I saw my Oncologist (cancer specialist) today for an update on treatment going forward. So far no-one has been able to determine exactly what was on my liver, but the evidence points strongly towards cancer secondaries, and I expect my liver specialist / surgeon to confirm that in the next week. I am also down to have a PET scan to add to the MRI and CT scan and to confirm the spots on my liver are behaving like cancerous cells. The tumor had perforated the wall of the bowel, so I guess some cells may have spread that way. The 31 lymph nodes they removed with the section of the bowel all tested negative for spread however, which is good news – it means the tumor is graded as Stage II (or Dukes B).
In any case, I am due to start chemotherapy toward the end of the month, which will involve tablets and some intravenous drips. The exact composition of what they intend to give me will depend on some further tests of my genes (something called the K-ras gene, to be exact) and will be made much clearer in a few weeks. This should discourage any regrowth in the bowel, and hopefully help with whatever is going on with the liver too. Side-effects should NOT include hair loss, but might be some tiredness and sore hands / feet. Oh, and probably some of my old companion, diarrhoea, as well. All quite acceptable for the benefits it will bring me, I think.
Then, after 3 months, it will be time for more liver scans to check if there has been any change. At this stage, on the assumption that nothing has improved, I think there is a reasonable chance I may need to go for liver surgery to have the small sections removed. Liver surgery has come on leaps and bounds in the last 10 years, and the overall prognosis for this operation is not dissimilar to the bowel operation I had. Plus the liver is super-regenerative, so should heal easily. After a recovery period, I’d expect another 3 months chemotherapy.
So some quite tough roads ahead, but one step at a time and it should all be manageable. My key philosophies are that I am not my illness, and life is not getting put on hold for a year (or more) because of this – although it may come down a notch or two for a little while ! The specialist indicated some people do not return to work for the duration of this treatment, but I think that would stand against this main objective of getting back into life properly. There will still be frequent clinic appointments and tests going on in the background too, so whilst other plans should still go ahead, much of my time will very much be in the hands of doctors for the next year.
As always, armed with this information I am keeping a positive head on it all. It is all a bit scary, but I have had some good news with the lymph nodes being clean and the surgery so far has healed very well – only 2 weeks after the operation and I am up and about to a very favorable degree. I walked for almost 30 minutes today, cooked a big meal this evening, and my muscles don’t hurt too much as a result. Still have a few back pains when the various muscles there are overworked (compensating for the weak tummy muscles) but hopefully that will improve in the coming weeks. Looking forward to heading out for some sun and relaxation at my folks place in Portugal in the next week. There both Mimi and I can relax a bit more, and get my head away from London for a while, and into a few good books.