Round One goes to me...planning for a TKO in this fight

Many of you who are my Facebook friends have seen my latest status update shouting out the news about my 6 month CT scan....that (and I quote) according to the Radiologist report from my enhanced contrast of pelvis, abdomen, liver, lungs etc. "there is no convincing evidence of metastasis".  And I know that it is just six months in but I will rack up this milestone as a first round victory.

What an emotional, thought-provoking, anxiety-laden process this has been since Monday's scan.  You see this represents the first real surveillance of my cancer...in combination with the CEA (carcinoembryonic antigen) blood tests recently which came back normal (no elevation of a specific protein/antigen that is positive in 75% of colon cancer patients).  The CT scan from this past Monday would be compared with the CT scan done in-hospital March 16 2012 just prior to the colon resection surgery and with a scan done a few days later after surgery when fluid was detected in my colon near the resection site and I had developed an infection / fever.  It was at THAT scan that they detected a 3mm shadow/spot on my liver.  Shock and fear immediately flooded through me at that time.  These kinds of findings can touch at the very darkest fears for cancer patients as it very well could indicate spread of the primary cancer to other systems/ organs.  In my case my tumour was staged at Stage IIIb with 2 of 17 lymph node samples taken from surgery come back positive for cancer.  So the fear of spread and infiltration into the lymphatic system consumed me.

Within seconds of coming in the door to my Oncologist's office on Thursday she turned to Victoria and I and smiled and said it all looks good, she is not worried and does not see any evidence of spread.  Her positivity immediately put me and Victoria at ease. She pulled up the final report from the radiologist and after reading it I swallowed hard and asked for clarification.  You see the latest scan showed 3 small (4mm) spots on the left lung - which I was never aware that had been detected in March.  However, Dr. Lingas described them as abnormalities (actually "normal" imperfections like skin pimples, scars, etc.) which are rather normal.  More importantly there was no clinical change / visual change whatsoever in terms of these spots from 6 months prior which indicates no growth, no change, no malignancy.  The spot on my liver that had been at the focus of the second scan in March was exactly identical as 6 months ago - again indicating no malignancy or spread.  I will repeat the final sentence of the Summary paragraph of the report:  There is no convincing evidence of metastasis.

Yeahhhhhhh!!!! F$@#ing right!!!!!  Let's celebrate this first significant milestone.   Next surveillance will be a colonoscopy at 1 year from surgery  -next March - or almost 6 months from today.  In terms of my future and surveillance I need to put this all into context. This scan was the first surveillance...there will be many more over the next 3 to 5 years.  Pretty much every 6 months or so whether it is CEA bloodtests or colonoscopies or CT scans I will be monitored for the next 5 years.  Remember 5 years is the end goal to be completely cancer free, no recurrence, no metastasis.  Statistically with colon cancer a huge percentage of recurrence rates occur within the first 3 years.  So this will be my life for the next few years.

Using a boxing analogy I have decided to break down this 5 year period into a 10 round fight - 10 Rounds of 6 months surveillance.     The end goal is a TKO (technical knock-out) over this cancer.  And as far as I am concerned Round 1 goes to Dave Brown...I am still in the ring fighting and will continue to fight, to punch, to kick the crap out of this cancer.

I cannot end this post without sending a shout out to all of you who bless me with your support, your encouragement, your positive energy.  Believe me when I say that even though I may not respond to every text message, email, blog comment, Facebook message etc. I read and receive every single message and they continue to give me strength.

Thank you, thank you, thank you all.  You are all honourary members of The Kicking the Crap Crew!!!!

Tell me why I don't like Mondays

Those of you who are regular followers of my blog know that I like to integrate music and lyrics references into my blogs when it strikes as me in just the right way...so visualize me singing to the famous Boomtown Rats song. The chorus goes like this:

Tell me why I don't like Mondays

Tell me why I don't like Mondays

Tell me why I don't like Mondays

I wanna shoot the whole day down

You see yesterday Monday September 24 was a "busy" day (substitute the word busy with words like exhausting, anxiety-laden, intense).  Not only did it include (hopefully) the next treatment but also the crucial enhanced CT scan at six months surveillance to determine the status of my cancer.  So yesterday began with an 8:30 visit to the Oncology clinic at St. Josephs for bloodwork prior to my scan.  From the 6th floor East building getting blood-work drawn it was downstairs to Ground level Main floor Diagnostic Imaging for registration and prep which involved drinking a tall glass of special water one hour in advance of the scan.  My parents accompanied me today and actually came down the night prior, staying in the guest suite of our condo building...more on my parents and our time together shortly.  We waited in the DI waiting room for an hour until the scheduled scan, talking, keeping my mind busy not dwelling on the scan until called in (and had to drink another tall glass of that special water). Smartly I had applied some EMLA cream on my wrist where I thought they would insert the IV line while waiting and the IV line insertion was pain free (thanks again Barb and Nancy!!!!).  The actual CT scan was not something new to me.  If you remember I had two when in hospital / inpatient for my surgery back in March - the first being a scan prior to surgery and the second one mid-week while recovering from surgery (since I had developed an infection / fever) producing a real scare when it detected a spot on my liver (which ended up being cleared as not detectable through a follow-up ultrasound.  A spot on a distant organ from the primary site detected on a scan/ X-ray/ ultrasound whatever can be sooooo intensely scary for a cancer patient or at least in my mind.  It is almost the ultimate in bad news that caused me so intense an anxiety reaction then despite the ultrasound clearance.  It hit to my darker fears and came right in the context of an already intensely emotional time when so much was happening all at once.  But back to the scan yesterday...the procedure itself takes about 10 minutes or so, involves no pain but does involve the machine injecting a special dye about halfway through the scan that warms you internally all over your body and instantly gives a strange metallic taste in the mouth that doesn't go away for some time.  You are instructed to breath, hold your breath, breath, hold your breath repeatedly as this loud machine spins around you.  It really is a unique experience.

After the scan was over it was back up to the 6th floor Oncology clinic to find out how the blood-work taken earlier had come back and for treatment.  The nurses called me in for treatment which was / is positive news...at the end of the day it means the team assessed my blood-work as being healthy enough to continue treatment.  Although it does turn out that my platelets had dropped significantly...81.  Again not in the danger zone for imminent bleed but still low.  Everything else of significance incidentally - WBCs, neutrophils, hemoglobin - all showed normal to strong/healthy levels.  So my Oncologist and pharmacist conferred and decided to continue with treatment as we are determined to push through the last three treatments if healthy enough and continue with Neupogen injections to keep the WBC and neutrophil counts up.  So another four weeks of pretty brutal side effects, extreme fatigue and some bone pain that radiates out from my spine to my hips, legs and neck, but in the immortal words of my friend and fellow battler and blogger Barb - bring it on!!!!  There is nothing we can do about platelets dropping other than delay treatment (not ideal) and reduce dosage.  The decision was made to continue treatment, monitor the platelets closely, and keep me at full dosage of the chemo.  And folks...from my perspective that is good news.  I want to keep pushing on through these last three treatments at FULL dose...let's give this cancer everything we got...kick the crap out of it NOW.  And let me recover enough strength to be there fully for my wife and baby on the way...THAT is the ultimate goal for me.

So...Treatment 10 is underway.    YIPPPPPEEEEE!!!!!!! Again referring to my grade school math I think that works out to 83% of the way done!!!!!!!!!  Only 2 more treatments to go.   Let's get it on.  I am sitting here on my couch with my 5FU infusion bottle by my side slowly infusing me through a tube in my chest hooked up to my port as I write this. Tomorrow a nurse will come to my home and disconnect the infusion as normal.  Thursday Victoria will begin injecting me daily with Neupogen for 5 days.  

But I hope that I am not giving off entirely negative vibes in this post.  You see my parents came down for this important day and that is something that is really special to me.  They hadn't joined me at any of my treatments prior and were adamant that they wanted to be there for the CT scan...they had heard and felt my anxiety about the day and expressed a desire to be a part of the day.  As I wrote above they came down for a visit with Victoria and I Sunday night and we went out for a wonderful dinner at Lahore Tikka in Little India of Toronto...one of our favourite spots...and enjoyed authentic Pakistani and northern Indian cuisine which we all love.  Conversation flowed and just like my short-term sabbatical to Tobermory the week before was just what I needed, just what the doctor ordered.  Although we talked a little about my feelings about the day to come we talked about so much else that really allowed me to forget all about it at least temporarily.

And honestly I think not only was it great for me to have my parents with me for the day I respectfully think it was really good for them as well...to see my routine, my process if you will with regard to the Oncology treatments which have been my life for the past 4 months.  They got to meet my nursing team and my Oncologist, Dr. Lingas, who are all so caring and so positive.  In fact Dr. Lingas was kind enough to come see me during treatment and talk to me about the CT scan and next steps...as I had requested to talk to her about it.  I have a scheduled appointment to discuss the results with my surgeon, Dr. Hart, but not until the following Thursday October 4 - 10 days of agonizing waiting - not ideal.  As soon as she heard or saw my anxiety she suggested we meet this Thursday when she will have the report from the Radiologist.  And I immediately agreed.  She made a point of saying in front of my parents that I am one of her patients she is NOT worried about...that the scan will be good news and that she doesn't worry.   Her positive attitude and energy is so helpful.  I don't want to speak for other cancer patients or patients who are battling such a serious life-altering disease but I would rather have the information, regardless of what it is, sooner rather than later.  I can act on information.  As my blog suggests I am all about my own empowerment to take in information and act, advocate, drive things as I need to.

My parents Jim and Jean accompanying me in the treatment room (we were one over the limit!)

The two-hour infusion complete waiting for the loading dose and hook-up to the 5FU infusion bottle and head home

So...Dr. Lingas and I will meet on Thursday to discuss my CT scan.  Victoria is going to join me- nothing short of her going into early labour will stop that. And I will share the results afterward.  When, how, to who, how soon...I don't know.  But I will post and update you all on my blog when I am inspired to.  And I plan to SHOUT the GOOD NEWS out so loudly that everyone can enjoy it with me without need for smartphone, text, email, Internet blog.  I cannot wait to celebrate that as of six months of battling I am currently cancer free, winning the battle and kicking the crap out my colon cancer.

Before I end this long, rambling but emotionally laden post I want to give a special shout out to some very special members of Team Brown, honorary members of the Kicking the Crap Crew.  Not to exclude anyone else but these people have been so supportive from day one of diagnosis, have been my coaches if you will...and have selflessly surprised with big little gestures like timely messages, gifts of golf shirts, autographed picture of Bryan Adams - accompanied by notes to me full of support and love that have just buoyed my spirits and given me a burst of internal strength on days when I haven't felt so strong.  A shout out to my Aunt Diana and Uncle John Loomis, cousin Liz Loomis-Taliano and her family John and Isabella.  I appreciate your love and support...and I appreciate you.

\

And a shout out to some others in the inner circle...my sister Jodie and her husband and my brother in law Brad, my parents, my sister Laura and her partner Bill, Colleen Baker, husband Rob Baker, co-workers and friends Kelly L, Julie-Noelle,  friends of ours Diane, Tony, Linda...and last but certainly not least my rock, my best friend, Victoria - your messages to me throughout the day yesterday helped get me through the day.  For anyone I have missed I blame it on the chemo brain ;-)  Just know that I definitely felt the positive energy you sent my way - and appreciate you for it.

Sending out positive vibes into the cosmos...and hoping for all your positive energy in return.   Until next time stay healthy everyone.

Rub a dub...hello from The Tub

Hello from beautiful Tobermory! I decided to escape from the big city earlier this week to the cottage for some much needed peace and tranquility...and I have it here in spades. Wow is it quiet up here on the lake and in town. In fact, Parker and I went into town yesterday with intention to grab a cup of green tea, blog on the patio of The Coffee Shoppe and grab some fresh local whitefish for dinner. We didn't make it into town until later in the afternoon, after 5pm, and much to our/my shock... everything was closed except the Foodland and LCBO. The Coffee Shoppe apparently closes at 3pm daily now and the fish store closed at 5pm. And I think I counted 4 people out on the streets of Tobermory while Parker and I walked around. Yikes! What a contrast from mid summer when The Tub is a busy energetic town thriving with tourists.

But this peace and quiet is exactly what I wanted...exactly "what the doctor ordered". You see... next Monday is an anxiety laden day for me (and my family). I am scheduled for a CAT scan for enhanced imagery of my pelvis, liver, abdomen, chest and lungs. This scan at four months is an important surveillance test which will assess the state of my cancer four months post surgery and with adjuvant therapy. Essentially it will tell my doctors whether (to quote my surgeon) "they got it all"...whether there has been any spread of the primary tumour to other organs...whether the chemotherapy has done its job to date in preventing any recurrence of the cancer. And admittedly I am worried. I am trying to NOT dwell, to NOT fear the tests (the results not the actual test), and to focus on ALL the positive things that have been going on with my life like my marriage to Victoria, the birth of our child in November, my wonderful in laws, family and friends...and all the positive things related to my battle against cancer such as my surgeon's assessment that his team was successful in removing the entire tumour, the low grade nature of the tumour suggesting that it was not aggressive, the blood tests that came back recently that showed no elevation of carcinoembryonic antigen, etc.

While I was hoping to spend some time outdoors up here at the cottage and potentially even take the boat out and land Cameron Lake Charlie my hands and feet neuropathy just would not allow me to do anything outside...just a couple of minutes trying to take off the boat cover had my fingers stinging like they were being stuck with needles. So no dice on doing anything outdoors in the cold. But I had no itinerary for my retreat up here other than to rest and relax...so I rented some movies and made a great dinner and chilled out with P dog. Perfect. And whether it is the cool fresh air or just being at the cottage I slept well...deep...refreshing...and well.

Anyway it is time to head back to the big city and reconnect with Victoria and attend our pre-natal class...enjoy the beautiful long drive home...and keep focused on the positive, think about positive results next week and continue to be winning the battle.

Until next time...sending good thoughts out into the cosmos. Take care all.

All by myself...don't wanna be...all by myself

To appreciate the title of this posting you will need to picture Eric Carmen sitting at a piano singing his mournful song "All By Myself"...and then imagine me sitting in a recliner at the Oncology Clinic at St. Joe's with tubes sticking out of the port in my chest all by myself...all alone other than the nurses and fellow patients of the clinic. With Victoria back at work and my treatments moved to Mondays I ended up driving myself in to treatment today...and never again. Maybe it is the drugs, maybe it is the sight of some of my fellow patients...maybe I am just tired today...sick and tired of being sick and tired....who knows....but for some reason I am feeling a little emotional today...sad...lonely. But then I think "Hey! You have made it to treatment 9!!! 3/4 of the way there!!!" and I feel so much more positive.

And today the news is all good. My bloodwork came back with my neutrophils back up to 2.02 and my platelets are up over 90 so that is good news. My Onc has written another Rx for Neupogen - 5 injections starting this Thursday....so that is good news for Victoria since she will be able to "stick it to me again" :-)

I talked to my Onc about the severe bone pain I experienced last weekend and she reassured me that it was related to the Neupogen injections and NOT the cancer. And for someone battling cancer it was very easy for me to worry immediately that the pain I felt in my spine, my lower back, my neck, my hips and my skull was indicative of a spread of cancer to my spine, my hips, my neck and my skull. So for this round she recommends that I take Tylenol or Percocet if needed before my injections to combat the pain.

And today I decided to source some Emla cream to numb the port and negate any pain from my nurses drawing blood or hooking up my IV. THANKS, Barb!!! You rock. Boy what a difference that makes. I figure I have endured enough pain in the past six months so if I can numb the pain for the remaining four treatments and further blood tests then let's numb the pain!!!

My next treatment and hospital visit will follow a CAT scan to surveil my organs and system for any signs of cancer. Two weeks. Two weeks. My anxiety is already high. I will plan to mentally focus on positive things over the next two weeks like our baby that is growing so quickly now in Victoria's belly...maybe I will go to the cottage by myself for a couple of days of serenity...maybe I will book a deep tissue massage before the 24th to release any anxiety that I carry.

Until then let's keep doing what we are doing. It is all part if the treatment plan...the battle...to kick the crap out of this f^**ing cancer.

Until next post...take care all. Thank you for stopping by and "listening" to me.

And the results are in...

This past week has been quite an event filled week...a return to treatment on Monday, a series of Neupogen injections starting on Thursday, a visit by good friends, Andrew and Leah, who so graciously donated so many things for our baby, a wonderful dinner out with Victoria's brother, Rob, and his daughter, Olivia, and partner, Sara...a visit to my Naturopath for reassessing our approach to date and adjust...a great visit with Victoria's parents in Wasaga Beach with wonderful weather and R&R, and a lovely dinner with my family to end the last weekend of summer before back-to-school/work.

Our visit with Dr. Genuardi, my Naturopath, was excellent.  It seems that she is happy with my dietary program and adherence to the program.  We added a couple of things such as goji berries for added Vitamin C intake and discussed some supplementation of both Vitamin C and magnesium.  It seems that it is unrealistic to obtain these critical vitamins and minerals from diet and that some supplementation is required.   We also discussed a natural approach to boosting my immune system and to encouraging the immune system to generate neutrophils...and approaching long term immune system support after the treatments are completed.  Her guidance is to use colostrum/ bovine milks from cows that have just calved - just like human breast milk apparently this milk source is full of antibodies that stimulate the immune system.  I will discuss with my Oncology team and explore this supplementation as part of our treatment plan.  Victoria was also able to obtain some guidance for her drop in iron levels at this stage in her pregnancy and a supplement to address it and she has started on an iron supplement that will hopefully help her energy level, mood and swelling.

The actual Neupogen injections, administered by Victoria with joy I am sure ;-) were really not that bad at all...the needle is so small in terms of gauge that the pain was pretty much non-existent. The injections are required to stimulate the immune system, my bone marrrow, to raise the neutrophil levels and to prevent any further delay in treatments.  However on the weekend I developed a real deep pain and "spasm" that originated in my lower back and pulsated out to my hips, my neck, my skull...and it admittedly concerned me.  Not only was it a bit debilitating but it was scary. I wasn't expecting this type of side effect (I assume it was a side effect of the bone marrow stimulation from the Neupogen) nor have I ever felt this type of pain before.  I had cautioned by my Oncology team to expect bone pain but didn't know exactly how that would manifest itself. As a cancer patient I struggled mentally to NOT go to a place of thinking immediately that this pain, originating from the centre of my lower back and pulsating outward, was indicative of a spread of cancer to other areas of my body.  I put it down to a side effect of the  drug stimulating my bone marrow in my spine and elsewhere.   When it spread to my hips I felt really really old....like an old man with barely the strength to walk upright.  Thankfully this only lasted a couple of days.

But it's not all bad...the analysis of my bloodwork prior to my last treatment included a requisition by my Oncologist for a Carcinoembryonic Antigen (CEA) test to monitor the cancer markers in my blood / serum.  Cancer of the colon typically secrets a protein known as carcinoembryonic antigen and 70% of colon cancer patients return positive markers for this protein . http://www.lifelabs.com/Lifelabs_BC/Patients/MedicalConditions/Colon_Cancer_-_CEA.asp

So...elevated levels of CEA in the blood can indicate recurrence of the tumour or metastatic spread to other areas of the body.  This CEA test is one of the key surveillance / monitoring tools particularly for colon cancer.  

My Oncologist and I had discussed this test several weeks ago as an answer to my question about how we would monitor or surveil my cancer and the success of the treatments to prevent recurrence or spread.  This CEA test, after four months post-surgery and two-thirds of the way through adjuvant therapy, would be part of this surveillance.  This would be followed by the CAT scan at the end of September to give a thorough picture of my status.  Admittedly, I had quite a bit of anxiety leading up to this first blood test.  I am aware of the limitations of the test in that it can return false positive results, that only 70% of those with colon cancer actually return a positive elevation in CEA, that chemotherapy can cause an elevation in these markers and was conditioning myself mentally to consider the results of the CEA test as objectively as possible.  

And the results are in...at this stage in treatment, 4 months post-surgery and with adjuvant FOLFOX therapy, the CEA test showed this protein within normal levels...no elevation of the CEA levels in my blood nor any significant trend upward in CEA levels from prior to the initiation of adjuvant therapy.  And THAT is great news!!!!!  My Oncologist is not concerned with the CEA levels in any way and THAT is also great news.

So...this news goes a long way to keep me positive....to keep me fighting the good fight...to urge me to kick the crap out of this colon cancer.