The quick version: a scan in late July found a tumor just over 1 cm in my liver.
After four rounds of chemo, the tumor appears unchanged, but there aren’t any
more of them and it hasn’t grown. So the plan is to zap it with radiation,
probably starting in about three weeks. The radiologist seems very optimistic
about good results. The full details are actually kind of
interesting...
Pancreatic cancer is a pernicious, persistent, systemic
disease. It is hard to find, it spreads rapidly, and it almost always comes
back. Therefore, the most efficient treatment is chemotherapy, a systematic
approach. That is why I just did 4 more rounds, and have done 20 rounds overall.
I am fortunate that chemotherapy has worked well for me and my body can tolerate it. However
it makes me miserable; profoundly fatigued, depressed, nauseated, and depressed,
did I mention depressed?
However, occasionally the tumors are isolated
and there is no evidence of spread. In this case my tumor is isolated, somewhat
easily accessible, and most importantly, far from any other major organs. So, I
am a candidate for SBRT radiation, which is a very high dose radiation protocol,
given over five consecutive days. It is pretty common for attacking colorectal cancer, but not often used for pancreatic since the latter is usually widespread. I have already done SBRT, in December 2015
after chemo and prior to the major surgery on the two tumors I had then. My surgeon then felt that it was an important factor in his ability to clear those two tumors
from difficult positions.
For SBRT radiation, I try to lie perfectly
still for 30 second intervals over about a 45 minute period while I get zapped.
I had virtually no side effects the last time around. So I’m really pleased that
we can do this approach instead of more chemo.
The most unpleasant part is just getting to Johns Hopkins five days in a row, not to mention the scans and evaluations before and after. If any of you local folk would like to
volunteer to take me for one of the trips, we would be very
appreciative!
It may not seem this way but I am in fact a very lucky man.
I do have to remind myself of this frequently. And I am lucky to have lots of you
as my friends!
😘
Rick
