The week I started chemo, I had a baseline CT scan which the doctors will compare to another scan that will be done after three months of treatment to determine whether the chemo is working. As I also had a CT scan when I was first admitted to hospital at the end of August, they were able to compare the two to see how the cancer is currently progressing.
Whilst I really hoped the scan would show no progression in the cancer, I knew this was unlikely, so I was disappointed but not exactly surprised when I was told the tumours on my lungs, liver and various lymph nodes have grown in size. On the plus side, there is nothing in my colon still! Whilst I will never give up hope, I have to be honest that the cancer progression did give a reality check on my chances of long term survival.
Given the progression, now we have a little more idea of how aggressive the cancer is, and how I was coping with chemo, my oncologist and I talked further about the treatment options. We discussed the various newer treatments, like cyberknife treatment (sounds cool hey?! Google it, it’s amazing), but unfortunately my cancer is too wide spread for this to be any use. At the moment, by far the best option remains chemo, which hopefully will stop the cancer growing for a while. There were two drug combinations that were first line treatment options for me; FOLFIRI and FOLFOX. I’m on FOLFIRI because the OX in FOLFOX is Oxaliplatin which can cause peripheral neuropathy (nerve damage to the distal nerves, ie hands and feet), and as I’ve already got nerve problems in my hands from the spinal tumour, my oncologist hadn’t wanted to add to this. However, given the cancer’s progression and because I’d tolerated round one of chemo so well, he suggested adding in Oxaliplatin on top of the FOLFIRI. A trial done fairly recently where the drugs were combined, showed that those who had all of them from the start of chemo, had a prolonged period of stability before the cancer returned to progression, than those on one or the other. Whilst this may make the chemo side effects tougher, I’m prepared to give anything a go to give myself the best chance of living longer!!
This is perhaps a good time to touch on statistics. I have avoided so far talking about prognosis/ life expectancy etc as the doctors can only tell you averages, and it’s fair to say that nothing about my situation is average! Bowel cancer is generally a cancer of old men… and guess what, that’s not me (less than 2% of people diagnosed with bowel cancer in the U.K. are under 40 according to bowelcanceruk.org). However, we now know a little more about my cancer and how it’s behaving. I also know that some of my friends and family have looked up the stats and I’m very aware of them because, whilst reading research they are unavoidable, so as with everything else, I’ll face them head on. Here’s the main ones: around 35% of women diagnosed with stage IV colon cancer live more than a year, and 8% more than five years (source: Cancer Research UK). Not great numbers! But there’s a few things to keep in mind;
- being young does improve my odds- 64% of those under 50 with stage IV bowel cancer live more than a year
- Stats are always out of date. By definition, if you’re looking at 5yr survival rates, the diagnosis was at least 5 years ago, and cancer treatment is advancing all the time
- I am otherwise a healthy person, and doing all I can to support my body with diet and supplements. Whilst there is limited evidence on how much these things help (largely because there haven’t been formal trials on them), living a healthy life certainly can’t hurt!
So, as unlikely as it is, maybe I’ll be in that 8%. I certainly won’t give up hope that that will be the case, although I think it’s important to balance hope and realism. For now, whilst I’m not exactly going to ‘live every day like it’s my last’ (that would be exhausting and actually, I want as much normality as possible to a degree), I will continue to look for the positive in every day, and only do things that I want to do (or that might save my life, as I can’t honestly say I WANT to spend time in hospital/ on chemo!)
Back to the chemo… round two so far hasn’t been very different to round one. No major reaction and similar side effects to last time, although I do feel more tired. The only problem this time was that the steroids hit me hard and had me wired, keeping me awake until 4am the first night! Previously I’d been on them long term (since pre surgery to help reduce the inflammation round the spinal tumour), but I’m now off them day to day, so my body reacted more. Never mind, there are worse side effects I could be dealing with! Fingers crossed I keep tolerating the chemo well and it’s doing it’s thing on the cancer cells!