Latest medical developments

It is a long time since I posted an entry. In part this has been because I have been taking the opportunity to enjoy the beautiful summer we are having, with some travel to see family and friends, and, on return to a balmy Wellington, to enjoy walks and little fishing forays with Miang in the evening. We have cast our lines at Makara beach, Titahi Bay and off the Miramar pensinsula, for two fish caught and one landed.

But the real reason I have delayed blogging is that I have been in a sort of "medical limbo" following a mid December CEA measurement which indicated a rise, from my famous 3.0 ng/ml, to 3.8. In proportional (or logarithmic) terms, this was actually a big rise, but still, down at the lower levels of measurement where the errors are probably on the order of 0.5 ng/ml. Hence, my oncologist and I resolved that we would not read too much into this rise, and await the next measurement in mid January. Today I got the result. 4.3 ng/ml. Disappointing, one might say.

So, this seems to be a real trend, not a statistical fluctuation. Miang and I spent some time discussing this with the very capable oncologist registrar who saw me at the hospital today. There seems to be a high probability that the cancer has not been vanquished by the Sydney surgery and hyperthermic intraperitoneal chemotherapy. Of course, I can always find some silver lining in the clouds of gloom. First, the latest fractional rise was less than the one immediately previous. You can see this very clearly in the logarithmic graph shown here. Second, I feel very well, having completely recovered from surgery with the various wound pains finally disappearing in the last couple of weeks. Finally the rate of rise may be sufficiently slow to give me many months of good health and normal activity.

There is a down side, I do have to admit. Essentially, I have run out of treatment options. Whatever cancer remains now has survived all the previous chemotherapy drugs. This is Darwinian evolution and natural selection at work. The new cancer cells are likely to be resilient to Oxaliplatin, Capecitabine, Irinotecan and possibly even Avastin. And that's about all there is on the menu, apart from the ancient 5FU, the workhorse of oncology from decades ago.

But, the fact remains that the sun is shining brilliantly as La Nina brings us the summer of my childhood memories. I will persist with the current oral chemotherapy, and with an increased dose. And of course, there is always uncle CC's vegetable juice. I am downing this elixir every morning, before my daily walk with Miang. Life seems not too bad.