Chemo #14

I'm sitting at the dining table sipping my green tea after my peanut butter toasts. Marie-Josée is in front of me making her morning tour of her favorite websites (Facebook, email, blog about cancer, my blog, news). I take the time to write this blog before leaving for the hospital where I should receive my chemo # 14 (3rd Folfiri).
Yesterday I had an appointment with Dr. L.. Guess what? He talked to me about surgery. He said he had reviewed my case with my surgeon and Dr. P the best radiologist in the hospital. They agreed that the reduction in cancer was important. This led me to ask if I was in remission. He said in partial remission ... YES!

Then he told me he had spoken to a surgeon at Maisonneuve-Rosemont for the super specialized operation called HIPEC. The surgeon, given the presence of a spot on the liver, no matter how small, has refused to take my case. He considers that I need to continue chemo to reduce whatever is left, the less there is the better.

But in our conversation with Dr. L. we talked about another surgeon that can do the HIPEC, Dr Y.
Dr L. said he would call to ask for his opinion. We must understand that in the case of this kind of surgery there is no consensus among surgeons. Dr Y is at the CHUM (Montreal University hospital network) therefore practice philosophy is sometimes different from one hospital to another.

Yesterday evening I received the call from Dr. L who told me that he spoke directly to Dr Y about my case. The latter agreed to meet me in 3 weeks. This will be a preliminary meeting where I expect he will explain the reasons why I am a candidate or not for this surgery. Dr Y has requested a PET scan before giving its final decision on the feasibility of the operation. As this examination requires a cessation of chemotherapy for a period of 3 weeks before, we will take this opportunity to go to Dubai. We will be there 2 weeks and my stepfather and his wife will be with us for 8 days (they live in Kuwait, just next door ;-). They will retrieve my Piccline and I'll get a port-o-cath installed when I come back. A Port-o-cath is a system of distribution for the chemo which is implanted under the skin like a pacemaker. This has the advantage of allowing me to bathe, take a shower without worry of a bandage and a direct opening to my heart.

All this to tell you we were excited yesterday, partial remission, exploration of the possibility of surgery, yes sir!
There was just a little news that brought us back on earth, my markers went up rather than down. My CEA were 8.8 (6.2 last time). Dr L. as usual is quite stoic. His comment was "This shows that we made the change in treatment at the right time." In other words, it could be a possible indication that FOLFOX started to lose its effect. There was a slowdown when one considers the trend of the CEA markers(13, 12, 10, 7, 6.7, 6.2, 8.8). Of course the toxicity forced us to change but what he says is that the efficiency points to this change also. So for him Folfiri is a good deal at this point.

I gotta go. There may be no blog for a few days but don't worry too much.