The ‘C’ Word

Reversals of Fortune

Posted on January 24, 2010. Filed under: The 'C' Word |

Apparently, I’ve been a complete and total slacker on posting updates, thoughts, musings, and general crap to my blog.  Sorry – I do apologize.  So, let me make up for that:

Happy Holidays, and Best of the New Year to everyone!

So, now we’re generally caught up.  I turned 50 yesterday.  My kids think it’s just a hoot that I’m ‘old’.  Right.  It’s a number – get over it.  I don’t feel any differently today, Sunday and 50 years plus one day than I did on Friday, 49 years 364 days.  It’s a number.  Let it go…..  Seriously.  Worrying and fretting over such mundane and stupid things causes ulcers, tension headaches, and the downfall of the world economy.  (I have a few thoughts on that subject and a few more, but I’m not going to turn political in this blog….)

On Monday (tomorrow) I go back into the hospital.  No worries – this is all planned.  The intent was always to reverse the ileostomy and reconnect the small intestine to the colon.  What that means for me is that there is no more ‘bag’ catching waste via a stoma in my abdomen (right next to my belly button) to deal with.  Overall, a good trade.  But, it does mean another ~5 day stay in the hospital, and a home recovery period of potentially up to 3 – 4 weeks.  Again – good trade.

And, once more I’m getting on the soap box: 

If you are having odd bowel habits or note blood in your stool – see your Dr.  Soon.  Just to be 100% sure: There is no normal reason to have blood in the stool.  None. Zip. Nada.  See your Dr.

Set up and get those colonoscopies. Be honest with yourself and your Dr. about any symptoms that seem to be abnormal.  Don’t bury your head in the sand and just try and convince yourself that the symptoms will go away.  They may be very normal, but what if they aren’t?  The message is simply this – if there is a problem – ignoring it is not going to make it go away.  Cancer or pre-cancer lesions don’t ‘just get better’. The first thing that needs to happen for your overall health is listen to your body and respond when things seem wrong.  I’m not advocating a lifestyle as a hypochondriac. I am advocating seeing your health care professional when you are experiencing something that is not normal FOR YOU.  What’s normal for me is one thing – and you’ve read what is not normal for me in this blog.  Talk to your Dr.  Remember – early detection means that your chances of a cure are GREATLY increased. 

You can hit the lottery just like me.  But, my lottery means a lot more years of life rather than cash.  I’ll take the years, thank you.


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A few random thoughts during this special time of year….

Posted on December 14, 2009. Filed under: The 'C' Word |

As mentioned in my most previous post (Odds, and what I’ve actually accomplished – December 13, 2009) I talked about beating the odds for colon cancer.  If that’s not enough to get you thinking about your own health, then – what else could?

Let’s make no mistake – the preparation FOR a conoloscopy sucks.  It’s not fun.  But, it’s only about 4 –6 hours of hard work, and then you’re pretty much out for the actual procedure.  If there are no issues with your preparation, then the actual colonoscopy itself takes about 15 minutes. Yes, you’re going to get a camera stuffed up your butt, however – remember you’re not remembering any of this.  Really.  I promise.  The actual time you spend getting ready FOR the procedure once you get to the Doctor’s office that will perform the procedure takes about 4 times as long as the actual procedure.

Oh, and if you have relatively decent insurance, it’s going to be covered.  If it’s not – start shopping for new insurance, because – let’s be honest….  It’s cheaper to detect early and cure rather than detect later and then have to go through chemo, radiation, and surgery.  But, as we are finding out through this whole mess called the “Health Care Reform” bill, some insurance is pretty retarded, much like the so-called recommendations about breast cancer screenings being changed completely – and would have ended up with 100’s to 1000’s of women dying due to cancer not caught in time.  The basic concept of insurance is to take as much of your money and pay out as little as possible.  That’s the business plan – and your health is really not their concern.  If you doubt that – then, I’m not sure the rest of this conversation is going to make any sense anyway.

Can you see that I’m being a bit of a militant radical when it comes to early detection and screening?  Going through what I have (the massive up’s and down’s – with the final thrill ride at the end of a Surgeon literally walking on air as he came in to my hospital room to tell me “We got it all!  You are no longer a cancer risk from this tumor!”) since 9/24/2009 when I first found out about this tumor – and knowing the right decisions on my part and my Primary Care Physician (by the way – his name is Joedy Istas, M.D. and I’d be honored if his patient load went up because of me…..  He’s already heavily in demand…  Don’t blame me if you can’t get an appointment with him.  He IS that good.) and my surgeon (Dr. M. Shashidharan, Colon and Rectal Surgery, Inc. [just call him Dr. Shasi {Sa’-shee}, everyone does – colleagues and patients alike]and he does colonoscopies as well, as you might suspect) contributed to an astounding outcome.  And, contrary to my usual nature, I didn’t procrastinate for a year or five before going and getting the colonoscopy.  As mentioned, I hit the lottery on this one.  The odds were not in my favor on this.

As my brother-in-law, John, who has lost more friends and relatives to cancer than I, famously says “F#%k you, Cancer!”, I get to add my own, which I’ve used in more than a few places.  Thanks for letting me borrow this, John:  “F#%k you, Cancer!  I WIN!!!”

But, I do have to give a nod to friends and relatives who are either currently fighting or have lost their battle, and I am forever indebted to for their contributions to what the medical community knows about cancer:

Richard T. Kingslan, Sr. (Passed 1995)

Kelly Hendrickson (Passed 1998)

Ron Pieters  (Passed 2008)

Eleanor Jones (Passed 2009)

Matt Kamprath (Passed 2009)

Bill Greve (Still fighting)

My final plea – give money to the American Cancer Society.  Research into cancer is really, really good.  What the Doctors know today as compared to 5 years ago is – simply stunning. 

Get your colonoscopy – even though you feel fine and seem to think you’re immortal.  I hope I’m not bursting any bubbles – you’re not immortal.  But, you kinda want to die really old – or at least doing something you like.  And, I’m sure that none of those I’ve named really liked dying of cancer. Seeing the strongest man I’ve ever known, my father, wither from his cancer was the hardest thing I’ve ever done.  And, I don’t want you or any of your loved ones to have to see your die in such a miserable and painful way.

Get tests… Avoid cancer like you would the plague. And, if anything – be like me and realize that you have a second lease on life – and now you have to figure out what your mission is.

I think, in some ways, you can likely figure out what my life mission is going to be. If I can save one person, I get to tell cancer “F#%k you!” once more.  Make no mistake – that’s fun – and very, very fulfilling.


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Odds, and what I’ve actually accomplished

Posted on December 13, 2009. Filed under: The 'C' Word |

I’ve won the lottery.  You now, the Powerball – with a powerball value of x5.  Plus, the Publisher’s Clearinghouse folks dropped by to give me the grand prize check the other day.  Add to that – I found out that a deceased person needed me to help get the family estate money out of Africa and I got 3 million dollars just for helping.  And, it wasn’t a scam!.

OK – none of the above actually happened. But, seeing my Oncologist and my Radiation Oncologist – they both had a message that was more important than all three of the above:

“Rick, it’s time that we end our professional relationship.”

What this means, simply – is that I beat huge odds – massive ones when we are talking about colon cancer.  I am cancer free. It was caught in Stage 1. The rarity of this actually happening is small – surprisingly so.  And, there was a set of circumstances that were set into place in early September of 2009 that allowed this all to happen this way.

1. My Primary Care Physician LISTENED to me when I was describing some odd bowel issues.

2. He decided, rather than waiting another year, to send me in for a colonoscopy.

3. Contrary to my nature, I didn’t procrastinate – and made the appointment for a week after seeing my Primary Care physician.

4. From that point forward – things took on a life of their own – to the conclusion of Friday.  I am well.

I also thank the wisdom of my Doctors to keep going back to trying to get a biopsy that CONFIRMED the diagnosis of the second colonoscopy and the endoscopic ultrasound.  If they did not keep trying for this hard and fast diagnosis, or that one of the biopsies returned a positive on the cancer, radiation and chemotherapy would have started for a carcinoma that needed only to be REMOVED – not killed off and reduced.

Because this cancer was completely and totally contained in the wall and muscle of the colon, there was no further involvement of any other tissue.  No lymph nodes, nothing.

Yes, I have won the lottery.  Check the odds.


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Biology and the workings of cells are so complex….

Posted on December 8, 2009. Filed under: The 'C' Word |

It’s been a long time since I’ve posted a message to the blog.  There are a couple reasons for this:

  1. I’ve had surgery, and frankly didn’t much feel like posting
  2. My wife took over the day to day communications to most people, so there wasn’t as much of an immediate need for me to do it


So, that is it.  Not much desire to get on the computer.  I’ve got an incision from my belly button (Dr. fixed a herniated belly button while he was there – thanks, Dr. Shashi!) all the way down to my pubic bone.  About 10 inches of nicely healing scar. During the surgery (possible over-share violation upcoming), the Dr. removed some inches of my rectum and colon, containing the tumor.  Remember the tumor was only a 5 cm mass, but it was very important to take enough to ensure that the entire mass was removed.  In addition, they harvested a large number of lymph nodes in that area because of the high suspicion that they might be involved. Once the clean up was done, the ends of colon and the remainder f the rectum were reconnected in some specific manner.

To give the newly reattached plumbing time to heal, the Dr. installed an ileostomy. An ileostomy is done by separating the ileum or the end loop of the small intestine that attaches to the large colon on hte right side of the body, and presenting it to the surface of the abdomen through a hole in the surface skin and muscles.  The intestine in turned inside out where it exits the hole, and is sewn in place.  The exposed inner intestine in impervious to the output fluids, however, the skin is not.  The patient in fitted with a replaceable appliance that serves to protect the skin and act as a ‘port’ to a bag to retain the output from the ‘stoma’, or the external intestine.  The stoma and the appliance must be replaced, and contains a pectin that provides the skin barrier and the seal between the appliance and the stoma.  The bag needs to be emptied as it fills.

So, as you might imagine, there are two types of ileostomies – permanent and temporary.  Mine is temporary.  When my doctor determines that the rectum/colon is healed, I’ll go in for a much less radical surgery to reconnect the ileum to the colon, and to remove the ostomy in my abdomen.

Waiting is the hardest part…

When you have cancer, you are always waiting for news.  Is it back?  Is it gone? How bad is it? Will I die?

The news that I was waiting for was very simple – do I have cancer or not?

Once the colon tumor was out, the pathologist had full and complete access to every bit of the mass.  And, remember those lymph nodes that were harvested?  He had access to those two.  If there was cancer, it couldn’t hide any longer.

My Doctor did a great job in calling in some favors and the Thursday after the surgery was able to tell us that the tumor was fully contained in mass.  Nothing outside of the colon walls, period.  And, for good measure – none of the lymph nodes showed any signs of cancer.

For the record:

I did have cancer.  The mass was malignant. But, of the three walls of the colon, it had penetrated two of them.

And, for the record:

I’m a cancer survivor.   And, damn happy to be among that class of champions.

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The END (My End, rear end) is in sight?

Posted on November 2, 2009. Filed under: The 'C' Word |

Puns, being one of my favorite comedy elements (simply because they are typically very subtle, are usually intelligent, and are something the people closest to you get) have found their way into my daily vocabulary.  Much like the title above does not speak to any demise, but (no pun intended) to my own derrière… On which, the surgeon will be working on.

I guess that you could say, in car parlance, I’m getting a new rear end.  Eventually, at least.  I am scheduled (Finally!  Something is moving forward!) to go into the hospital and have the tumor removed. In technical terms, the procedure that I SHOULD have is called an LAR, or a lower anterior resection.  For those of you that aren’t interested in going to Wikipedia and searching around, reading the details, it means that the surgeon will go in, remove the tumor (and the surrounding large intestine) and then put me back together. However, with all things medical (remember this post….) nothing can be predicted with 00% accuracy, except of course, for death and taxes.  Those are inevitable.

There is the possibility that Dr. Shashidharan (He goes by Dr. Shashi and he’s from Hyderabad, the garden spot of India –a truly a beautiful city in the south of India with history going back 1000’s of years, and one of my personal favorite cities that I visited during my 2 year stint doing international travel with the Microsoft Vista SWAT Team.  His first name is Maniamparampil – sure, go ahead and pronounce it. ) might just find that the tumor has done too much damage or is too close to the anus to allow a complete resection and normal function.  In that case, he will need to do what is known as a APR, or Abdominoperineal resection.

The APR results in a lower quality of life, simply because it involves removing the sphincter muscle and the anus, resulting in a colostomy from the rest of the patient’s (in this case, me) life.  Regardless of which procedure, LAR or APR, I will have a colostomy from some 8 – 10 weeks.  Not a big deal – I think I can handle that.

My confidence is further buoyed by a guy whose acquaintance I’ve made though other friends.  He has Crohn’s disease and as a result has had many resections of his colon. He has a permanent colostomy and has pretty much assured me that his quality of life is pretty darn good.  He told me that there has yet to be anything that he’s wanted to do that he couldn’t because of his condition and his colostomy.  He’s also been very forthcoming on discussing anything with me, including the care of a colostomy and what I should expect.  It’s people like Marc who I most appreciate – as he has reached out to me to help quell some of my jitters and unease as I go into this long process.  Obviously, the biggest concern is the unknown.  And, when talking with your doctor you are often not educated enough on your condition and the upcoming surgery to know what questions to ask.  It’s the old quandary of How can I ask a question on something I don’t even know enough to know what to ask?

Now, the interesting thing is that – as mentioned – through all three biopsies, no cancerous cells were detected.  Only pre-cancerous cells.  So, this does mean one of three outcomes:

1. The tumor is removed, biopsied completely, and is found to be fully contained and no or minimal follow up treatment for cancer needed

2. The tumor reveals cancer in the tumor that has penetrated the wall of the colon, but has gone no further.  This might require some follow-up, such as chemo, but maybe not radiation

3. The tumor exhibits exactly what was diagnosed some 6 weeks or so ago – that it has gone past the colon wall and has involved a few small lymph nodes.  This would involve a full regiment of post-operative chemotherapy and radiation therapy.

In the end (again, no pun intended) the chances now seem to be better for #1 and #2. But, if it does turn out to be #3, then we are only doing the recommended treatment in reverse order.  The suggested treatment is to do radiation, chemo THEN surgery.  But, it is what it is.  I’ll get the tumor out.  Then we see what we have when the pathologists have the entire mass to test.

All in all, so far this has been a pain in the a$$.  And, no – that’s literal – and pun fully intended.

Carry on, all.  I am, and so should you.  By the way – if you are 30 years and older – and have a familial (especially parental) history of colon cancer, you should talk to your Doctor about being screened.  If you are 40 or older, you should start having that discussion with your Doctor.  If your medical history doesn’t warrant a screening, your Doctor won’t likely have it done.  BUT, you should, should, should start raising the issue. If you are nearing 50, you should insist that your Doctor schedule a screening, regardless of your medical history.

I am going to be very, very frank – and I am going to post another article here relating to this very subject of screening: The cancer is MUCH worse than the screening.  In fact, the preparation FOR the screening is MUCH worse than the screening.  All of the prep you could possibly have to do is much less than what I’m going through right now.  And, I still feel VERY, VERY, VERY lucky that my Family Practice Doctor took my symptoms to heart and decided NOW was a good time to do a screening.  He probably saved my life.

Let me say this:  The prep sucks.  Seriously.  I’ve done it twice, I’m getting ready to do it again, so I think I’m becoming a pro at it.  You drink (literally – no joke) 2 liters of a purging mixture (read: heavy duty laxative) in about 1.5 hrs.  Then you purge.  A LOT.  Then, you wait about 6 hrs. and you do it again.  2 liters, 1.5 hrs. and purge.  Folks, they call this stuff ‘colon blow’ for a reason – and it’s obvious the first 2 liters why.

But, it’s necessary.  You need to have a clean colon for the Doctor to make it from the anus to the caecum (the caecum is the furthest most end of the large colon from the anus, just beyond where the small intestine and the colon join, and appendix is attached to this end of the colon).  If they cannot get all the way through, due to solid matter in the colon, you may have to endure a second colonoscopy with a more intense purge process (starting with a 10 oz. bottle of magnesium citrate drunk all at once.  Bottoms up!).  Really, you only WANT to do this once every 5 years or so.

But – the procedure itself is a breeze.  You are put into one of those ‘twilight’ sleep states where you are conscious enough to respond if the Doctor needs you to move or do something.  But, you won’t remember a thing about the procedure.  You remember the anesthesiologist beginning to ‘push’ the drug into your I.V., and then you wake up back in the recovery area.  Total time from “Hi.  you ready to do this?” in the colonoscopy room to the time you wake up – maybe 30 minutes.  Tops.  My second colonoscopy also involved an endoscopic ultrasound, and the Doctor was done with the colonoscopy and study of the known tumor via the ultrasound in 20 minutes.  I guess that’s why these guys and gals get the big bucks.

Ultimately, why am I telling you this?  Don’t IGNORE YOUR SYMPTOMS.  They are not going to go away and you might find yourself in my situation.  If something seems wrong, it probably is.  If you think you’re being a hypochondriac, let the Doctor determine that.  Colon cancer is a mostly silent killer.  It doesn’t hurt or present most of its symptoms until it’s too late.

Next post – we’re going to discuss (as delicately as possible) my symptoms, how long I’ve had them, what I should have done, and what I urge YOU to do if you are experiencing anything similar to my early symptoms.


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Well, it IS called the Practice of Medicine….

Posted on October 25, 2009. Filed under: The 'C' Word |

My Dad (God love him, and rest his soul), a well-known curmudgeon, skeptic, and Doctor-hater had a saying: “The profession is called the practice of Medicine, and they are practicing on YOU!”. Well, in reality, this is right.  Nothing about the Medical profession is perfect, but it’s better than what we would have had a scant 400 years ago when the typical treatments were to use lancets to open a vein and ‘let blood’ or any other number of barbaric treatments for what might ail you.  And, yes – as little as 100 years ago the Barber, the Dentist and the Doctor were usually the same person.  Your best hope was that he remembered why he was seeing you, and if he was cutting, pulling, or whatever – it was what you actually came to see him for.  Seemingly a diverse set of talents there.  I can’t really imagine going to my Dentist today and saying, “Um, have a little bit of a toothache in the right upper molar, and oh… Can I get the hair just a bit shorter this time? And, how about a steam and a shave?”

Anyone that has been following my Facebook along with my wife, Sue’s, knows that the tumor just isn’t cooperating.  Or, if you want to look at it another way – it’s cooperating just fine.  Visually, anyone could concede that I’ve got cancer.  It’s not pretty, and it does some very nasty things, all in all.  But, I’ve submitted to a total of three biopsies – all of which keep coming back as “high grade dysplasia”, which essentially means “It’s not cancer – yet…”  I’m fairly sure that the Insurance Co. isn’t going to want to pay for any more biopsies – as least one’s that aren’t mandated with the removal of the mass.

Being unlike my Dad, I generally like Doctors. I’ve met some real clods in my day – complete lack of a bedside manner, no empathy whatsoever or sympathy for the situation – just a cold, clinical attitude to whatever you’re going through.  I get the need to emotionally detach, but there are limits to that as well.  Fortunately, none of the Doctors that I’ve seen are in that category (but then – I didn’t have much of a discussion with the first Doctor who did the initial colonoscopy….  Sue says he pretty much fit into that ‘clod’ category.  Me, I was simply enjoying the Fentanyl and I don’t remember much. Possibly that’s why I like Doctors…  For the drugs?  🙂 )

So, I’ve had pretty meaningful discussions with my oncologist, my radiation oncologist, and my surgeon over the past couple of days.  The bottom line – three biopsy attempts do not show any cancer activity.  Only ‘suspicion’ of cancer.  Suspicion is not a good reason to submit someone to extremely aggressive therapy such as chemo and radiation. So, the oncologist says seriously consider having the tumor removed and we’ll biopsy it after the fact.  The radiation oncologist says pretty much the same thing.  The surgeon – right in line….. We can either do more biopsies (of which the insurance company at some point is going to wonder if we’re just waiting for it to BECOME cancer….) or we can go in, remove the tumor, put me back together as well as possible, and then determine what the steps are post-surgery.

There is still the real possibility that there is cancer.  Best scenario is that the cancer is localized to the tumor itself. Second best – the cancer has left the main tumor and involved the bowel wall. Third scenario – and what we’ve been thinking it is all along – it has left the main tumor, involved the bowel wall and a couple small lymph nodes.

I’ve already made the decision to go ahead with the surgery.  It’s time to move forward and get something done.  I should have a conversation with the surgeon’s scheduler tomorrow (Monday, 10/26) and would expect to have surgery to remove the tumor and a section of the bowel within two weeks or so.

One thing is for sure: Once the tumor is removed and the biopsy on the tissue is done – we will know with 100% certainty if we are dealing with any form of cancer. With it out, it doesn’t really have any place left to hide.  And, if the pathologist’s do find something – then it can be dealt with post-operatively.

In the end (no pun intended) there may be no “glowing”, short of the PET scan which apparently associated me rather closely with a lightning bug – given that both myself and a lightning bug have a butt that glows.  OK, now that I’ve ruined your love for lightning bugs by comparing them with my glowing tumor in a PET scan, I’ll leave for now.


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Odd situation right now. I WISH I had cancer…..

Posted on October 19, 2009. Filed under: The 'C' Word |

This is just frustrating to some degree.  The two Doctors that did the colonoscopies, the Oncologist, the Radiation Oncologist, and the Surgeon – all are 100% certain that the tumor is cancerous.  When something acts like cancer, reacts like cancer to the tests that have been done so far, it should be pretty easy to conclude that it’s cancer.

I wish someone would tell the biopsies and the pathologist.  Two biopsies, re-read by different pathologists, and the same diagnosis comes back: “High grade dysplasia with properties suspicious of cancer” or something really close to that.

Why is this so frustrating and so critical?  Well, oddly enough, no one will treat you for cancer until you are actually 100% beyond all shadow of doubt deemed to have cancer.  And, apparently, a doctor with years of experience is trumped by a biopsy of a tumor that just does not want to be properly diagnosed for what it is.

So, I’m currently in limbo and have another appointment with my Doctor to go back for another rectal exam and biopsy. What’s kind of scary (to me, at least) is how big of a piece of this thing is the Doctor going to want this time?  I think that all of the actors involved here pretty much know that we need to get a solid diagnosis and get the treatment started. I guess if the drugs are good enough, he can take as big a piece as he wants. :o)

One thing for sure – the tumor isn’t going to get better on its own…..


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Taking Me Apart and Putting it All Back Together Again….

Posted on October 17, 2009. Filed under: The 'C' Word |

Make no mistake – the practice of Medicine has always been a fascination for me.  It’s detective work in the most critical sense, and I love the puzzle.  Aside for the cynical attitude (which mimics me so well that he could be my brother), it’s likely one of the reasons that I like the Fox TV Show “House” so much.  Far fetched?  Sure – but an hour of ‘suspension of belief’ is OK.

So, why this bit of information? Your General Practitioner may not strike you as the most brilliant Doctor ever.  They deal with cold symptoms, this hurts when I do this (“Uh, don’t do that…”), flu, and a whole host of other things that are just – mundane. But, I owe my GP a debt of gratitude, and very likely my life.  He knew enough from my symptoms to order up a colonoscopy.  Thank goodness he did.

So, to date I have met two Gastro-Intestinal doctors, an Oncologist, a Radiation Oncologist, a Research Coordinating Nurse, and a Colo-Rectal Surgeon. My surgeon is a fascinating guy with a massive amount of credentials behind him.  Creighton, College of Surgeons – Edinburg, Scotland, multiple memberships in various medical associations.  Plus, he has a very good bedside manner (and, that’s not as easy to come by these days as it once was). More importantly, he had time to listen, talk about what is going on and what the potential outcomes would be.  Plus, he’s from Hyderabad, my favorite city in India (of course, Microsoft has a really big campus there….).

What we discussed specifically was the current state of the tumor (partially obstructing in the lower bowel in the rectum) and the fact that if all goes well with the radiation therapy and the chemotherapy, the odds are better than not that he will be able to remove the tumor and re-attach the ends of the colon to return me to near perfect – minus some inches of lower bowel.  Of course, they do call it the “Practice of Medicine” for a reason.  No one has perfected medicine.  Nothing is a guarantee.  What I know in addition to the above is that the possibility is that he won’t be able to put me back together.  And, that means that I’ll have to have a colostomy – not the worst outcome ever.  But, regardless – I’ll have a colostomy for a couple months anyway, as the resected bowel heals.

What does all of this mean?  It means that I have met everyone that is going to be directly involved in my cure.  Now, all I want to do is to get going.  Bring on the radiation, bring on the chemo.  Bring on the surgery.  I want this little, 5cm parasitic thing out of my ass.  Tomorrow would be OK.  🙂


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I Expect to Glow in the Dark Soon……

Posted on October 13, 2009. Filed under: The 'C' Word |

This morning I went back over to the hospital for a PET scan.  PET stands for Positron Emission Tomography, which basically means that they create a 3-D map of your body.  But, before they toss you into the ‘field of nuclear bombardment’, they give you an infusion of radioactive tracer material.  In my case, I’m pretty sure that it was flourine-18.  It’s mixed with a glucose (sugar) solution and injected into the body via a vein.  The end result is once you’ve sat for about an hour, giving time for the radioisotope and the glucose to move through your body, the glucose is eaten up by the more voracious eaters in your body.  In my case, that’s the cancer – which lights up like a beacon in the PET scan.

The good news is that there is only one area that was indentified by the PET scan as having any kind of activity – and that was the known tumor in my rectum.  Yeah, it’s good news when they only find cancer where you already know you have it!  Certainly, the bad news would have been that there was another area of interest. There wasn’t, and that’s a good thing.

The PET scan results are being used to map out what the best approach to delivering radiation to the tumor. The Dr, his radiation mapping experts and the physicists (right – physicists…. They help to determine how strong of a dose to be given to achieve the desired results) work to determine the best course of therapy.

Me, I’m just looking forward to moving ahead.  I have a meeting with a surgeon this Thursday, and hopefully soon I’ll know what leg of the research project I fall on. I have a 50% chance on needing a port installed in my chest – but, one way or the other, it’s all good.

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The cure now begins….

Posted on October 7, 2009. Filed under: The 'C' Word |

I met with the oncologist, Dr. Silverberg yesterday.  Very, very enlightening meeting, and very positive.  (It’s all about the positive aspects of the fight, yes?)  Dr. Silverberg is a bit quirky.  Great guy, don’t get me wrong – but the more doctors I get to know, the more I realize that the more intelligent you are, the more quirky you are.  He has a tendency to answer his own questions, and says things out loud that you don’t expect in a conversation. For example, he’s talking and just stops – pauses for a minute – and says, “Wow.  I’ve been talking a lot.  I need to get some water”.  Umm, yeah – ok.

Which, in the end means that he’s human – and that’s a good thing.  I don’t much like the sterile, precise and rather distant attitude of some doctors (and professionals in my own field).  I like quirky – it’s fine.  For those of you that know me well, I’m just a tiny bit quirky as well.  🙂

He described my cancer as an early Stage III, and this is because (again, as I understand it) of the early involvement of a few lymph nodes.  But, the radiation (I see the radiation doctor on Friday) and the chemo will clear that up, as well as stop the growth and reduce the size of the tumor.

What is exciting is that my type of cancer (location, involvement, etc.- and if cancer could EVER be termed ‘exciting!’) is applicable to a current research study that is being done. What is exciting about it is that there is new drug therapies that are developed and in late stages of testing that are being finalized for use in colon cancer.  These drugs have been used very successfully in breast cancer, and the research is to study the applicable uses for colo-rectal cancer. I’ll be on the cutting edge of treatment for this type of cancer.  I am going to participate in the trials and the research for a couple of reasons:

1. People before me participated in research trials that are driving the treatment that I will receive.  I owe it to those of us that will be afflicted in the future by my experiences and the findings of this research.

2. There is no placebo (or, simply “no sugar pill”) involved in this research.  The least treatment that I will get is what is the norm today – radiation therapy and 24/7 infusions of FU-5 (fluorouracil or 5-fluorouracil – the most common type of chemo drug). 

3. I could (by complete randomization of research candidates) get one of three other approaches:

  • FU-5 and another IV-administered drug called Oxaliplatin and radiation therapy
  • Oral (by pill) chemo drug called Capecitabine (Xeloda) and radiation therapy
  • Oral Capectibane and the IV of Oxaliplatin and radiation therapy

However, the best news was received this morning from Dr. Silverberg’s office.  I was sent over to the radiology lab to have blood drawn and for a complete CAT scan, including the wonderful barium ‘milkshake’ (I’ll be pooping chalk for a week…) for an upper gastro-intestinal study and an iodine solution delivered via IV.  Both of these provide a very clear picture of the chest, abdomen and pelvis by providing a high contrast for the CAT scan to pick up any other abnormalities. (oh, and for those of you that might have to have a high contrast vein study with an iodine infusion, when the iodine hits your pelvic area, it ‘feels’ as though you’ve just peed your pants.  (You haven’t it’s normal, and you’re just fine….)

There are no other sites located – which means that the cancer is very contained and has not metastasized (invaded other organs, bones, etc.).

So, this is a really, really good day.  I’m excited about getting started on the treatment and getting cured.  There are a lot of hurdles yet to go, and there are going to be some down days in the near future.  So, I have (initially – there may be more….) 6 weeks of radiation and concurrently 6 weeks of chemo (on one of the ‘legs’ of the trial that I noted above.  After that, we wait a few weeks so that the treated areas can stabilize after the bombardment from the radiation.  Then, it’s off to the surgeon to get this little parasitic bastard removed from my bum.  Or, more appropriately, about 4 cm inside my bum.  that should take place right around the very end of December, or beginning of January.  (mark your calendars….)

If you have ever seen the movie ‘Alien’ (still on my top 3 list of scariest movies EVAR), you’ll recall that Kane (John Hurt) is ‘attacked’ by one of the egg ‘creatures’ (termed ‘face huggers’) and has an embryo planted in his chest. During dinner, this embryo – now more matured – bursts from his chest (of course, killing him) and skitters off to terrorize the rest of the ship as it grows quite rapidly into the eight foot tall alien that the rest of the crew tries, in vain, to fight off and kill.

Think of that alien embryo as my tumor.  No one – including me – wants to see that pop out of where it would pop out of.  And, certainly – not during dinner.



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