Since this is our third opportunity to experience chemotherapy, we get to try new things! Actually, this is very different from rounds one and two.
Bryan's original cancer diagnosis came in February 2002 when he had his initial colonoscopy following his 50th birthday. The gastroenterologist was unable to complete the exam due to an apple core lesion in the colon. Surgery followed soon thereafter and chemotherapy began six weeks later. Bryan's staging was B-2 since there was no lymph node involvement, but the tumor broke through the wall of the colon. The decision for chemo was left to us; watch and wait or go on the offense. We chose the latter because he was young and had a young family. We felt it was better to be safe, than sorry. The treatment schedule, at one per week, was to last six months. Due to a non-cancerous mechanical bowel obstruction, in October of 2002, Bryan underwent surgery again and missed his final round of chemo. He then went five years cancer free before it returned in May of 2007.
The colonoscopy, to confirm the malignancy, wound up perforating the colon wall and setting cancer cells free into the abdominal cavity. This meant that Bryan was now stage 4, metastatic colon cancer, the most dangerous form of colon cancer. After surgery in June 2007, removing all of the colon, except the sigmoid, Bryan underwent chemotherapy again, this time with a whole new array of drugs, including targeted therapies which attack an individual tumor's blood supply. Chemo is very caustic on the veins and with so many medications to be infused, we decided to get a Power Port surgically inserted in Bryan's chest in September 2007. After ending chemotherapy in February 2008, Bryan was 30 pounds lighter, weighing in at 130, not much for his 5'8" frame. Since then, we have worked valiantly trying to get some weight on his bones, but to no avail. Little did we know we were working against our enemy for nutrition.
He began to experience abdominal pain in May 2008. After several scans confirmed no reappearance of cancer, it was assumed pain management was all Bryan needed. It was assumed the cause of the pain was scar tissue from his previous abdominal surgeries. Trial and error led us to the best pain solution in December, and Bryan was finally pain free. Monthly port flushes, to keep the line open, made regular lab draws easy. The rising CEA (tumor marker blood test) didn't alarm us because it didn't register when he had active cancer previously. December's reading of 7 was high, the doctor was assuming it was due to inflammation or even a peptic ulcer. We waited one more month and his CEA measured 14! Dr. Chen ordered a PET/CT scan which was scheduled for Monday, January 26, but Bryan ended up in the ER on the Sunday morning before. Again, we were still assuming peptic ulcer or possible another bowel obstruction. The ER doctor ordered a CT scan and the results were quite alarming--metastatic cancer to the lungs, liver, small bowel, mesentery. And here we are, back to chemo round 3.
As for the new pump, it is actually the 5FU which is in the pump. It is about double the quantity he had before thus the need to administer it over a longer period of time. Bryan didn't sleep well Wednesday night, I think it would be difficult sleeping with a tube coming out of your chest attached to a box that keeps making swishing noises. (I'll have to share pictures someday!) I am sure, by the time we are finished, he will be quite used to it and will be able to relax and sleep well.