Post chemo
It's a couple of days post chemo now and I'm pleased to say that things are still going well. The post chemo symptoms are all mild at the moment.
The chemo fatigue is here again, but it's fine at this stage. Like most chemo patients I find the fatigue difficult to describe to anyone who has not been through it, but I will post something about it some day.
Food is already less appetising but I am still managing to eat well, keep the food down and digest it, which is a large part of the battle. I have found in the past that food plays a very important part in coping with chemo, it's amazing how quickly an energy hit can kick in after eating something.
One of the reasons for this is that chemo is a bit of a blunt instrument, not only does attack the cancer, it also attacks many of the body's healthy cells (especially any fast reproducing cells), therefore the body has to work extremely hard to constantly remake those cells. To do this it needs plenty of good nutritious food.
However, the unfortunate correlation is this: some of the bodies fast reproducing cells are in the digestive tract, meaning that they are at their weakest when they are needed most. Therefore food can become a huge struggle, especially when the different parts of the digestive system can't agree on what they can cope with.
On the up side, one of the revolutions in cancer over the years treatment has been the improvement in the anti nausea medications, they can usually find something that stops the worst of it.
The struggle with food is also a bummer because anyone who knows me knows that I LURV good food (food will probably get lots of mentions in this blog!), I think some of them have never gotten over the sight of me puking anywhere within 5 metres of good food last time I had chemo!
Cheers, Pete.
Wednesday 27 February 2013
Tuesday 26 February 2013
1st cycle of chemo finished.
At Home
Out of hospital, Yay!! It is always so good to get home for a bit, even if it is not proper home.
I also seem to be in better shape after this chemo than I was after the first cycle of chemo that I had in 2011, so things are going ok.
I am starting to get side effects, but they are all the usual, expected and unavoidable suspects at this stage. That means we know how to deal with the ones can be fixed and also to just monitor the ones that can't without worring to much.
At the moment I am trying to work myself up to giving myself the injections that I need every night. I used to sqib out and get the nurses to come around to do it but for some stupid reason I said that this time I could do it myself, maybe Robyn will do it... damn I hate needles!
Cheers, Pete
Out of hospital, Yay!! It is always so good to get home for a bit, even if it is not proper home.
I also seem to be in better shape after this chemo than I was after the first cycle of chemo that I had in 2011, so things are going ok.
I am starting to get side effects, but they are all the usual, expected and unavoidable suspects at this stage. That means we know how to deal with the ones can be fixed and also to just monitor the ones that can't without worring to much.
At the moment I am trying to work myself up to giving myself the injections that I need every night. I used to sqib out and get the nurses to come around to do it but for some stupid reason I said that this time I could do it myself, maybe Robyn will do it... damn I hate needles!
Cheers, Pete
Monday 25 February 2013
Lead up to treatment
God I hate surprises.
Monday 18th feb was the day I had my Perma-cath inserted, This the tube that goes into the large blood vessels near my heart to deliver the chemo. The procedure is done under sedation/local anaesthetic and is usually not a drama, takes only 45 mins form the time you walk in the front door of the hospital to the time you walk back out again.
This time however it seems that the tube may have been inserted a little to far and it touched my heart. Apparently I have a ticklish heart because it went into Atrial fibrillation (which basically means that one of the upper chambers of the heart went into a spasm and was not working effectively, displaying as a rapid and irregular beat). For me this was not as dramatic as it sounds, apart from a slight flutter in the chest I felt perfectly Ok, But it was still enough for the medical emergency team to be called to my bed. It is quite sureal to be surrounded by 10+ highly qualified medical staff when you are feeling fine, maybe it was just the sedation... At the end of the day my ticklish heart calmed itself after about an hour and we then spent a quiet night together in intensive care for monitoring.
I Also had a couple of tests to confirm that heart size, structure and function are normal. I'm pleased to say that they are. There have been no problems since, and a recurrence is unlikely.
Cheers, Pete.
Monday 18th feb was the day I had my Perma-cath inserted, This the tube that goes into the large blood vessels near my heart to deliver the chemo. The procedure is done under sedation/local anaesthetic and is usually not a drama, takes only 45 mins form the time you walk in the front door of the hospital to the time you walk back out again.
This time however it seems that the tube may have been inserted a little to far and it touched my heart. Apparently I have a ticklish heart because it went into Atrial fibrillation (which basically means that one of the upper chambers of the heart went into a spasm and was not working effectively, displaying as a rapid and irregular beat). For me this was not as dramatic as it sounds, apart from a slight flutter in the chest I felt perfectly Ok, But it was still enough for the medical emergency team to be called to my bed. It is quite sureal to be surrounded by 10+ highly qualified medical staff when you are feeling fine, maybe it was just the sedation... At the end of the day my ticklish heart calmed itself after about an hour and we then spent a quiet night together in intensive care for monitoring.
I Also had a couple of tests to confirm that heart size, structure and function are normal. I'm pleased to say that they are. There have been no problems since, and a recurrence is unlikely.
Cheers, Pete.
Sunday 24 February 2013
Treatment, Day 3 of 1st cycle
Going OK
Things are going to plan and I am feeling pretty good at the moment. I'm a bit tired but at this stage it probably has less to do with chemo side effects and more to do with the realities of a treatment regime that is very interuptive to sleep as it usually runs well into the night. Another reason for the lack of sleep is that one of the chemo drugs (ifosfamide) is potentially damaging to the bladder, to prevent this I am given another drug (mesna) to bind the damaging components and plenty of pre and post chemo hydration to keep me pissing out the dangerous stuff all night out after the ifosfamide has done its job... it just keeps coming (and hospitals aren't the place to get a decent night sleep at anytime anyway).
The nurses have shown me how to give myself the daily injections will I need when I go home, we practiced on a pillow, after my efforts that pillow is now in hiding somewhere.
I have been able to get out of the hospital and into the nearby parks with Robyn for a couple of hours on the last couple of mornings, very helpful, and fun to watch the leafblower guy achieving little more than making pretty clouds of leaves that soon fell back to where they were before his efforts, but we appreciated his unintentional artistry nonetheless.
We hope to be given some more dates for the upcoming treatment soon, will post them when I have them
Cheers, Pete.
Things are going to plan and I am feeling pretty good at the moment. I'm a bit tired but at this stage it probably has less to do with chemo side effects and more to do with the realities of a treatment regime that is very interuptive to sleep as it usually runs well into the night. Another reason for the lack of sleep is that one of the chemo drugs (ifosfamide) is potentially damaging to the bladder, to prevent this I am given another drug (mesna) to bind the damaging components and plenty of pre and post chemo hydration to keep me pissing out the dangerous stuff all night out after the ifosfamide has done its job... it just keeps coming (and hospitals aren't the place to get a decent night sleep at anytime anyway).
The nurses have shown me how to give myself the daily injections will I need when I go home, we practiced on a pillow, after my efforts that pillow is now in hiding somewhere.
I have been able to get out of the hospital and into the nearby parks with Robyn for a couple of hours on the last couple of mornings, very helpful, and fun to watch the leafblower guy achieving little more than making pretty clouds of leaves that soon fell back to where they were before his efforts, but we appreciated his unintentional artistry nonetheless.
We hope to be given some more dates for the upcoming treatment soon, will post them when I have them
Cheers, Pete.
Treatment Plan
So this time around it's high dose chemo. I can't say that I am not scared for the first time since this all began way back in 2007, there is no point pretending that this will be easy, unfortunately you all need to know that it won't be. Those of you who know me also know that I will be up for the fight.
The high dose chemo is done inconjunction with stem cell transplants. These stem cells (along with other supporting interventions such as standard blood/platelet transfusions, lots of antibiotics etc.) will kick start my system again after the high dose chemo has killed off my immune system and bone marrow.
Treatment will start off with pretty standard doses of paclitaxol and ifosfamide over two cycles. Inbetween these two cycles they will begin to harvest my stem cells so that they can give them back to me after the high dose chemo.
Key dates:
18-Feb. Perma-cath insertion (this tube gets inserted into my jugular vein from where it travels down to the large blood vessels near my heart, this is done so that the high dose chemo is released into my body at a point where there is high blood flow and therefore less risk of unintended damage. They will also collect and implant my stem cells via the Permacath.
22 Feb. Start cycle one of Paclitaxol and Ifosfamide.
25 Feb. End cycle one.
26 Feb. Begin daily GCSF (to stimulate stem cell production).
1 March, Pre stem cell collection appointment.
4 March, Apheresis (stem cell collection). We will probably begin stem cell collection on this day, although if my body is not producing enough then collection will be delayed for 24hrs. The process of collection sounds pretty straight forward from a patients point of view, I will be connected up to a machine that will draw of my blood, the machine will remove the stem cells for storage, the rest of my blood is returned to me. We are hoping to collect between 10 and 12 million of the little miracles so this may take a couple of days of sitting in a chair while the machine does its work, hopefully this turns out to be as dull as it sounds.
March 7, Clinic review with my Oncologist.
March 8, Start cycle two of Paclitaxol and Ifosfamide.
March 11, End cycle two.
March 18, Pre stem cell transplant check ups (heart/lung/kidney/liver function tests, dental check up, blood tests for any pre existing conditions etc).
March 20, Review with stem cell specialist for final go ahead of high dose chemo and stem cell transplant.
March 24, First cycle of high dose chemo begins.
March 29, First stem cell transplant.
April 21 (approx), second cycle of high dose chemo begins.
April 26 (approx), second stem cell transplant.
May 18 (approx), third and final dose of high dose chemo begins.
May 23 (approx), third and final stem cell transplant.
Early June (approx), Possible surgery to remove suspect lymph nodes. Known as a Retroperitoneal Lymph Node Dissection (RPLND).
Cheers, Pete.
The high dose chemo is done inconjunction with stem cell transplants. These stem cells (along with other supporting interventions such as standard blood/platelet transfusions, lots of antibiotics etc.) will kick start my system again after the high dose chemo has killed off my immune system and bone marrow.
Treatment will start off with pretty standard doses of paclitaxol and ifosfamide over two cycles. Inbetween these two cycles they will begin to harvest my stem cells so that they can give them back to me after the high dose chemo.
Key dates:
18-Feb. Perma-cath insertion (this tube gets inserted into my jugular vein from where it travels down to the large blood vessels near my heart, this is done so that the high dose chemo is released into my body at a point where there is high blood flow and therefore less risk of unintended damage. They will also collect and implant my stem cells via the Permacath.
22 Feb. Start cycle one of Paclitaxol and Ifosfamide.
25 Feb. End cycle one.
26 Feb. Begin daily GCSF (to stimulate stem cell production).
1 March, Pre stem cell collection appointment.
4 March, Apheresis (stem cell collection). We will probably begin stem cell collection on this day, although if my body is not producing enough then collection will be delayed for 24hrs. The process of collection sounds pretty straight forward from a patients point of view, I will be connected up to a machine that will draw of my blood, the machine will remove the stem cells for storage, the rest of my blood is returned to me. We are hoping to collect between 10 and 12 million of the little miracles so this may take a couple of days of sitting in a chair while the machine does its work, hopefully this turns out to be as dull as it sounds.
March 7, Clinic review with my Oncologist.
March 8, Start cycle two of Paclitaxol and Ifosfamide.
March 11, End cycle two.
March 18, Pre stem cell transplant check ups (heart/lung/kidney/liver function tests, dental check up, blood tests for any pre existing conditions etc).
March 20, Review with stem cell specialist for final go ahead of high dose chemo and stem cell transplant.
March 24, First cycle of high dose chemo begins.
March 29, First stem cell transplant.
April 21 (approx), second cycle of high dose chemo begins.
April 26 (approx), second stem cell transplant.
May 18 (approx), third and final dose of high dose chemo begins.
May 23 (approx), third and final stem cell transplant.
Early June (approx), Possible surgery to remove suspect lymph nodes. Known as a Retroperitoneal Lymph Node Dissection (RPLND).
Cheers, Pete.
Background info for newcomers,Original Diagnosis & Relapse
My journey to date (November 2007 to February 2013)
There is a lot to write here, I have been fighting the cancer off and on since 2007 and fighting the side effects of the disease and the side effects of the treatment every day for nearly six years, so I will need to add to this section bit by bit.
November 2007, Rude good health, then a rude shock - Original diagnosis.
In November 2007 I was a seeming very healthy 37 year old, life was good, and then I joined the club that no one wants to join (as it has been so elegantly referred to). My partner noticed a small lump on my right testicle (I wasn’t in the habit of checking myself, I now highly recommend all guys to do it regularly, or even better, get someone you really like to do it for you!). So off I went bare my nut to my GP who assured me that it was probably just a cyst but also that it was very important to get it checked out and referred me on to have an ultrasound. Being young, healthy, busy and stupid I didn’t get around to booking the ultrasound for a couple of weeks. By the time I had it my ball had started to ache slightly. The Ultrasound itself was hilarious, it was performed by a somewhat severe looking east European who instructed me that “YOUMUST BE HOLDINK ZE PENIS ZHUS ZO AZ TO LIFT ZE TEZTIZ!” The stasi has ways of making hold your dick.
Very shortly after the ultra sound my doctor contacted me to advise me it was very likely to be cancer and he referred me to the Peter MacCallum Cancer Centre in Melbourne, Australia.
I was lucky enough to be referred to Prof Guy Toner, in my first meeting with me he gave me the full rundown on what my likely situation was and he booked the required tests, scans.
First Blood Tests
The first blood test revealed highly elevated βHCG and Alpha-fetoprotein. These substances are used as tumour markers, elevated numbers are very likely to mean that a cancerous tumour is active and treatment will be needed (I don’t have the original numbers accessible as I write this so I will have to add them latter).
First CT and Pet Scans
The scans revealed metastasis (cancer spread) to both lungs, predominately the left lung (but again I don’t have the numbers/sizes at hand). There was also metastasis to the mediastinal cavity in my chest.
Orchiectomy
Given the results of the blood tests and ultra sound the left testicle had to go. This also occurred Peter Mac The surgeon who was to perform my orchiectomy name was… Waaaait for it…. Mr Cleave. The images that appeared in my mind with every mention of that name in association with the removal of my ball remain memorable. Of course he proved to be a totally competent surgeon, and a likeable person. The surgery occurred in early December (in the couple of weeks between first noticing the lump and the surgery the tumour had grown alarmingly). The surgery was without complication and I was out of hospital the next day. Unfortunately the patient proved a bit of a boofhead and was too active too early, leading to the wound reopening... no real harm done, but a nastier than needed scar would be the legacy (and possibly a lesson learned on my part... possibly)
Post Orchiectomy Pathology, Full diagnosis now complete
Pathology on the removed nut confirmed that I had a Non-Seminoma Germ Cell Tumour, the cause of this subtype of testicular cancer is still undetermined, but it is believed to be caused by a genetic abnormality or bad cell division at embryo stage, for the unlucky few this problem can develop into full blown cancer later in life, usually between the ages of 15 and 40.
Non Seminoma Germ Cell Cancers usually consist of several subtypes of tumor, in my case choriocarcinoma, teratoma and yolk sac tumour were present. I will not discuss the other subtypes of testicular cancer here as I have not experienced them and I don't have personal information or detail to share
What The Diagnosis Meant
In general terms the survival rates for testicular cancer are amongst the highest for all cancers.
People who have a seminoma that are picked up early often need very little treatment before they can return to their normal life quickly (so if you are in this situation, get it sorted and get it over and done with NOW).
Those with a Non Seminoma often require more intensive treatment, how intensive depends on the tumour subtypes and how advanced the cancer is, but, generally, even in the worst cases there are still treatment options and still a chance that those treatments will work.
With a Non Seminoma consisting predominately of choriocarcinoma, reasonably high tumour markers, and spread to my lungs my situation was not ideal, but it was still far from a disaster, a well established treatment path was laid out based on my particular circumstances, with a good outcome expected by all.
Treatment: First Chemo and Thoracotomy
My treatment plan was to consist of 3 cycles of BEP chemo (consisting of the chemo drugs bleomycine, etopocide and cisplatin) This was to be followed up with a thoracotomy (surgery) to remove any residual, and hopefully now dead, tumour from my lungs and mediastinal cavity.
Tumour markers were initially responsive to treatment, indicating that the chemo was working and the cancer was dying. So far so good, until the middle of the third cycle, and then AFP tumour marker levels jumped again, this indicated that part of my tumour was resistant to the current chemo. My treatment team decided to go ahead with the thoracotomy as planned (after a couple of weeks to recover from the chemo).
A new treatment plan was now needed to deal with the resistant tumour. This was to be 2 cycles of TIP chemo (Paclitaxel, Ifosfamide & Cisplatin), the BEP chemo was also discontinued as I had begun to show signs of reduced lung function, one of the side effects of bleomycine. Thankfully the AFP responded to the new regime, by July 2008 my tumour markers had returned to normal levels and all my scans were clear, my treatment was completed and showed every sign of having been successful, I was placed on a close monitoring regime and, after a bit of effort to recover from the five cycles of chemo, returned to normal life.
So what was chemo like? How did the experience affect my life?
I will add more here shortly.
1st Relapse, 2011
In March 2011, 2 years 8 months after my initial treatment finished my doctors informed me that one of my routine blood test indicated that my βHCG tumor marker was elevated and climbing again. As βHCG is a marker for chorriocarcinoma, which is the most problematic component of testicular cancer, there was no doubt that that the cancer was active again and more treatment would be required.
The recurrence in the tumour was probably due to a tiny, undectable part of the original tumour that had always been, or had become, resistant to the chemo I had had so far and now it had started to grow. The other aspect of concern was that this was considered to be a late relapse, statistics indicate that late relapses can be problematic, and relapses are scary at the best of times.
Other markers remained at normal levels and scans only showed some borderline/questionable enlargement of some lymph nodes in my groin.
Due to the fact that we were again likely to be treating an aspect of the tumour that was resistant to all the chemo I have had previously, a new chemo regime was devised. This time it was to consist of four cycles of VeIP (vinblastine, ifosfamide and cisplatin). The good news is that early in the treatment my βHCG dived to normal levels and stayed there. I found this chemo to be more of a challenge than what I had back in 2008, diet, nausea and weigh tloss were a problem, as were blood count recovery and numerous other complications. Nonetheless normal life beckoned, and I hurried back to it.
2nd Relapse (current), 2013
Find out more about this, and follow my treatment and rantings elsewhere on this blog.
There is a lot to write here, I have been fighting the cancer off and on since 2007 and fighting the side effects of the disease and the side effects of the treatment every day for nearly six years, so I will need to add to this section bit by bit.
November 2007, Rude good health, then a rude shock - Original diagnosis.
In November 2007 I was a seeming very healthy 37 year old, life was good, and then I joined the club that no one wants to join (as it has been so elegantly referred to). My partner noticed a small lump on my right testicle (I wasn’t in the habit of checking myself, I now highly recommend all guys to do it regularly, or even better, get someone you really like to do it for you!). So off I went bare my nut to my GP who assured me that it was probably just a cyst but also that it was very important to get it checked out and referred me on to have an ultrasound. Being young, healthy, busy and stupid I didn’t get around to booking the ultrasound for a couple of weeks. By the time I had it my ball had started to ache slightly. The Ultrasound itself was hilarious, it was performed by a somewhat severe looking east European who instructed me that “YOUMUST BE HOLDINK ZE PENIS ZHUS ZO AZ TO LIFT ZE TEZTIZ!” The stasi has ways of making hold your dick.
Very shortly after the ultra sound my doctor contacted me to advise me it was very likely to be cancer and he referred me to the Peter MacCallum Cancer Centre in Melbourne, Australia.
I was lucky enough to be referred to Prof Guy Toner, in my first meeting with me he gave me the full rundown on what my likely situation was and he booked the required tests, scans.
First Blood Tests
The first blood test revealed highly elevated βHCG and Alpha-fetoprotein. These substances are used as tumour markers, elevated numbers are very likely to mean that a cancerous tumour is active and treatment will be needed (I don’t have the original numbers accessible as I write this so I will have to add them latter).
First CT and Pet Scans
The scans revealed metastasis (cancer spread) to both lungs, predominately the left lung (but again I don’t have the numbers/sizes at hand). There was also metastasis to the mediastinal cavity in my chest.
Orchiectomy
Given the results of the blood tests and ultra sound the left testicle had to go. This also occurred Peter Mac The surgeon who was to perform my orchiectomy name was… Waaaait for it…. Mr Cleave. The images that appeared in my mind with every mention of that name in association with the removal of my ball remain memorable. Of course he proved to be a totally competent surgeon, and a likeable person. The surgery occurred in early December (in the couple of weeks between first noticing the lump and the surgery the tumour had grown alarmingly). The surgery was without complication and I was out of hospital the next day. Unfortunately the patient proved a bit of a boofhead and was too active too early, leading to the wound reopening... no real harm done, but a nastier than needed scar would be the legacy (and possibly a lesson learned on my part... possibly)
Post Orchiectomy Pathology, Full diagnosis now complete
Pathology on the removed nut confirmed that I had a Non-Seminoma Germ Cell Tumour, the cause of this subtype of testicular cancer is still undetermined, but it is believed to be caused by a genetic abnormality or bad cell division at embryo stage, for the unlucky few this problem can develop into full blown cancer later in life, usually between the ages of 15 and 40.
Non Seminoma Germ Cell Cancers usually consist of several subtypes of tumor, in my case choriocarcinoma, teratoma and yolk sac tumour were present. I will not discuss the other subtypes of testicular cancer here as I have not experienced them and I don't have personal information or detail to share
What The Diagnosis Meant
In general terms the survival rates for testicular cancer are amongst the highest for all cancers.
People who have a seminoma that are picked up early often need very little treatment before they can return to their normal life quickly (so if you are in this situation, get it sorted and get it over and done with NOW).
Those with a Non Seminoma often require more intensive treatment, how intensive depends on the tumour subtypes and how advanced the cancer is, but, generally, even in the worst cases there are still treatment options and still a chance that those treatments will work.
With a Non Seminoma consisting predominately of choriocarcinoma, reasonably high tumour markers, and spread to my lungs my situation was not ideal, but it was still far from a disaster, a well established treatment path was laid out based on my particular circumstances, with a good outcome expected by all.
Treatment: First Chemo and Thoracotomy
My treatment plan was to consist of 3 cycles of BEP chemo (consisting of the chemo drugs bleomycine, etopocide and cisplatin) This was to be followed up with a thoracotomy (surgery) to remove any residual, and hopefully now dead, tumour from my lungs and mediastinal cavity.
Tumour markers were initially responsive to treatment, indicating that the chemo was working and the cancer was dying. So far so good, until the middle of the third cycle, and then AFP tumour marker levels jumped again, this indicated that part of my tumour was resistant to the current chemo. My treatment team decided to go ahead with the thoracotomy as planned (after a couple of weeks to recover from the chemo).
A new treatment plan was now needed to deal with the resistant tumour. This was to be 2 cycles of TIP chemo (Paclitaxel, Ifosfamide & Cisplatin), the BEP chemo was also discontinued as I had begun to show signs of reduced lung function, one of the side effects of bleomycine. Thankfully the AFP responded to the new regime, by July 2008 my tumour markers had returned to normal levels and all my scans were clear, my treatment was completed and showed every sign of having been successful, I was placed on a close monitoring regime and, after a bit of effort to recover from the five cycles of chemo, returned to normal life.
So what was chemo like? How did the experience affect my life?
I will add more here shortly.
1st Relapse, 2011
In March 2011, 2 years 8 months after my initial treatment finished my doctors informed me that one of my routine blood test indicated that my βHCG tumor marker was elevated and climbing again. As βHCG is a marker for chorriocarcinoma, which is the most problematic component of testicular cancer, there was no doubt that that the cancer was active again and more treatment would be required.
The recurrence in the tumour was probably due to a tiny, undectable part of the original tumour that had always been, or had become, resistant to the chemo I had had so far and now it had started to grow. The other aspect of concern was that this was considered to be a late relapse, statistics indicate that late relapses can be problematic, and relapses are scary at the best of times.
Other markers remained at normal levels and scans only showed some borderline/questionable enlargement of some lymph nodes in my groin.
Due to the fact that we were again likely to be treating an aspect of the tumour that was resistant to all the chemo I have had previously, a new chemo regime was devised. This time it was to consist of four cycles of VeIP (vinblastine, ifosfamide and cisplatin). The good news is that early in the treatment my βHCG dived to normal levels and stayed there. I found this chemo to be more of a challenge than what I had back in 2008, diet, nausea and weigh tloss were a problem, as were blood count recovery and numerous other complications. Nonetheless normal life beckoned, and I hurried back to it.
2nd Relapse (current), 2013
Find out more about this, and follow my treatment and rantings elsewhere on this blog.
Current Diagnosis
2013 Diagnosis (see separate posts for 2007 and 2011 diagnoses and treatments)
The circumstances surrounding this current relapse are much like 2011 in that I had no idea whatsoever that anything was wrong, if anything I felt better in the last couple of months than I had for the previous 12 months.
The problem was again picked up with a simple bloodtest that showed an elevated level of betaHCG, which is a marker for my type of cancer. The blood test was repeated a few days later to preclude the possibility of a lab error, unfortunately the second test confirmed that the betaHCG was elevated and climbing.
Given my previous medical history this was enough to confirm that the cancer has returned and for the docs to begin planning more treatment, which goes to show how important those regular blood tests are. As with the previous relapse the rise in betaHCG indicates that it is the coriocarcinoma aspect of the cancer that is active, coriocarcinoma is very often the most problematic subtype of testicular cancer.
I also had a CT scan which showed nothing, this was followed with a PET scan that showed possible enlargement of the lymph nodes in my part of my groin, this may require surgery but a decision has not been made yet. The possible surgery will involve the removal of any suspect lymph nodes and is known as a Retroperitoneal lymph node dissection (RPLND), it's major surgery but the long term side effects are likely to be minimal.
The fact that the scans have shown very little is a good indicator that we have picked up the activity in the cancer early in it's life, this is a good indicator that we can beat this again.
It does need to be said that the treatment I am about to receive is difficult and not without risk. Also, given that this is my second late relapse, there are certainly no guarantees that the treatment will succeed. For me those downsides don't really matter, there is no time to waste thinking about them, nor is there anything to be acheived. Life is too good and the world is too weird/amazing for me to not want to hang around for plenty more years side by side with Robyn. In other words, I'm up for another fight.
I will make a separate post to describe the planned treatment in a bit more detail.
Cheers, Pete
The circumstances surrounding this current relapse are much like 2011 in that I had no idea whatsoever that anything was wrong, if anything I felt better in the last couple of months than I had for the previous 12 months.
The problem was again picked up with a simple bloodtest that showed an elevated level of betaHCG, which is a marker for my type of cancer. The blood test was repeated a few days later to preclude the possibility of a lab error, unfortunately the second test confirmed that the betaHCG was elevated and climbing.
Given my previous medical history this was enough to confirm that the cancer has returned and for the docs to begin planning more treatment, which goes to show how important those regular blood tests are. As with the previous relapse the rise in betaHCG indicates that it is the coriocarcinoma aspect of the cancer that is active, coriocarcinoma is very often the most problematic subtype of testicular cancer.
I also had a CT scan which showed nothing, this was followed with a PET scan that showed possible enlargement of the lymph nodes in my part of my groin, this may require surgery but a decision has not been made yet. The possible surgery will involve the removal of any suspect lymph nodes and is known as a Retroperitoneal lymph node dissection (RPLND), it's major surgery but the long term side effects are likely to be minimal.
The fact that the scans have shown very little is a good indicator that we have picked up the activity in the cancer early in it's life, this is a good indicator that we can beat this again.
It does need to be said that the treatment I am about to receive is difficult and not without risk. Also, given that this is my second late relapse, there are certainly no guarantees that the treatment will succeed. For me those downsides don't really matter, there is no time to waste thinking about them, nor is there anything to be acheived. Life is too good and the world is too weird/amazing for me to not want to hang around for plenty more years side by side with Robyn. In other words, I'm up for another fight.
I will make a separate post to describe the planned treatment in a bit more detail.
Cheers, Pete
Treatment, first couple of days
Start of first chemo cycle
I re-entered Peter MacCallum's ward 9 on Friday 22/2/2013 to be greeted by many of the old faces I have have come to admire so much, the staff here are great, it's not just what they do but the way that they do it that matters. Plenty of old memories are coming back too.
My current chemo regime consists of drugs that I have had previously (paclitaxol and ifosfamide) so I am well aware of the side effects to be aware of, and so far things are going as expected. I need to be vigilante because the amount of chemo I have had in the past can make things a bit more challenging this time around, and if we can get on top of the side effects quickly then that will be great for my general wellbeing as well as putting me in good stead for the more intensive treatment that is to come.
So far so good.
Cheers, Pete
I re-entered Peter MacCallum's ward 9 on Friday 22/2/2013 to be greeted by many of the old faces I have have come to admire so much, the staff here are great, it's not just what they do but the way that they do it that matters. Plenty of old memories are coming back too.
My current chemo regime consists of drugs that I have had previously (paclitaxol and ifosfamide) so I am well aware of the side effects to be aware of, and so far things are going as expected. I need to be vigilante because the amount of chemo I have had in the past can make things a bit more challenging this time around, and if we can get on top of the side effects quickly then that will be great for my general wellbeing as well as putting me in good stead for the more intensive treatment that is to come.
So far so good.
Cheers, Pete
Saturday 23 February 2013
About This Blog
- What is it for, who is it for.
- My primary reason for starting this blog is to keep family and friends updated on my condition, treatment and movements (locality, not bowel movements...). Whilst we deeply appreciate your phonecalls I have found that in the mid and latter stages of my treatment when the chemotherapy is really kicking in it can be very difficult to keep everyone up to date with accurate info by phone.
- I also intend to include a bit of information that other suffers of testicular cancer might find useful, so I must include some obvious disclaimers here.
- I am not medically qualified, the advice that I offer may help interpret the advice you get from a doctor but it should never replace it.
- Don't take anything that I write about my testicular cancer and treatment to be applicable to your circumstances, there are several types of TC, numerous subtypes and numerous treatment options. To further muddy the waters, everyone will respond to the different treatments slightly differently.
- If you are here because you have concerns about your health then I strongly advise you to get it checked out immediately, in most cases lumps on the testes turn out to be nothing more than a cyst but that is no excuse not to go to a doctor because an "it'll be alright" attitude won't work, cancer doesn't care what you think. Delaying because of fear of what might happen will only make your fears come true, the cancer will just go about it's business regardless of how you feel. If it does turn out to be cancer you might even find that the treatments bark is worse than it's bite, but only if you get in early, also remember that survival rates for this type of cancer are very high if you get to a doctor and start treatment early. Just do it.
- There are plenty of good resources on the net that provide more info than I could ever provide here, one of the most comprehensive resources can be found here: http://tcrc.acor.org/
- If you want to chat to people who have experienced testicular cancer then give this forum a go: http://www.tc-cancer.com/forum/forum.php
Subscribe to:
Posts (Atom)