I had my six month check-in with my oncologist today, to go over the results of my latest CT scans and treatment plan moving forward. Six months was the rough estimate for how long they would keep me on the aggressive 4-drug infusion regimen we started in April. This turned out to be an accurate prediction since my final (12th) infusion was cancelled at the end of September because my blood platelet count dropped below the threshold where they authorize treatment.
Even with the cancellation of that final infusion, the last set of scans — taken October 5th — show a continued and substantial decrease in the size of the areas they are watching in my liver. This is really good news. The largest area has dropped from 3.8cm before start of treatment to only 5mm (roughly 1/8 the original size). That is a 50% decrease since the previous scans. Other areas have become too small to show up on the scans. So the aggressive regimen over the summer really paid off.
The challenge, as I wrote in my last update, is that I am not currently a good candidate for surgery, given where the areas of disease remain. The multidisciplinary treatment group my oncologist belongs to, and consulted last week, agreed with this assessment. So chemotherapy remains the best option for me during the next phase of treatment. I’ll continue to do twice-monthly infusions for at least the next three months before we evaluate again. The silver lining is that I will only be on two of the four drugs during that time and the two we are eliminating had the most onerous side effects (Irinotecan and Oxaliplatin). I completed the single on-site infusion (Leucovorin) in about an hour this morning and feel pretty normal. Now I’m just hooked up to the take-home infusion (Fluorouracil, or “5-FU”) for the next 46 hours, which — while logistically a bit annoying — doesn’t typically make me feel crummy. So hopefully my day-to-day energy and routines will be a bit more stable with a less intrusive treatment regimen — yet with continued progress on reducing the cancer cells. My oncologist will also consider it a successful intervention if they keep the cancer spots from growing; all of my other markers for healthy organ function remain stable and good. We will continue to assess how the drugs are working and add/remove things as necessary in addition to considering whether surgical intervention becomes a viable option.
While not full resolution/remission news (which would have been GREAT but which, given the last assessment, we didn’t expect) this is a positive trajectory overall and I am glad to have a sense of what the shape of the next three months will be like in terms of daily and weekly routines. Thanks to the support from my colleagues, I continue to work remotely and flexibly from home to minimize COVID-19 and other exposures while I am immunosuppressed. I am also a candidate for the booster shot which I am working to schedule at some point in the near future.
We are grateful for all of the ways your care has made this rocky road easier to handle. My parents are planning to visit again over Thanksgiving and we look forward to our typical slow end-of-year holiday season where we take some extra vacation time to reset as we look toward the beginning of a new year. I hope all of you have some holiday plans to look forward to that suit your own style and COVID situation.