Scan analysis

We had to wait for half an hour before we got to see the doctor this morning. Usually that's nerve-wrecking when there's a CT analysis on the agenda and I'm booked with the senior doctor. This morning the TV was on and I got to watch the third period of Sweden-Slovakia, Olympic ice-hockey quarter-finals, and I almost forgot about what was to come. Sweden surprisingly lost.

The CT scan showed that the direction is still good. No new tumors and the existing tumors are the same size or slightly smaller. CEA had gone up to 57,6 (from 30,3 in December). I was a bit worried about this but the doctor said the pictures are the most important and that other non-cancer factors can impact CEA. The tumor measurements were:
* 6,3 x 3,4 cm (previously 6,7 x 4,1 cm)
* 2,5 x 4,3 cm (previously 2,6 x 4,2 cm)
* 2,1 x 1,5 cm (previously 2,1 x 1,9 cm)
* 1,7 x 2,4 cm (previously 1,7 x 2,4 cm)

We decided to continue the weekly chemo though it's quite tiring. The doctor said I could also change to a bi-weekly treatment schedule, but the schedule I am on now is the most common and most studied one and it is probably also the most effective way of doing it. So I decided to stay on the weekly schedule for the time being, but it is nice to know there is a bi-weekly option as well.

Marjo brought up the issue of future treatment alternatives. We can at least forget the RFA radiation (radio-frequency ablation), which the Independent article in my previous blog post talked about. The doctor explained it would do more harm than good in my case because of the positioning of the tumors. They're sitting too close the border of the liver and thus the radiation might cause damage on other organs close to the liver. He did mention some other possible treatments but Marjo was in a hurry to get to work (as the doctor was half an hour late) so we didn't have much time to discuss that. Will have to ask more about those some other time.

Actually, the doctor didn't discuss the future alternatives much but he mentioned that a longer break from chemo to let the body recover may be possible/necessary at some point as I have been on chemo for almost two years soon. I could also continue with Erbitux and Xeloda only and leave the heaviest chemo Camptosar out for a while. I said a break would be great during summer time but we didn't make any detailed plans.

Scan time

I had another CT scan yesterday but have to wait for the result and analysis until Thursday next week. I've been scheduled to meet the senior doctor this time so I'll have to ask Marjo to think of difficult questions to ask.

Today I was in for a round of full treatment (Camptosar, Erbitux, Xeloda). The platelets count has been consistently good for a long time, but in yesterday's blood sample the count was below the treatment threshold. This was surprising as I've had one week off the heavy drugs (Camptosar and Xeloda). The doctors decided I'd still get the drugs but with reduced Camptosar dose.

My sister forwarded an interesting article in The Independent about a success story of a bowel cancer patient. He got very much the same diagnosis as I got and used the same chemo as I am on now (cetuximab is another name for Erbitux).

Our sons had birthdays earlier this month and they are now three and six. The younger one especially is at a very funny age. A quote from him from this morning while sitting on toilet: "Mom, I don't like dad, he is stupid, he sings stupid songs and gives us too many sandwiches".

Taxi driver

I actually made a New Years resolution this year. I'd try and update my blog a bit more often. Looking at the time stamp of the previous post, I can't say I'm off to a very good start. I have a feeling 2010 is going to be a good blog year though.

My weekly treatments were moved from Wednesdays to Thursdays. When I checked in at the cancer ward a couple of weeks ago the nurses asked if I wanted to share the room with another Norwegian. It turned out he had been there for a while as well but on different days up until now. Pretty cool to have a Norwegians-only room though only for a few hours. We'll try and meet up outside of the hospital as well.

I had to check in at First Aid on Tuesday evening. There has been a stomach bug going around in the family and I eventually got it too. I had a bit of fever and the doctors took it pretty seriously even though I told them it must be the same stuff as the rest of the family has had. I guess they wanted to ensure it was not the swine-flu. I even had to stay over night at the cancer ward. All the rooms were actually booked so they put me into a storage (or something) room. There was a lamp above the bed that looked like those they use when doing surgeries. I didn't sleep too well, but the following morning I felt fine and was sent home. Later on in the afternoon the stomach starting acting up but it lasted only until midnight.

I took a taxi home from the hospital and had a good conversation with the taxi driver. We touched upon important issues like the beautiful winter we have had so far and the status of her taxi business. The usual topics. Well, we also discussed problems around immigration (not sure why) and she was horrified when I gave her some bad examples from Oslo that I've picked up from Norwegian newspapers. Then I noticed she wore no seat belt. I think it's the first time I've ever seen someone drive without a seat belt. I was pretty close to ask her why but managed to keep my mouth shut. It was a pretty nice Mercedes with probably a lot of good air bags, but still I don't get that.

P.S. A note from the wife: what is it with the taxi drivers and immigration?? More than 50% of the time the topic comes up. Gitta Helin even mentioned it in her column in Aamulehti (newspaper) today, she said in Helsinki they have two kinds of taxi drivers: loud racists and those who don't know where Kalastajatorppa is. (Kalastajatorppa being a famous hotel which is not situated downtown Helsinki)

Santa Claus

We've stopped using alarm clocks. When the kids wake up in the mornings, usually a bit earlier than we'd wish for, they jump into our bed to cosy. This morning, the oldest kid had just curled up when he asked "Is there more than one Santa Claus?". Smart kid, he had been doing some thinking during the night. Marjo took an easy way out and answered that the issue is a bit complicated. We've organised for Santa Claus to visit tomorrow afternoon. He may have to answer tricky questions.

We'll be celebrating a traditional Finnish Christmas at home with Marjo's parents and sister. On Boxing Day we've made it a tradition to cook pork ribs, a Norwegian-style Christmas dinner. The visit at the butcher is always exciting. We need to give very specific instructions how to cut out the piece of meat and not to make it into a Finnish-style ham. It usually works out well.

I have another secret to share. Most of the hair of my body fell off after I started the Camptosar treatment last summer. My eyelashes on the other hand, took off to the other direction and grew wild. Weird stuff. Marjo will do a Christmas eye-lash cut tonight. By the way, the hair on my head has actually slowly grown back and I haven't been bald since autumn.

Merry Christmas!

Another CT

CT scans start to be a routine. I had another one on Friday and got the feedback from a doctor today. Yet another good scan! Marjo and I were quite relieved. It means we've got some peace of mind for another 2-3 months until the next CT scan. CEA was down from 33,6 (on 24.11.2009) to 30,3. Despite the rather small decrease in CEA some of the tumours had shrunk quite much. We were even talking centimeters with some of them this time. This was a good example why they want to use both CEA and CT when they analyse the situation, one alone is not enough.

The CT report talked about four tumours. It seems Mr. Big is still doing fine and size isn't changing very much, but Number 2 has had a collapse. These were the strategic measurements:
* 6,7 x 4,1 cm (previously 6,6 x 4,3 cm)
* 2,6 x 4,2 cm (previously 3,6 x 6,1 cm)
* 2,1 x 1,9 cm (previously 2,6 x 2,3 cm)
* 1,7 x 2,4 cm (previously 2,0 x 2,4 cm)

After the initial positive message that the direction is still good I was more or less ready to leave the room. The doctor, however, went through some nail, skin and well-being stuff before she let me run. I got a prescription for 1 kg tubes (buckets?) of body lotions as some of the medication makes my skin extremely dry. I've got to put on lotion every day at least once.

Winter has finally arrived. We've had a couple of beautiful days with minus 15 degrees, some snow and clear sky. I'm back at hospital tomorrow (Wednesday) to continue the weekly treatments. Afterwards I may shoot some winter photos and go and buy a Christmas present for Marjo.

Another day at cancer ward

We had another doctor's appointment today. We discussed a few well-being issues, like nail-bed infections. That has been a continuous problem since summer. The infections don't heal very easily and I've been on two antibiotics treatments this autumn for it. The doctor was not in favor of putting me on a third round so we'll try some other tricks first. For example, every day I've got to stick my toes and fingers in a blue disinfectant liquid, which makes them brown. Our oldest kid thought my brown nails looked cool and wanted the same.

The blood values are more or less fine. The platelets count has been consistently on or slightly above the magic value of 100. Well, three weeks ago it was 99 but they still decided to give me chemo. The CEA had gone slightly up to 33,6 (all time low is 29,8 measured on 3.11.2009). The doctor didn't consider it alarming. There was a note from the lab that the measurement technique had changed. CEA can also be influenced by other factors. The next CT is now scheduled for Friday 11.12.

I have a confession to make. Every Wednesday YLE, the Finnish TV broadcasting company, sends Niklas Mat just when I'm in bed at hospital and hooked up to the IV. The shows are last years re-runs from Swedish TV. It's actually a really good cooking show and much of the stuff is so simple that even I can get going. And video learning works! Tonight I made an American apple-pecan pie with the youngest kid. He loved the cake dough. The cake eating we'll do tomorrow with in-laws.

Green and reds

Two weeks ago a friend and myself travelled to Manchester to see the world's best football team play. Manchester United that is.

Friday

We had to wait a few hours in Stockholm for the connecting flight to Manchester. Instead of hanging out at the airport we jumped in a taxi to the old city (Gamla Stan). A colleague we met on the plane from Tampere joined in as he had to wait for his connecting flight as well. While Tampere was cold and below freezing point, Stockholm was pretty warm. We had lunch and walked around a little before heading back to the airport.

As soon as hotel check-in was done in Manchester we headed off to MEN Arena and concert with Green Day. I thought beforehand that punk rock isn't my genre of music, but I've got to say this was maybe the best concert I've ever been to. Those guys were true entertainers with a great sense of humour.

Saturday

After stuffing ourselves with bacon, eggs, hash browns, Yorkshire pudding and what-ever belongs to the English breakfast, we spent the morning hours walking around downtown Manchester. It isn't a very pretty city all in all, but the restaurants and stores are really good. And it has an amazing football club. We sat down in The Old Wellington Inn, a pub over 450 years old. There were some other Norwegian football tourists there as well. They told us to go as early as possible to Old Trafford if we were to buy shirts to avoid line-ups. We ran straight off to the train and arrived at Old Trafford some five hours before kick-off.
I bought a home shirt with 11 Giggs on the back and the 1999 Champions League final shirt (where Solskjær scored the winner). The shopping bag got pretty full as I naturally had to buy stuff for the family and in-laws as well. The credit card bill was exciting reading!

After successfull shopping we spent the next hours in a nearby pub. Soon after we arrived the pub filled up with Man United supporters and the chants started rolling. The atmosphere was electric. Those guys sing for hours straight, quite impressive. Ole Gunnar wasn't forgotten either. "You are my Solskjaer, my Ole Solskjaer, you make me happy, when skies are grey, ..."

An hour before kick-off we headed towards the "500 Club lounge" at the stadium and had dinner while reading through the match-day program. The facilities were superb and access to and from the stands was fast and easy. 75000 people watched as the teams entered the pitch to the sound of....

Glory glory Man United,
Glory glory Man United,
Glory glory Man United,
As the reds go marching up up up!

Unfortunately, Giggs was injured and not in the squad but Man United won 2-0 still. Berbatov and Rooney scored two beautiful goals and Morten Gamst Pedersen came onto the pitch for Blackburn during second half.


Sunday

Sunday morning we decided to visit Liverpool, only a short train ride from Manchester. Or so we thought. The train was delayed so we got to explore Victoria station for a while longer. Once in Liverpool we visited the Beatles museum, walked around the harbour and had lunch in The Pumphouse. Nice place. We then took train straight to Manchester airport and were soon off to Finland. Or so we thought. In Stockholm and while waiting in the bus that would take us to the plane, we were told the flight had been cancelled. Some of the crew members had gone sick and there was no backup. We were rebooked to the Monday morning flight and had to stay overnight at Arlanda.


That was a great weekend and I hope to be able to do it again some time!

Sicko

We dug into our DVD collection the other weekend and found Sicko by Michael Moore. I've read a couple of his books and seen several of his films. I doubt his films really classify as documentaries, but they are great entertainment.

In Sicko he puts his finger on the American health care system and the role of the insurance companies in particular. The funniest scene is probably where he first shows clips from American TV on how good health care the prisoners in Guantanamo Bay get. Then he fills up three boats with 9/11 rescue workers who have been denied sufficient health care by the insurance companies and don't get treated in the US and heads towards Cuba. Outside Guantanamo Bay he picks up a megaphone and shouts out loud that he has sick 9/11 rescue workers on board and requests the same health care as the al Qaeda prisoners. Nothing more, just the same treatment! Hilarious!

Private health care is a growing field also in Finland, and we discussed if that is a threat to the quality of public health care services. At least I have very positive experiences with Finnish public health care during my cancer treatment. But have to admit that we use the private sector often when our kids are sick, mainly because we get to see a doctor on pretty short notice and we have an insurance for our kids. We have noticed that many of our friends don't even bother to contact the public health care any more but take their kids directly to the private side as you don't have to line up so long. Many companies have hired private health care companies for their employees. You can now also get cancer treatment in private hospitals in Finland, if you have the money. Is this a worrying trend? Will the best doctors end up on the private side?

Good scan

Today I got the feedback from Friday's CT scan. Marjo and I saw yet another doctor we haven't met before. When she eventually came by to call us in one hour late (!) I immediately calmed down a little as I knew she's not one of the senior doctors at the cancer ward. I figured they'd set me up with a less experienced doctor only if the treatment plan would continue unchanged. In other words, I expected to hear good news.

And good news came. CEA had come down from 40,6 on August 18th to 30,2. This is an all time low and I've come a long way since June last year when the CEA value was 6257,1. Even though 30,2 is low (for me) it still means there is active cancer cells and that there is no other target than zero. The CT analysis also stated there were no new tumours and that the existing tumours had shrunk in size. We're only talking about a change of a few millimeters but that we also expected. All in all, yet another good scan and they'll continue the current treatment plan (Camptosar + Erbitux + Xeloda). This means I'll have to continue to visit the hospital every Wednesday for another three months or so before next CT scan.

I requested a one week break from the treatment plan. The doctor said she would consult "my" senior doctor to check his opinion, but probably it would be fine. The thing is, I'm off to see Manchester United versus Blackburn at Old Trafford in Manchester on Saturday October 31st. I'm lucky to have friends sharing the same passion for ManUnited. In the past we've been bravely talking about going to see the best team in the world "some time". A few weeks back a friend of mine told me we're going and organised flights, hotel and tickets. Thanks JP! Now, what if I would contact Ole Gunnar Solskjær and ask him to join us or sit down for a coffee and exchange ideas how good football should be played? Well, maybe not.

By the way, Marjo is slightly disappointed as she would have liked to join. Maybe we'll go and see the second best team in the world together? I had Barcelona in mind.

Women

Finland hosted Uefa Women's Euro football tournament during the first weeks of September. Several matches were played in Tampere and I ended up seeing Germany-Norway, Netherlands-France (quarter-finals) and England-Netherlands (semi-finals). In the latter two matches we were surrounded by Dutch fans, mainly family members of the players I suspect. They were pretty good supporters and put up a good show on the stands. Some had made an effort dressing up.
On the cancer front, nothing much has really happened during September. My blood values have been good and platelets have stayed above the limit of 100. I've therefore received the weekly planned dozes of drugs. I'm in for my next CT scan on Friday this week.