lot of people complain about their port, that it hurts and it gets in the way of their every-day life. Imagine when you go driving, wearing a seat belt, and how it can cause discomfort. My Port doesn't hurt, itch or anything. I often forget that I even have it.

OK....

My Doctor and I then discussed diet etc. He tells me that I need to cut back on the alcohol. Not that I drink a lot. As a matter of fact, I am always watching what I drink. but the fact is that since I was feeling soo good lately, I have allowed myself an extra drink here and there. Nope. Gotta keep it to four drinks a week, or if I go out only one night a week, then no more than three drinks. My solution to that is to switch from beer to wine. I can seriously sip on a glass of red wine for a long long time, and frankly I don't need to drink when I go out, but it is out of habit to down a beer when I am in a bar.. nope, now I will sip on a wine.

Next, I was told that I could have red meat twice a week. hmm. I have kept red meat to a minimum - like once every six weeks. Well, my doc told me that it really depends on the cut of meat. Not some fast-food hamburger.. but a nice, well prepared steak, with no char on it, is good and necessary otherwise I might develop a dietary deficiency. Well. We will see about this. Maybe once a month or so. I plan to enjoy some steak this holiday season.

In general, as the saying goes, everything in moderation, including moderation.

The good news is that I might have that port out before New Years. (no pun intended) So stay tuned and maybe I will have some really wild photos to show you when that procedure goes down....

How Eating Red Meat Can Spur Cancer Progression

University of California - San Diego. "How Eating Red Meat Can Spur Cancer Progression: New Mechanism Identified." ScienceDaily 14 November 2008. 17 November 2008 . full article here

ScienceDaily (Nov. 14, 2008) — Researchers at the University of California, San Diego School of Medicine, led by Ajit Varki, M.D., have shown a new mechanism for how human consumption of red meat and milk products could contribute to the increased risk of cancerous tumors.

Their findings, which suggest that inflammation resulting from a molecule introduced through consumption of these foods could promote tumor growth, are published online this week in advance of print publication in the Proceedings of the National Academy of Sciences (PNAS).

Varki, UC San Diego School of Medicine distinguished professor of medicine and cellular and molecular medicine, and co-director of the UCSD Glycobiology Research and Training Center, and colleagues studied a non-human cellular molecule called N-glycolylneuraminic acid (Neu5Gc). Neu5Gc is a type of glycan, or sugar molecule, that humans don't naturally produce, but that can be incorporated into human tissues as a result of eating red meat. The body then develops anti-Neu5Gc antibodies – an immune response that could potentially lead to chronic inflammation, as first suggested in a 2003 PNAS paper by Varki.

"We've shown that tumor tissues contain much more Neu5Gc than is usually found in normal human tissues," said Varki. "We therefore surmised that Neu5Gc must somehow benefit tumors."

It has been recognized by scientists for some time that chronic inflammation can actually stimulate cancer, Varki explained. So the researchers wondered if this was why tumors containing the non-human molecule grew even in the presence of Neu5Gc antibodies.

"The paradox of Neu5Gc accumulating in human tumors in the face of circulating antibodies suggested that a low-grade, chronic inflammation actually facilitated the tumor growth, so we set out to study that hypothesis," said co-author Nissi M.Varki, M.D., UCSD professor of pathology.

Using specially bred mouse models that lacked the Neu5Gc molecule – mimicking humans before the molecule is absorbed into the body through ingesting red meat – the researchers induced tumors containing Neu5Gc, and then administered anti-Neu5Gc antibodies to half of the mice. In mice that were given antibodies inflammation was induced, and the tumors grew faster. In the control mice that were not treated with antibodies, the tumors were less aggressive

Others have previously shown that humans who take non-steroidal anti-inflammatory drugs (commonly known as NSAIDs) have a reduced risk of cancer. Therefore, the mice with cancerous tumors facilitated by anti-Neu5Gc antibodies were treated with an NSAID. In these animals, the anti-inflammatory treatment blocked the effect of the Neu5Gc antibodies and the tumors were reduced in size.

"Taken together, our data indicate that chronic inflammation results from interaction of Neu5Gc accumulated in our bodies from eating red meat with the antibodies that circulate as an immune response to this non-human molecule – and this may contribute to cancer risk," said Varki.

Additional contributors to the paper are Maria Hedlund and Vered Padler-Karavani, UCSD Departments of Medicine and Cellular and Molecular Medicine. The study was funded in part by a grant from the National Cancer Institute, of the National Institutes of Health.

Click here for a discussion on this.....
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=5234

Images of my insides..

In light of my recent CT scan and the results coming back totally clean (Whoo hoo!), I thought you might like to see some of the images.. Sort of a celebration I suppose - this is what a clean bill of health looks like. I requested a copy of the CT scan from the hospital and they gave it to me on a CD. It is a good idea to have this and keep it in a safe place. Every doctor that I see, or will see in the future, gets a copy of these.




Different cross-section views of my abdomen using two different scanning techniques (I think, because one looks more sharp than the other) You can see my spine and back muscles on the bottom, then the ribcage on top. A view of various organs all in the middle. The top photo is roughly hip-height and shows some of the pelvic bone in white. The second photo is a cross-section from higher up, near the belly button.



(I deleted some of the personal information from these, like account number and name, etc. I looked through tons of these pictures, which are slices through my body from different angles. The ones I posted here just looked like they showed the most "stuff" but I really don't know what to look for. I leave that up to the doctors.





They say there are surgical clips in me where the reconnection is, but I don't know what to look for. I think that would be cool to see. I was also trying to see how my large intestine is now positioned differently because I no longer have the sigmoid portion of it. What am I looking at? Tell me what you see.

Aftermath: Well now, the CT scan is done and the next one wont occur for another two years provided my bloodwork continues to be normal. I see my Oncologist at the beginning of December and if all goes well, we will make arrangements to have the port in my chest removed. Stay tuned for more...

My CT scan results - you can call me Mr. Clean

Hello,

It has been over a year since my surgery, so it was time for a CT scan of my chest, abdomen, and pelvis. The short story is that there was no evidence of disease found and the scans came back totally clean. I am very happy about that however it doesn't mean I can relax my focus on my health. Absolutely not. Statistically 80% of recurrences happen in the first two years, so I have at least another year to go before I want to even think about easing up. I still need to be very vigelent with my health. More on this in the next post... but first here are some highlights of the scan:

(I will be adding some interesting pics of the scan shortly.)

All of my organs appear unremarkable, meaning there is nothing odd about them. One interesting thing is that there are surgical clips still inside of me, which I guess will be there for the rest of my life, where the large intestine was reconnected.

My Oncologist tells me that I will not need another CT scan for two years - provided my blood tests continue to remain stable. Furthermore if my blood test remains excellent three months from now, I can start making arrangements to get the port in my chest removed.

I should say that I don't even feel the thing and I am not in any hurry to get it removed, but it will be good if the time is right- Just another step in the process of healing, recovering, and moving on with my life...

With that plan on the horizon, I met with a plastic surgeon to discuss what my scars will look like and what he can do to minimize them. I will research this further, but at the time that I have the port removed, I might have him step in to close up the wound. He told me that the skin where the port was located is fatigued because a foreign body was under it for so long, the skin has been stretched, and in general the scar wont look great without plastic surgery, a procedure referred to as "scar revision." The plastic surgeon may also revise the scar that is located on my lower abdomen, although he told me that he already considered it a darn good scar. The problem that I have with that scar is, as he explained it, the skin has been attached to the abdomen wall and there is no layer of fat right beneath it (compared to normally). Therefore when I sit or bend a certain way, it looks like it is dented or creased -and to me it doesn't look so attractive. Since I am single, I might want to do something about it. He would go in and separate the skin from the muscle wall and use a technique to restore the layer of fatty tissue that is normally sandwiched in there, then sew up the skin using plastic surgery stitches so that the scar would be quite minimized, and the appearance restored- not 100% but much better. This is all a personal choice and is not medically necessary, so I dont know if, when the time comes, I will actually do this... The ballpark out-of-pocket cost is about $1500.00.

What else? Well summer is definitely coming to a close here. It sure went fast. I am not looking forward to winter at all. Instead of biking I will be switching to swimming laps indoors for exercise, along with continuing to lift weights, yoga, and I am actually trying to find some other things to do. Typically winter is a time where I dont exercise as much I need to. I don't belong to a gym, but I may have to look around and see what is out there. Any suggestions? My finances still need healing from all of this too.

Avoid Stress - Avoid Cancer

Photo by Eric VanDyke.

"Don't get stuck in spider webs."

"Stress may raise breast cancer risk in young women"

http://news.yahoo.com/s/nm/20080828/hl_nm/breast_cancer_dc

By Anne HardingThu Aug 28, 3:20 PM ET

Young women who experience more than one stressful life event are at greater risk of developing breast cancer, but a general feeling of happiness and optimism may help guard against the disease, Israeli researchers report.

The findings shouldn't be interpreted to mean that optimism is all you need to prevent breast cancer, Dr. Ronit Peled of Ben-Gurion University of the Negev in Beer Sheva, study's lead author, told Reuters Health. The best way to protect oneself against the disease is still to eat well, be physically active, and follow screening recommendations, she said in an interview.

Peled and her team investigated the role of severe life events, such as losing a parent before age 20, in breast cancer risk. The breast cancer incidence in Israeli women is among the highest in the world, while stress is also a fact of life for people living in the country, Peled noted.

She and her colleagues recruited 255 women between 25 and 45 years old who had been diagnosed with breast cancer and 367 women of the same age who were free from the disease. They asked the women whether they had experienced any severe life events, such as loss of a spouse or a close relative, as well as events considered to be mild or moderately stressful, such as severe illness, job loss, or separation from a spouse. Women also completed a 15-item questionnaire to evaluate their levels of anxiety, depression and happiness and optimism.

Women who had experienced two or more severe or mild-to-moderate life event were 62 percent more likely to have breast cancer, the researchers found. "This suggests that stressful events do not protect us from the effect of additional events, and even 'moderate or mild events' seem to have a cumulative effect," Peled and her team write in the medical journal BMC Cancer.

Women with breast cancer were statistically more likely to have higher scores for depression and lower score for happiness and optimism.

However, they also found that women with a "general feeling of happiness and optimism" had a 25 percent lower risk of having been diagnosed with breast cancer.

The fact that women with breast cancer were asked about their mood pre-diagnosis but surveyed after they had been diagnosed is one limitation to the study, Peled conceded. However, she added, the number of life events a person experiences can be measured objectively.

Based on these findings, she concludes that "women who suffer severe losses in their young age should be considered as a (breast cancer) risk group and be treated accordingly."

SOURCE: BMC Cancer, August 21, 2008.

Ok so this is not directly related to Colon Cancer, probably because the relationship between colon cancer and stress has not been studied fully yet. Science has a way of moving very slowly. However my money is on the notion that stress can have an impact on a person's health in many different ways, including various cancers.

Reading this just reminded me of how important it is to protect myself from undue stress, and be in a peaceful environment where I can work on my self and focus on my health. Although it has been 7 months since I finished chemo, the battle isn't over.

Avoid Nitrates in foods

Just a quick reminder - avoid foods with Nitrates. Your body will thank you:

http://www.thecancerblog.com/2006/06/26/avoid-nitrates-in-foods-when-possible/

1-year NED - July 12th

Yay!

Last night at the stroke of midnight, I was at Improv Olympic, an almost weekly hangout of mine for the last ten years. I participated on stage in the JAM, which is a series of improv games similar to Who's Line is it Anyway. Had a blast, and as I exited, I saw some lightning and felt the cool breeze of a rain storm brewing - which a summer rain is another thing I enjoy too, and drove home listening to Reggae on the radio.

Then this morning I awoke to learn that Tony Snow has died. Tony Snow was the White House Press Secretary who was diagnosed with Colon Cancer a few years ago. Stage III also, and last year had a recurrence in his liver. Information is still not available detailing exactly the most recent events.

Well without sounding too selfish, that kinda puts a damper on my celebration, or changes it a little. Or maybe I should be feeling even more lucky at this very moment.

The shock of this news hasn't truly set in yet, but I suppose it means that being 1-year NED isnt a reason to let my guard down, and I must continue eating and living healthy, exercising religiously, and striving to accomplish everything that I want out of life. It is also a reminder that any way you look at it, time is short. Whether I live to be the ripe old age of 100, that isnt too far off from now, and there are a lot of things on my list of things to do.

I have been mapping out two different plans. Rest assured that both of them involve me making and performing music. However, each one takes a different approach. There will be more on this soon.

Right now I have a full day planned for myself. I will be attending a Relay for Life event but I dont know if it will get rained out or not. This is my first exposure to a Cancer fund raiser and I hope to talk with some people and share some ideas.

Well,

I leg pressed 360 lbs today; not bad if I say so myself. When I saw my surgeon last week, he said I could do whatever I want now. Im glad I took it easy, pacing myself getting back into lifting. Being cautious, letting things heal, etc.

So anyhow, now I plan to start swimming laps again too. Once I get to the point that I am biking 36 miles a week (which Im already doing now), swimming 2 miles a week, and lifting once or twice a week, I will be back where I was two years ago. However healthy that sounds, according to the Doctor's timetables, I already had developed the tumor in me. Actually they say it could have been five to ten years in the making.

Some Colon Cancer Patients do not need Chemo

Read this article

http://www.medicinenet.com/script/main/art.asp?articlekey=89574


Not All Colon Cancer Patients Need Chemotherapy: Study
By Amanda Gardner
HealthDay Reporter

FRIDAY, May 16 (HealthDay News) — Colon cancer patients with a specific subset of the disease don't need to receive chemotherapy. In fact, not only does chemotherapy not benefit this group of patients, it may actually harm them, a new study found.
Latest Cancer News

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* Want More News? Sign Up for MedicineNet Newsletters!

"If you are found to have [this type of colon cancer], then you should not be treated with chemotherapy. Surgery alone would be standard treatment," said Daniel Sargent, lead author of the study and a professor of biostatistics at the Mayo Clinic in Rochester, Minn.

"In our data, patients who have [this type of cancer] who had surgery alone had a 93 percent survival at five years. In our study, chemotherapy actually lowered survival to 75 percent. So, we have a group of patients who can be spared the toxicity, the expense and the inconvenience of treatment and have a very good outcome even without any [chemotherapy] treatment," Sargent said.

The findings, presented Thursday at the American Society of Clinical Oncology annual meeting, in Chicago, confirm previous research and now give physicians a clearer roadmap for treatment, the study authors said.

About 15 percent of colon cancer tumors are known as deficient DNA mismatch repair (dMMR) tumors, because they have lost the ability to repair DNA damage. This particular type of tumor seems to be less aggressive than other forms of colon cancer, the researchers said.

A study published by the same group of researchers in 2003 in the New England Journal of Medicine also found that this subset of patients did not benefit from standard chemotherapy for colon cancer. Because the finding was so novel, the results needed confirmation before they could be incorporated into clinical practice. This new study offers that confirmation, the researchers said.

"We're talking about patients with early stage colon cancer. These are patients who sometimes get chemo and sometimes do not," Sargent said. "We have sought for a long time to try to determine if there was a way to predict which patients might benefit from chemo and which might not."

But, Sargent added, "we felt that in order to really recommend this in clinical practice, we needed to validate it."

The new study analyzed data from 1,027 patients in the United States as well as Canada, France and Italy who had participated in previous trials. Sixteen percent had dMMR.

"The goal was to validate that the 15 percent of patients who have defective mismatch repair did not receive any benefit from 5-FU therapy, and that is indeed exactly what we found," Sargent said.

"We now feel this is appropriately validated for clinical use," he added.

In fact, there is already a simple test for this type of cancer.

"The test is available and, in a patient with stage 2 disease being considered for treatment with chemotherapy, we think that this test would be useful," Sargent said.

One Year Anniversary - and a Toast!

"All Hail the TriLyte"

Why am I writing to you? Well, the reason is obvious. I am approaching the one year anniversary of my surgery - that is One Year N.E.D. No Evidence of Disease. A milestone for sure.

But let us not jump to early conclusions. With that date approaching, I am embarking on my annual colonoscopy - which will occur tomorrow morning. And this will help determine whether I indeed get the stamp of NED for the year. Yay!

So the process involved now, at this very instant, is the official drinking of the major laxatives to clean out my intestines. You missed it, a couple of hours ago, I celebrated the popping of the four laxative pills. I think they had the insignia of a skull and crossbones on them.. Anyways...

So if you will, let us raise our cups of TriLite (basically propylene glycol and water, with a so-called cherry flavor additive) and have a swig. It cleans you out real nice like. ooo weee!

Smile, as you step a little closer to the bathroom door.. And remember that its a small price to pay for early detection of a possible recurrence.



This isnt TriLyte, this is something I saw a few doors down from a bar called The Twisted Spoke, in Chicago.

So this is what I have been doing...

As you can see, there is some work going on.


Biking, Yoga, walking, lifting weights... Spring Cleaning...


My diet has been consistently healthy too. I have been getting back into things and in general bouncing back to my old self. And that is why there have been some weeks between posts.


Soon things should be back to normal. As this occurs, I will be posting here less frequently. It is time to get out and have some fun.

I promised my self that I would post a new blog entery and so here it goes.

First off, I was in to see my Oncologist again last Wednesday for a monthly examination. I am pleased to say that everything continues to be going well and I am disease free - N.E.D. The next appointment will be in three months.

Acupuncture takes care of most of the neuropathy for most of the week and every week I see lasting improvements in that area. I know it is helping because this week I cancelled my appointment and can feel the difference.

The other good news is that I have been gaining weight slowly but steadily too. Im really only 5 lbs lighter than I used to be at this point.

Winter has been hanging around a little more than I would like. Its the middle of April here and it snowed last night. This is sort of a good metaphor for the uncertain times that Im going thru right now.

Recovering well

Has it been 7-8 weeks since I finished chemo already?  Time flies and I am happy to say that I have been recovering nicely.  I have been back at work full-time for a while now.  My appetite is way up and I have been going out on the weekends and am on a decent workout schedule too. 

The Erbitux rash has cleared up and there are some remnants but nothing to get excited about.  I do have to limit my exposure to the sun this summer though.  Sunscreen and a wide brimmed hat were recommended by the doctor. That wont be stopping me from having fun though.  

My weight has been climbing back to normal too.  I have a ways to go.  Met with a nutritionist at Northwestern and she told me that I need to eat 2,500 calories a day in order to gain one pound a week. That means I get to eat like a pig for another 10 weeks.  (sigh)

I have been lifting heavier and heavier weights, attending a pretty challenging Yoga class, and still doing acupuncture weekly too.

I go my hair cut and lo and behold it is no longer curly. It is straight now. Told my barber to style it differently and suddenly started getting all kinds of complements.  Really that is fun, and I am starting to get flirty again.  

I feel pretty good these days.  Lots of energy.  As a matter of fact I feel so good, that sometimes I wonder  if I am "overdoing it" and need to purposely take it easy and rest a little more.  Well probably I dont want to drive myself too hard just yet.  But even the memory of going thru chemo, feeling yucky, etc.  is fading fast, yet I still have the subcutaneous port in my chest (which I dont even feel really)  

On the flip-side, what lingering effects I do still have is the dreaded neuropathy I was trying so hard to avoid.  I have that and it is not good.  My fingers and feet oscillate between being either numb, or sensitive and tingly.  My fingertips are very tender and the fingers themselves are, at times, weak and clumsy.  Because of this, activities like typing, playing the guitar, and writing are somewhat diminished.  This neuropathy will take the longest to go away, anywhere from months to years, and I would say that it represents a significant source of distress for me.  Acupuncture, B-100 tablets, and L-Glutamine capsules is the therapy that seems to get mentioned the most and that is what I am doing.  It should improve much over time, but there are plenty of survivors out there who, years later, continue to have neuropathy.  I will be very happy when I am able to play the guitar like before and am dedicated to making it happen.

So...

well.. 

I did not get the 12th round of chemo.  My Oncologist said that I had enough.  Even though all I felt was weakness, I guess it was a serious event that sent me to the hospital.  Getting dehyrated from the chemo was the tip of the iceberg because the chemo stays in you for a while and it would have continued to dehydrate me unless I was receiving fluids and being monitored 24/7.  I found out that my White blood cell count was only 500, where 4,300 is the very bottom of the normal range.  I also lost weight until I was only 118 pounds.  

While in the hospital I had some tests done.  An ultrasound of the liver came back totally clean.  Also a chest x-ray and blood test came back saying there was no evidence of disease.  Further examinations also came back great.  

Three weeks later, I was at my primary physician's office and got another chest x-ray because I had a bad chest cold and was coughing a lot.  That is all gone now..

My schedule now will be to meet with my Oncologist every month for the next 6 months, then every two months for the first year, then every three months, etc.  to be evaluated.  I will have a yearly colonoscopy now for the next 5 years.  

Other than that I am free to walk the planet.  I am to limit my alcohol intake to only 2 drinks a day and should avoid red meat, and should eat a lot fish, and fruits & vegetables and other nutritious foods.  I should really cut back on sugars too.

I have been building my strength slowly and feeling better.

Getting Back to Normal

Whew...

I was hospitalized for 6 days and have been home now for over a week. I have been recovering still and have had an at-home nurse come in three times to administer m0re fluids.

It was determined that the cause of this was a reaction to the chemo. I guess the toxicity of the chemo grew to a high level in my system and my body decided it had enough.

At the height of this dehydration, I weighed only 118 Lbs. A week and 1/2 later, I've already gained 10 lbs back.

Feeling much better, my appetite has returned, and a lot of my energy has returned too.

Now I am feeling like creating some new music.

Resting up and drinking chicken soup today.  On Tuesday I will meet with my 

Oncologist to be evaluated.  At that point I will find out whether they recommend a 12th round of chemo, or if it is too toxic.

Bump in the road

Like all things, sometimes there are bumps in the road that must be dealt with. I practically sailed through the first 10 rounds of chemo (they say), but it didnt work that way for the 11th. -So close to the end -

But I am writing to you in the hospital now. Somehow yet to be determined... I either caught a bug, took too many antibiotics, or from the chemo itself, my GI tract had a reversal of fortune, and over the course of 10 days, I became extremely dehydrated. and worn out and weak. I have not really eaten anything in 5 days because I couldnt keep it in me. Kinda gross to talk about, but somewhat typical of chemo. I lost almost 20 lbs in 2 weeks.

This sudden change of events scared me and I went into the Onc office two days in a row to get fluids - 3 liters in all, but it wasnt enough. So they told me to check into the hospital. Im in the hopsital now getting fluids and they are doing some tests to rule out what this is exactly and get me back on my feet. I only had one round of chemo left after this and want to get it too. But there is talk that they might end it now. Or really lower the dose.

The good news is that my stomach is finally settling down and eventhough the real test will be when I can eat something and everything is fine, but I feel good about things now.
I should be out of here in a dayh or two

the computer im using at the hospital _ the keyboard really sux so please excuse the typos and i will fix er up as soon as im fixed up>

more later