Mets Day 529 Prepping for salvage chemotherapy

Mets Day 529

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Tomorrow morning I leap dose dense MVAC (or ddMVAC) chemotherapy. The objective of this chemo circular purely is hardly ever very to cure me of my optimum cancers. The doctors have made clear that they lack the capacity or skills to "cure" (because of this to location into remission for more than five years) metastatic bladder optimum cancers. There has on no account been a proven healing remedy for my kind of optimum cancers that may also be replicated with any reliability. It is wanted to appreciate the bounds of a treatment ahead of embarking on it. I get it.
Instead, the target of this job chemo is palliative, because of this to deal with and hopefully diminish indications, yet with out a healing intent. This kind of chemo additionally is pointed out as "salvage chemotherapy." The indications that this chemo is in quest of to keep up is the unfold of my optimum cancers to remote components — chiefly the so many lymph nodes in my torso, yet additionally to gradual the boom of tumors in different organs, extraordinarily my liver, lungs, bone marrow, and brain.

As I've recounted in my prior blog entries, doing this ddMVAC regimen at this factor is an competitive treatment, for three reasons. First, we're proceeding with out problems. We are not waiting till I have lymph nodes which are over 1.5 cm in measurement, that's the ancient threshold for measurable metastatic disorder. Doctors consistently want to wait till they see nodes or tumors of that measurement, so they'll be able to later measure them to see if the treatment labored. But it made no sense to me to seem ahead to the disorder to improvement ahead of we leap making an try and gradual its boom. It's like making an attempt ahead to weeds to solely take over a garden ahead of you apply a herbicide. Better to assault the weeds ahead of the roots get too deep.

Second, the recommendations that ddMVAC actually works purely is hardly ever very as robust as many doctors would like. There is some info that it may possibly gradual the construction of the disorder in up to 50% of patients, yet the literature additionally unearths that once the consequence (if any) wears off, the optimum cancers progresses quicker. Returning to my gardening metaphor, the ddMVAC herbicide may also gradual the boom of the cancerous weeds, yet whereas the herbicide wears off, the weeds grow quicker than ahead of. But if it slows the boom of the weeds for some length of time, then the chemo will have labored.

Third, ddMVAC carries with it the likelihood of a few imperative aspect effects. It is inclined to hurt my GI tract, sooner or later causing blisters to the mucosa layer on the internal of my lips, mouth, and throat. I'll potentially have the 2 constipation or diarrhea, or the 2, to boot as nausea and vomiting. I'll have fatigue and malaise. I'll be at danger for infections and fever. I'll potentially lose my hair. During this regimen I'll be walking on the ragged edge of toxicity, taking slightly not up to the dosage that would so weaken my body that an illness would be fatal. I can't guard taking the ddMVAC for more than six doses at a time, and 12 doses well-liked, in view that over time the chemo drug ideas are so poisonous that it may also kill me. The hope is that the chemo will have major of a prophylactic consequence that it be miles going to delay the added boom of the optimum cancers, yet not so an awful lot as to bring about a systemic crumble. My doctors have told me that they reflect onconsideration on that I will "tolerate the chemo well" and that they they'll be able to tackle these aspect effects, yet I'll be the simplest barfing and writhing on the ground in chilly sweats.

I'm going into this with my eyes vast open, opting for to space myself to the aspect effects in view that this treatment provides the surest danger for extending my existence. I have made clear to my doctors and beloved ones that I don't are making an attempt out to torture myself to purchase a pair of additional weeks of existence. In weighing the aptitude benefits in festival to the negative aspects, even supposing, I have concluded that ddMVAC does not rise to the level of torture. Maybe in a pair of weeks I'll modification my thoughts, yet for now, we're transferring ahead.

I've done a pair of subjects to arrange for my chemo. On Sunday, I began taking 500 mg. of ginger twice an afternoon to reduction lower nausea. My sister introduced to my interest an NIH-sponsored learn published very last year (link here), which concluded that ginger reduces acute chemotherapy-induced nausea whereas taken for six days together with each unmarried chemo cycle, commencing three days ahead of and going till three days after. There's no cringe to taking the ginger tablets, and I'll additionally be taking the anti-emetics. I'll additionally be taking Miralax on a on a daily basis foundation. I've been to this rodeo ahead of, and feature a purely a little greater theory on how to guard my GI formula in balance.

I had a baseline CT scan at NIH the day past. As I lay on the desk and felt the iodine sizzling my body and accumulate in my neobladder, I realized that this was my ninth CT scan in 20 months. It's historical hat now. One of purposes of the day past's CT was to see if it is going to detect a tumor in my liver. If so, we're going to potentially pull the plug on the chemo, as ddMVAC does not work well with liver tumors. Assuming the scan does not disclose a liver tumor, we're going to proceed. [After I at the leap posted this blog entry, Dr. Apolo emailed me the CT report, which did not detect any liver metastases or different enlarged nodes.] I'll have an commerce CT scan in December or whenever I cease this regimen, to see if my optimum cancers has unfold. If not, and dependent on how I tolerate the chemo, I may also have an commerce six rounds of ddMVAC early subsequent year. If it the disorder has progressed, then we're going to know that the chemo didn't work.

Dr. Aragon-Ching's nurse purely also referred to as to tell me that she wanted to do all 4 drug infusions tomorrow. This is choice from what she had told me formerly(the M drug on day one, and the VAC drug ideas on day 2), with no explanation as to why. I'll stumble on that out tomorrow morning. Tomorrow will be a protracted day, lasting 9 hours or more for the infusions, plus the blood work and port placement. I'll potentially absorb the laptop non-public computer and blog, and even I'll leap having a look at a glossy day miniseries. People have recommended Breaking Bad (teacher with optimum cancers does horrible subjects) or Mad Men (ad executives do horrible subjects) or House of Cards (politicians do horrible subjects). On 2d thought, maybe I don't are making an attempt out to watch oldsters doing horrible subjects. Yesterday I held my new granddaughter for purely about three hours. There are only a few subjects greater than that.

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