Wednesday, December 21, 2005

An Unwanted Journey: Day 0027 - Medical Oncology

My eldest son joined me again today for another trip to Grand River Hospital. This time, instead of medical imaging, we had our very first trip to the Grand River Regional Cancer Centre. The GRRCC was able to find a cancelled appointment for Wednesday the 21st and get me in to see the Medical Director of Systemic Therapy a full month before the date offered me yesterday. This was very good news for me.

The consultation and physical examination was straight forward and went as expected…almost. I had to revise my expectations for the duration of neoadjuvant treatment. In addition, I hadn’t fully realized in my research thus far that I would also be getting adjuvant chemotherapy. Preoperative chemotherapy will be delivered 24 hours a day by ambulatory infusion pump for a full five weeks and will involve low-dose 5-Fluorouracil (5-FU). Postoperative therapy will begin about 4 or 5 weeks after surgery and will likely involve a “cocktail” of drugs – either FOLFIRI (folinic acid, 5-FU, and irinotecan) or possibly FOLFOX (folinic acid, 5-FU, and oxaliplatin). For both preoperative and postoperative chemotherapy, I will have a catheter in a vein with a pump connected. Each week, I will have a nurse replenish the medicine.

There are, as you might expect, a number of precautions and possible side-effects with which I may have to deal. The most important of these, and possibly life-threatening, is a fever of 38.3 Celsius (101 Fahrenheit) at any time or 38.0 Celsius (100.4) for more than one hour. A fever may indicate a severe depletion of white blood cells.

Other side effects are what one might expect, the most feared of which for me personally is general fatigue. The GRRCC has a short seminar planned to explain the chemotherapy treatment, side effects, and how to deal with fatigue which I will attend early in the New Year. My hope is that I can manage general fatigue well enough to get substantial work done in my role as IT Manager. Although I don’t like admitting this, some of my self-esteem derives from how well I perform my job functions, a major part of which is my mental agility and energy levels.

I really do appreciate and am grateful for the progress being made on treating my cancer. But now that I am so close to actual initiation of chemoradiotherapy, the impact is becoming less theoretical and more real. Today was, emotionally, one of highs and lows – highs because of getting this appointment, our annual company Christmas party at King Crab Oyster Bar & Grill (which was absolutely fantastic, by the way!), going to see a Vinyl CafĂ© Christmas with Stuart MacLean at the Center in the Square with my family, and lows because of the realization of what I and my family are going to be going through very, very soon.

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