Thursday, October 30, 2008

Round six

I was in at hospital again today to start the sixth round of treatments. We had first the doctor's appointment in the morning. Again, a new doctor. We went through the blood values as usual. They were all fine, some slightly outside the range but still normal for cancer patients. There was a surprise. The value of the CEA marker had dropped from 3482.0 at the end of August to 228.3! That's pretty good news. The doctor wouldn't speculate what this means for the size of the tumours. The next CT scan is scheduled in three weeks and will tell the facts. The CT scan will be a routine full body scan to check if there's any cancer elsewhere than in the stomach region.

We discussed about future treatment alternatives. Nothing can be decided before the CT scan. Surgery could be an alternative but for surgery the tumours in the liver must be small enough and their position in the liver must be suitable for surgery. Doctors also seem to be reluctant to do surgery if there is cancer outside of the liver, e.g. in lymph nodes. So I am not a candidate for surgery yet. Continuing with chemotherapy is possible and more likely in this phase. The chemotherapy I'm on now will at some point of time loose its effect but exactly when is very individual and cannot be predicted. The doctor said some people have been on the same chemotherapy treatment for years. If the chemotherapy treatment has to be changed there are at least four to five other medicines on the market that could be used instead. Different kinds of radiotherapy could also be used in combination with other treatments, e.g. surgery.

The IV chemo took some five hours. On my way home I stopped by in a café close by to briefly celebrate that great CEA value. I ordered tea and a cake with some orange icing. Then rushed to day care to pick up the kids.

Tuesday, October 14, 2008

A Norwegian professor

Back in September there was a Nordic event in Tampere about surgery of my type of cancer. The exact name of the event was “Nordic post graduate course in colorectal surgery”. My wife found the agenda and participants list on the internet. Looking through the list, she found a couple of interesting names. One of the doctors I've met at the Tampere University Hospital was to attend to talk about use of chemotherapy as additional treatment for patients with cancers that are thought to have spread outside their original sites. She also noticed a Norwegian professor on the participants list. He works at the university that I studied at in Norway (NTNU) and is at the same time a surgeon at the university hospital in Trondheim.

I sent him an email asking if he would have some spare time while being in town to discuss my treatment plan and if there were differences in treatment practises between Finland and Norway with my type of cancer. He actually replied but after the event was over. He had been too busy to read all his emails before the trip to Finland. He explained that guidelines in Norway and Finland are the same and that I would have got the same treatment plan in Norway. He also said I'm in very good hands at the Tampere University Hospital and that he personally knew the very competent head of the department for colorectal surgery there.

Thursday, October 9, 2008

Trip to Norway

Since I am feeling fine we used the opportunity to travel to Norway to my parents' farm. My wife and our youngest son stayed for a long weekend, and I stayed for one and a half weeks with our oldest son and came back on Monday night this week. All my sisters and their families visited, which was great. It was a bit exciting to meet relatives and friends at first. I felt many people were a little anxious what they'd see when they met me for the first time after the cancer diagnosis. How does a person that is seriously ill from cancer look like? Hair gone? Brain still working? I could imagine I would have similar thoughts if I were in their situation. However, I more or less look like I used to and I have not lost my hair. Actually I feel pretty good and sometimes I even forget about the entire cancer situation. I think many were a bit relieved.

It's nice to bring the kids to my parents' farm and watch their excitement about small things. The first morning our oldest kid woke me up asking if I heard something outside. Heard what? I asked half asleep. We opened the bedroom window and heard loud and clear one of my parents' roosters. Another morning, we heard the tank lorry that picks up the milk from the cows. Our oldest kid got so excited he ran out in pyjamas to watch, and it was not that warm outside. Yet another morning he complained he was woken up in the middle of the night by a mooing cow. In fact so was I.

My father has a rather new tractor. It's a New Holland and our oldest kid loves going for rides with it. He got very interested in how all the levers and buttons worked. The tractor has high and low gear groups of which have activation buttons and dashboard pictures. The high gear group has a hare symbol and the low gear group has a turtle symbol. He got to press these while we were driving and this way selected hare speed or turtle speed. Quite brilliant and even kids get that hare is for fast driving and turtle for slow driving. He also made bargains with my father, myself and my tractor-driving sisters to take him for rides. My father was rated the best driver while my sisters and myself were pretty good runner-ups.

Once our oldest kid joined my father filling diesel on the tractor. He got very interested in how the diesel tank worked and how the tank was re-filled. We explained my father would call in a tank lorry to do that. He wondered what colours the lorry had. Later we visited one of my uncles and his wife. They also run a farm, and they have four tractors. My uncle started telling about the age and names of the tractors when our kid suddenly interrupted asking where his diesel tank was. Kids are cute.

The youngest loves exploring the surroundings. He fancies anything that can be pulled, pushed, turned and bent, and often subsequently broken. He discovered that he could stop my parents' dishwasher by turning a knob and he wouldn't let go of his new hobby. We had to fix the position of the knob with tape.

One of my hobbies as a kid was climbing trees. I've climbed every single tree in a pretty large radius around my parents house. It was great fun except that one time I couldn't find my way down and had to shout for a long while until my parents came for rescue. I've had this weird idea that it would be nice to show the kids great trees to climb on the farm. However, nowadays the woods there seem to have grown into a jungle and also the amount of ticks seems to have exploded. Possibly as a result of the warmer climate. Some of the ticks could carry various diseases, especially Lyme disease (borreliose in Norwegian), which makes walking in the woods a bit discouraging. It's a pity as I used to love the woods myself. I guess we'll be concentrating on tractor driving in the future.

Some friends of mine threw a party and I got to make the invitation list. We gathered around twenty people and had a great Saturday night. I thought afterwards we'd probably never have done that if it wasn't for my situation.

Today I was forced back to the cancer reality. I had to go to hospital for another treatment round. I had no doctor's appointment this time and was put straight onto another IV. In the blood test they had measured only some very basic values like red and white blood cell count and level of infections which were all fine. We interpreted not seeing a doctor this time so that they believe the liver and body are functioning fine and that they will give Avastin a bit more time to work, until the next analysis of the situation.