I am now in the middle of my 5th treatment cycle-and overdue to provide an update.
As usual the cycle commenced with a consultation with my oncologist ,Richard Sullivan.It confirmed that I am continuing to travel well.
The side-effects from my chemo remain negligible .I take no anti-nausea medication yet I have a healthy appetite.My energy levels in general remain high(I notice a couple of ’slow’ days in the middle of my cycle)and the rash I experienced in the early cycles has not reappeared.
My blood tests show that my immune system is holding up very well. The usual ‘mid cycle’ dip in my white blood count is not major and it is recovering well by the end of the cycle . My red blood count is staying within or above normal levels indicating that I remain healthy.The higher calcium levels in my blood , noted earlier, are a sign that(litic) bone metastases have been mending.
I continue to feel well and have not experienced even minor illnesses during my treatment.The earlier discomfort and sensations from metastases appear to have disappeared or substantially subsided.
As a result of the data and observations outlined above Richard and I have decided to cancel the plan for a mid-term CT scan .We will instead have Trevor Fitzjohn undertake a PET scan at the end my next and final cycle(at least for the forseeable future) .That will provide detailed data on my progress while undergoing the current chemo treatment and a ‘base’ against which we can monitor(probably 3 monthly) my progress using Tarceva .
During my consultation Richard informed me that my progress to date places me within the top 5% of people(I refuse to see myself as a ”patient” ) with my advanced type of cancer.
I picture my situation as follows.
The typical survival ‘curve’(probability distribution) for people with advanced cancer can be envisaged as a rather ‘peaky’ bell-shaped curve with the left hand tail cut off(ie, truncated on the left with a high proportion of outcomes around the mean and a long right hand tail). This means that a small proportion of the ‘population’ of people with advanced cancer survive for a relatively long time.
When I first visited Richard the distribution I faced had a mean of around 5 months.My very good starting health and ’never smoked’ status ,and my progress early on in the course of treament indicated I would be somewhere well along the right hand tail of that survival curve.
Since then the news that I tested positive for the EGFR mutation (for which Tarceva is an effective treatment) means that I face a similarly shaped distribution but with a mean of somewhere between 2 to 3 years(for a different population of people with stage 4 cancer -those that have the EGFR mutation).Moreover my continuing good progress, as outlined above, suggests that I will also be well along the right hand tail of this curve also.
My objective is to ultimately move myself to the survival curve of the general population of people of my age -and still be on the right hand tail! That implies that my immune system(which ultimately has to do the heavy lifting) eventually heals me of my cancer.At the very least I expect to ‘manage’ my disease with a high quality of life for some considerable time.
It takes just over 3.5 hours each cycle to administer the three drugs comprising my chemo ‘cocktail’.I approach each treatment positively-the medicine is my very good ‘friend’.I sit in a chair in comfortable clothing while it is administered via IV in the back of my hand. During the first hour or so I relax,meditate and visualize the medicine ‘dealing’ to the cancer in my body. I follow that up with reading that is generally related to the management of the disease(eg on ‘nutratherapy’, ‘psychoneuroimmunology’ etc).Finally I do a bit of work and make a few phone calls.
The intention is to make my treatment as small a departure as possible from my ’normal’ life .And once the sticking plaster on the back of my hand is removed, shortly after I leave hospital ,my brief period as a patient is over and I am back to (my new)normal.(I have the same approach to my many blood tests-remove the sticking plaster asap and avoid the ‘patient ‘ syndrome).
I have little doubt that medicine(my chemo)has played an important role in my progress to date and will continue to be important( Tarceva and possible medical advances which are likely already in the pipeline).However I am equally certain that the other aspects of my ‘integrative’ approach-rethinking my priorities and approach to life,my (strict)diet, the daily practise of meditation,relaxation and ‘visualisation’,and my exercise programme(I am currently rebuilding my stamina and strength)-have been critical inputs in my progress.(At the very least they significantly enhance my tolerance of and the effectiveness of my treatment). They have provided me with a lot more choices and more tools to control my cancer.
Ultimately they will be the key to my healing this disease.