I've had a pretty busy week so far – on top of fatigue that has been incredible. But, we've figured out what the main cause for the fatigue is and I've been able to get some help with that – more in a minute.
First, as many of you know, I was scheduled for a new CT scan on Monday so we could see how the cancer is progressing and responding to chemo. We met with our doctor on Tuesday to go over the results and unfortunately found that the results were a mixed bag of good and bad news. The good news is that the cancer has not progressed or grown, but the bad news is that it also hasn't reduced any from the initial reduction we reported on six weeks ago. As difficult as it was to learn that there hasn't been any further reduction, our doctor reassured us that this was not necessarily a bad thing. Based on some of the pain I'd been experiencing, he had thought that the tumors had begun to grow again, and he was quite relieved to discover that it had not grown. In fact, he said that if there had actually been a reduction he would have been giddy. Apparently, the maximum effectiveness with chemotherapy is usually reached after 4 – 6 treatments, so my response is what was expected. Any additional reduction would have been beyond the normal response expectation.
The plan at this point is to continue with two more chemo treatments to make sure we get the maximum effectiveness from this type of chemo. After that, I'll need some time to recover from being on chemo. Some of you will remember that the key to administering chemotherapy is to poison the cancer for as long as possible without killing the patient. And, true to expectations, each round of chemo has been progressively more difficult, so two more rounds would probably be about as much as I could handle anyway. So, I'll get a few months of respite from chemo while I recover from the effects of the last months' worth of treatment. Hopefully, we won't see any growth from the cancer during this period – if we don't, then once the cancer starts up again we'll be able to use the same type of chemo to knock it out. If, on the other hand, the tumors start to grow relatively quickly, that would indicate that they have become resistant to my current chemo treatment and I'll need to move to a different type of agent. Then it will be a race to get me to a point when I can handle a new chemo therapy before the tumors grow too much. Obviously, we're hoping for a long period when the cancer doesn't grow at all so that I can get back to relatively normal health before needing to go back on chemo. Besides, with enough time, my hair might actually grow back.
As for the increased fatigue and more difficulty I've been experiencing with each new round of chemo – a lot of it can be attributed to the effect that the chemo is having on my blood cells. The chemo I am taking targets fast growing cells and blood cells are some of the fast growing type of cells that tend to be hardest hit by the chemo. We've dealt with the effect on white blood cells by getting a shot which stimulates the blood marrow. However, my red blood cell count has continued to go down with every week. Since the red cells are the ones that carry oxygen to the rest of my body, it's no wonder that I have been having fatigue. This last appointment my levels were so low that the doctor was actually surprised that I had enough energy for the visit.
The solution? A transfusion of two units of packed red blood cells and a shot which stimulates the growth of my own red blood cells. The good news is that the transfusion was yesterday and I'm already experiencing much more energy. The shot was given on Tuesday and although it takes a little longer to kick in, it should be helping by today or tomorrow. It's nice to have a little more energy back. Of course, the bad news is that I'll have to give up my plans for competing in the Tour de France this year, since both the shot and the transfusion are exactly the type of "doping" that gets cyclists banned from competition. I know that's a disappointment to most of you who were looking forward to me competing this year, but sometimes that's how life goes.
Matt
