Chemo tomorrow amidst some new evidence of cancer progression

When I consider my situation, I find it interesting to have such a sizable collection of friends who care about my situation.   On one hand, I am bewildered, and on the other hand feel simply fortunate.  I'd love to be able to deliver some encouraging words, but all I seem to have recently is disheartening news about which I can simply make observations.

This week, I had a full-torso CT scan.  The purpose for this was to serve as the baseline against which we will measure the effectiveness of the upcoming chemotherapy.  Dr. Modi called me in to discuss a problematic new finding on the scan - a small pocket of loose air in my chest - evidence of a hole in my lung ("pneumo-thorax").  That turned out to be only part of the story, as he really wanted to meet with me face-to-face to discuss the other things revealed by the scan.  He's a kind guy.  The disease is progressing, as we knew, but in places we had not known.  I now know about two tumors in my spleen and one on my front right belly.  I can feel the latter with my finger, now that he pointed it out to me.  Yuck.  This is the first time the abdomen scan has shown any cancer since the large tumors were removed surgically in 2003.  Also, there is a new nodule in my left lung, as well as some fluid build-up around my lung - "Probably malignant fluid," he said.   These places we add to the other evidence of disease from last month - multiple right lung nodules, an elbow tumor, and a suspicious bump on the back of my head.  I haven't had any chemo since the spring, so the cancer has been enjoying itself. 

It turns out that the plan remains the same - to begin chemotherapy.  Only there is all the more confidence this is the right plan.  I will be taking a combination of chemotherapy drugs called "XELOX + Avastin".  It is the most toxic combination of the various chemo regimens I have had, and is nearly the same as what I took for twelve rounds in 2005.   The hope is that this regimen still has some oomph left in it.  We'll do three rounds over ten weeks then see how it's working.  This will be my 95th through 97th round of chemo since 2003, but who's counting. 

With the various cancer-related issues brewing, the two wildcards are the fluid around the heart, which landed me in the hospital last month, and the new lung hole.  The heart fluid, remarkably, is nearly gone.  The lung hole needs to be corrected, and may do so on its own.  One theory for how it got there is that some lung tissue was weakened by this summer's radiation and then I "coughed a hole" in it last week.  If it heals on its own, that would be wonderful.  If it needs some sort of corrective procedure, it will cause big delays in treating the cancer.

Yesterday, I invited my church, St. Thomas the Doubter, over to my apartment to celebrate our first five members - of which one is me.  Don't get any grand party images here - it is a baby church, with a two to three dozen people attending.  So basically, I had a party to honor myself.  I also had them rearrange my furniture to be sick-with-chemo friendly, and set up my tree, too.  This is the kind of thing you get away with when you have cancer.  In the pic, you'll see I hung a Moravian star on the balcony.  This brings back memories of living in Philadelphia, where it is popular.  Also memories of putting one up with my sister's family on their porch in St. Louis.  

All of these medical developments leave me feeling quite empty.  Joys in life are absurd mixed with CT scans and chemotherapy.  But I'm ok with that.  What else is there to do but simply press and enjoy each day - each gift.   Love and live as much as I can.  Not much has not really changed in my strategy over the past seven years.  And, I think, should not change should I live for another seven days or seven years.

Yes, I'm in some pain, but it's not too bad with my pills.  My breathing is short, but not alarmingly.  Tomorrow morning is the IV infusion of part of the chemotherapy.  Then fourteen days of pills.  Here we go.