The results from a battery of cancer tests are back, and it’s not good news. The eight weeks of chemo weren’t wholly ineffective. My swallowing symptoms improved, at least temporarily; and the amount of the antigen that the tumour releases into my bloodstream – a protein called CA19-9 — went down significantly after each session of chemotherapy. However, the scans show that the tumour actually grew. Most importantly, the new imaging showed my aorta, the body’s major artery, encased in cancerous tissue. The best explanation we’ve heard of this cluster of results is that the chemo did indeed kill some of the tumour, but the dead tissue stayed in situ and even got bigger. This is called a desmoplastic reaction. (See here: https://en.wikipedia.org/wiki/Desmoplasia.)
That may mean that my cancer is now inoperable.
Though not good, the news isn’t yet catastrophic. Way, way back, the plan had been to try a traditional combination of chemo and radiation. That’s not what we ended up doing, because a new protocol supported by trials in Europe called for more aggressive chemo without radiation instead. However, radiation is now back on the table: I’ll begin radiotherapy early in the New Year. Maybe this can shrink the tumour, and put surgery squarely back on the table. We’ve also been told that immunotherapy might become locally available for this kind of cancer in the next couple of years.
Next steps? 1) Meet with the oncology team to decide whether, in addition to radiation, a different cocktail of drugs would be useful. That will happen the day after tomorrow. 2) Get an MRI as soon as possible, to determine how intertwined the tumour is with my aorta, and thus whether it can be safely removed after all. That is scheduled for December 30th. What is unfortunately not on the agenda at this point are trips to warm and sunny climes. I’ll need to be more stable before I get on any planes. Sigh.
This being a blog about bipolar, I should comment on how I’m doing mood-wise. I continue to be pretty much in remission when it comes to symptoms like depression, anxiety, etc. And I’m still pretty much mystified about why this is the case. After all, long-story-short, we may be shifting back from “Our aim is to cure your cancer” to “Our aim is to slow down the progress of the disease, to give you more time”. That’s both sad and scary. Nonetheless, as my student Donovan observed, I was able to recount the rather bleak situation to him without breaking into tears; whereas, as he added, in years past I would have cried about much less serious matters. My sister-in-law Larisa also commented yesterday, as I shared the bad news with her, that she hasn’t seen me look so positive in years. I agree.
I hope my mental health remains good once treatment is done. Heck, I hope my physical health follows suit!