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.
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"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.