Cancer Boy in Chemo Land

Good Morning Folks. I went back and forth about whether or not I wanted to make this a proper blog post, but seeing as I have folks who read this blog but do not follow me on social media platforms, I am pushing forward with it. I guess a quick rundown of the last few months is probably in order, in case someone missed the chain of events. On January 21st, I had a routine colonoscopy, and one of the things that came out of it was the diagnosis of a cancerous colorectal tumor. There were a few paths that were outlined, but it all depended upon the specificity of my condition as ot which one we could go down. Effectively, there was what I called the “golden path” that was “surgery-only” and five to eight days in the hospital, and then I moved on with my life. There was also a path that involved four months of Chemotherapy, two months of Radiation, a Surgery, and then two months of being on a bag while things healed, and a follow-up surgery to hook everything back up.

For the last fifty-five days, I have been in limbo, not knowing which path I was headed down, and quite honestly… this is the worst part of the current situation. For as many mental health issues as I have struggled with in my life, I honestly do pretty well at adjusting to reality once it is forced upon me. However, what I do not handle super awesomely is waiting and not knowing. I’ve been through so many things over the last couple of months. Everything was going to hinge upon an MRI that would allow the surgeon to stage the cancer, but when it came time to get said MRI… no one checked the fact that I was bigger than the average bear and as a result was too damned big for their MRI machine. So I had to get scheduled for a totally different machine, which was out of network, and I had to pay a lot of the costs out of pocket. In the meantime, I have had a CT Scan, a PET Scan, Genetic Testing, and many bloodwork draws.

Because of limited scheduling, I have been going down the path of the industrial cancer treatment industry and attending orientation for chemotherapy, and even starting tirzepatide, a GLP-1 agonist, to help reduce my weight and lower the complications of the eventual surgery and radiation. I’ve been terrified of everything that is looming on the horizon, all the while not knowing at all which path I was going to be pushed down. On March 6th, I finally had the MRI, and I figured any day I would get the call from the surgeon outlining what we were going to do. Tomorrow I am scheduled for outpatient surgery to get a chemotherapy port grafted to my body, and I really had to know something before that, so I could either go forward with it or cancel it. Everything that I knew based on my reading and based on the results of various tests made me think that I was a borderline case, that it could go one way or the other and there was nothing that I could do to really predict the results.

Last night at 5:30, I got a call back from the Surgeon. In his eyes, it had progressed past the point where we can comfortably do the “surgery-only” route. So the two options in front of us were his suggested Chemo > Radiation > Surgery > Bag > Surgery route… OR Surgery > Bag > Chemo > Radiation > Surgery. There was no path that did not put me on a bag for some period of time. That is really the thing that terrifies me the most in all of this. If I were going to have to do Chemo and Radiation anyway… I might as well follow the path that was going to have me on the bag for the least amount of time, and also reportedly gives me the best chances for complete remission. So tomorrow at 7:30 in the morning, I will be having a twilight sedation outpatient surgery, and will come out with a fancy new multipurpose port, which they will be using for Chemo and blood draws during this whole ordeal. I’ve had a PICC line before when I was really sick in the hospital, and from what I understand, this is essentially a permanent version of that.

So that is the bad news, and I guess let’s talk about the good news. As I said, I have had a battery of tests, in part because when they did the CT Scan, there was a weird, unexplained nodule on my 7th rib on the left side. The CT and PET Scan combined show that the cancer is very well contained and has not touched any of the lymph nodes or metastasized to any other area of my body. The cancer itself is Stage II and shows high signs of “curative” treatment, because, in orientation, I have learned about all of the catch phrases that indicate your likelihood of survival. Technically, I have T3N0M0 Invasive Moderately Differentiated Adenocarcinoma. These are words that I have googled quite a bit, which I know is probably bad for my mental health, but various comorbidity charts put the 5 year survival rate at 90%. I have no genetic markers for cancer, or at least no known ones, so in theory I have a very good chance of walking out on the other side of this alive and well. It is just going to be a bit of a miserable mess getting there.

Another positive is that the particular treatment path that I will be on does not generally lead to hair loss. This is at least somewhat of a bummer because I was hoping it would come in curly afterwards, like happened with my sister-in-law. I will be on something called FOLFOX, and its major side effect is that, apparently, anything cold will feel like shards of glass and cause severe nerve pain for around the first five days after treatment. It is also going to decimate my immune system, meaning that I will have to be hyper-cautious about any sort of injuries or being around anyone who might be sick. There will also be diarrhea and nausea, but I will be taking some meds to counteract that, hopefully. Essentially, I will be on a two-week rotation, where I will go one day, get 30 mins of chemo in the office, and walk away with a pump that will deliver the rest of the chemotherapy to me over the course of 48 hours. After that, I will go back in and get everything unhooked from my port and begin the resting phase, returning essentially two weeks later to start over. I will be going through eight rounds of this, which will span four months.

I’ve been told that I should take notes during my first cycle because essentially every cycle after that will follow the same pattern. So the good days should land on the same days, and the worst days should follow as well. Five days in is supposed to be my low point, or my “nadir,” when my immune system and blood/platelet production are lowest. After that, everything should be improving until I then return to start it all over again. The orientation was honestly pretty freaking valuable because they prepped us to have a bunch of over-the-counter drugs on hand to deal with the side effects. Additionally, they gave some clear markers of when I should be calling in and getting help and when I can reasonably tough things through. 100.5 is apparently the magic temperature where I need to be taking immediate action in an attempt to stem an infection. I have not run fevers very often, so hopefully this is still a measurement that works for me. It has been wild just how standard this process has been, and how seemingly good they are at treating cancer now.

In other news, the Tirzepatide has been going pretty well. I give the injections to myself on Wednesday mornings, and I am on my 4th week, with next week being my first scheduled increase in dosage. As of this morning, I have lost roughly 28 lbs, and have started some light weight training in the hopes of staving off muscle loss. That is one of the side effects that folks worry about, and that is also one of the side effects of the chemotherapy that I am on, so I am doing some very simple exercises with weights every day. Nothing major, just ten-pound weights, but the repetition seems to be making some minor improvements already. I’ve also drastically overhauled my diet, which I assume is a big part of what has led to such rapid results. I’m only on about half of the final therapeutic dose, and already having significant losses. I’m forcing a lot more fruits and vegetables into my normal routine, and I have come to love a cold apple. I will be super sad that during my treatment, I will not be able to tolerate that due to the nerve pain nonsense.

The loss of my spouse last year already caused some significant shifts in my life, and cancer now… is going to cement even more. I am trying to look to the future and some of the goals that I really want to accomplish once I am on the far side of this situation. For example, I have a friend in the Chicago area that I am going to visit at some point, because that is also a reasonable driving distance for Cyl, one of my two adopted siblings. I also want to make good on the threat to go visit “Erasure” in the Houston area, since my previously planned trip got cancelled due to all of this. I am hoping to be a much smaller person at that point, and that will likely make travel way more enjoyable than it ever has been. I am trying to handle all of this the best that I can, but I also know it is going to be really fucking hard. However, it is eight months of my life… and I can endure anything.

Anyways… now you know as much as I know. I’ve been mostly radio silent about what is going on, because nothing was really certain. I will likely begin chemo before the end of the month, and after that, I will be on a routine path. As things change, I will probably talk about it, but I do not really want my “cancer boy” journey to dominate this blog. This is still a blog about the things I am interested in, mostly, and while cancer is now a part of me… I don’t want to make it the only important thing. If you’ve made it this far, thanks for sticking around.