First Chemo

I started chemotherapy on Tuesday March 29th. With the first session they go over a lot of information including all possible and likely side effects, possible complications and how we will respond, etc... We arrived at 8am and didn't leave until 2pm. It was so wonderful to have Lulu there with me. They start with some anti-nausea mediation, then a drug that enhances or catalyzes the effectiveness of the primary chemo drug, then finish with the chemo drug. I also go home with a pump that doses out the chemo for the next 46 hours. It looks like I have the oldest cell phone attached to my belt. I go back into the clinic on Thursday where they will disconnect the pump and also show me how to do this in the future.

So far the side effects are thankfully not too bad (KNOCK ON WOOD) - knot in my stomach, occasional kind-of headache, heart palpitations. I had difficulty sleeping last night but I expect that to improve.

Activity

I did the "Lawyer ride" last Thursday and Monday, though I did notice that my HR was unusually high given my perceived exertion. Margie had noted that my hemoglobin count is a bit low, so I'm taking iron supplements but will probably need to back off of the intensity (not so easy with that ride).

The Diagnosis & Plan

Diagnosis

On March 16th I was diagnosed with colon cancer via a colonoscopy. This test was done because of some annoying GI issues that everyone thought was either giardia, low bacteria in the digestive tract, or maybe colitis. So the colonoscopy was done to rule things out. Given no family history of cancer and specifically colon cancer and my age, little consideration was given to it being cancer. Alas - it is. The next day a CT scan found on spot on my liver - which complicates the treatment and makes the prognosis more difficult. I felt great prior and immediately after which I now understand is common with colon cancer. In a way I am thankful that I had some type symptoms that I pursued. For many, this isn't the case until the disease is very far advanced.

The next week we had some positive developments (or lack of bad which I GLADLY take)

• PET scan confirmed just one metastasis on the liver in a location good for later surgery
• No involvement of the lymph nodes or mets to lungs or other tissues
• Biopsy confirmed it is the most common of colon cancer (which makes treatment more straightforward)
• We completed appointments with the full medical team (one medical oncologist, two surgeons), completed all scans, and have the start of the treatment plan in place all within one week of diagnosis. My sister Margie is solely responsible for this wonderful timing.
• Given the otherwise good health, the limited number of mets (<=4), and the operable nature of the met on the liver, an aggressive treatment is pursue with a curative intent - that is to seek a full cure (though there are no guarantees by any means).

The Plan

• Start chemo right away to attack the overall disease. I started chemotherapy Tuesday (3/29) which includes ~4-hour in the clinic and then taking home a pump that I wear for the next ~2 days and continues to deliver medicine.  
•  After ~3 months of chemo I get liver surgery to re-sect the spot or possibly most of that lobe just to be sure of a margin of safety. Amazing the liver regrows fairly quickly though it does tap your physical reserves in doing so I did not know this!
• Resume chemo as soon as possible after the liver surgery for another 3+ months
• End with the colon surgery - at which time the chemo may make the surgery simpler as well