UPDATE

We are now into the sixth full day of our second treatment with Alimta and so far the side effects are pretty much the same as last time Stomach ache, intestinal termoil, lack of appetite, some minor shortness of breath, a pulse that is higher than it usually is, but not alarming. I am taking the stomach medicine that was prescribed, but so far I have not noticed any change. We'll keep you posted.

UPDATE

Well, we started yesterday with the second round of treatment with the new drug Alimta. I approach this with a certain amount of excitement and a certain amount of dread. The dread comes from hoping that the side effects won’t be as bad as last time. The excitement comes from hoping that we will be able to manage the side effects more effectively this time and thus they won’t be as bad. The other excitement comes from the fact that before the next cycle we will have a CT scan to see if the Alimta is working as well as the previous treatment. We are also going into this cycle a little better prepared in that the doctor has prescribed some medicine that is supposed to provide some relief from the stomach and intestinal discomfort. Unrelated to this treatment we are also taking B6 which has some promise of aiding the Neuropathy (numbness) in my hands and feet. The condition was caused by my previous treatment and is basically nerve damage that typical takes some time to improve. The B6 perhaps will speed up the process of regenerating the nerves. We’ll let you know how all of this works out.

DREAMS

I have for the most part always liked dreams (the kind you have when you are sleeping). They can be a pleasant interlude in an otherwise turbulent world and on occasion they can even help you solve problems. Of course nightmares sometimes intrude, but even they can be interesting and sometimes serve to let us know how silly it is to worry about some things. Since chemotherapy though the whole dream thing has changed. For one thing it used to always irritate me if I awoke in the middle of a particularly good dream and then on going to sleep was never able to resume the dream. Now, I will keep having the same dream, over and over, regardless of how many times I wake up. I rarely can remember the dreams, but I know they are always about some serious, problem solving, often mathematical situation that makes no sense. For example, in one of my dreams that I do remember my oldest daughter and I were cooking together. We were working our butts off and at one point we decided we finally had enough prepared to feed everyone from here to Prosser. Now Prosser is a town located about 180 miles southeast of Seattle and I would not have any idea how many people there are between here and there, but it would be a big bunch. Every time I went back to sleep that night we were once again slaving away trying to make enough food for the people between here and Prosser. As far as I can recall I don’t have pleasant dreams, only the serious, problem solving kind. I have no idea what all of this means, but I think it is interesting and thought you might think so too. If anyone has any profound explanations let me know.

It's Saturday now and I am feeling pretty good. The shortness of breath has improved and the stomach discomfort has abated. So feeling good just in time for my next treatment which is Monday.

Update

The irregular heart rate and erratic blood pressure seem to have calmed down so I am left with some shortness of breath, the tummy ache and some intestinal discomfort. Other than that I am feeling pretty good. Some relatively good news. Because of the shortness of breath I thought I might be getting fluid buildup on my lung so I went in yesterday to have that checked. The xray and subsequent ultrasound showed that there is very little fluid build up, not enough to tap. Also, the pathology report on the fluid that was drained about two months ago, showed that the mass of malignate cells in the fluid has been reduced. So taken together with the fact that the CT scans have shown the tumor to be reducing in size this seems to be encouraging news.

A Word About the Link to OncTalk

If you have scrolled down the left column you will see that I have linked to a blog called OncTalk. The blog is hosted by my doctor, Howard West, director of medical oncology at Swedish Cancer Institute. The blog contains a wide ranging wealth of information about cancer. Some of it is pretty heavy, but most of it is in reasonable lay talk. You may find it of interest as an information source. For example there is quite a bit of information about Alimta, the drug that I have just started taking.

And the Beat Goes On

Well, heart rate got to be part of the problem day before yesterday. Tuesday night we went to a West Seattle Chamber of Commerce party. Since I am a past president of the organization it seemed like the right thing to do. My cardiologist, however, said it wasn’t very bright. Apparently he was right. That night I had terrible sweats and Wednesday morning woke up with a heart rate of 140 which accelerated to as much as 191 during the day, and my blood pressure was erratic, but mostly low; like 80 over 53. This had happened once before a couple of months ago and without going into a lot of detail everything went back to normal after getting rehydrated with saline and magnesium. So, we tried that approach again yesterday with just saline and I really think it did help some, although I blacked out when I got up from the chair in the treatment center. That prompted a quick trip to my cardiologist. By the time I got to his office I wasn’t feeling light headed any more. I have had echo tests and stress tests and my heart is in pretty good shape so the doctor wasn’t too worried. He felt that I might have picked up something at the party, like a low-grade viral infection and he agreed that I still showed signs of dehydration. So, he sent me home, I drank a quart of broth ( I do love broth) and so far today both blood pressure and heart rate are in the normal ranges. So, I will continue the monitoring and the prolific hydration and we’ll see, but it looks like the worst has passed. We’ll keep you posted.

Update

It was been a rather uncomfortable week. The side effects of Alimta are not quite what I anticipated. I tire quickly, which I had been warned about, but I have also had more stomach ache and nausea than I expected. It is still with me eight days after treatment so I am hoping there will be light at the end of the tunnel sometime soon. But, we still have much to be thankful for. The storms did not affect us directly. In areas where the floods hit hardest it has been a true disaster. Most of the flooding occurred in Lewis and Pacific Counties around Centralia, Chehalis and Raymond. Our favorite BarBQ joint, about 15 miles west of Olympia, was completed destroyed by flooding and a mudslide. If you ever watch the food channel you might have seen Amy Anderson. She has appeared on many BarBQ shows and has won top honors at all of the national BarBQ contests. So, it is a shame. We are hoping she will be able to rebuild. Of course, the lose of a BarBQ joint is nothing compared to some of the other loses. Dairy farms lost all of their cows, a pig farmer lost all but two of his animals. But people are resilient and with a little help I'm sure things will return to normal.

My Philosophy - This Journey is Just Another Adventure

I have not availed myself of any of the support groups that are offered by the Swedish Cancer Institute so I don’t have any first hand knowledge of the emotions that others encounter when battling cancer. However, in talking with the oncology nurses and my doctor, depression, self pity and a general malaise are not uncommon. I only mention this because the nurses and my doctor seem to marvel at my positive attitude and happy outlook.

I feel that I have lived a very interesting life. I have had the privilege of walking on the mountains of success but I have also walked in the valleys of defeat and despair. One of my favorite quotes is credited to Theodore Roosevelt. He said, “The credit belongs to the person who is actually in the arena, who strives valiantly…who knows the great enthusiasms, the great devotions, …and expends himself in a worthy cause, who at best knows the triumph of high achievement; and who, at the worst, if he fails…at least fails while daring greatly, so that his place shall never be with those cold and timid souls…who know neither victory nor defeat.”

I can make no claim to greatness, but I believe that striving for things, competing, pursuing a purpose all contribute to a happy life. All of which goes along with my basic philosophy.

I have always felt that happiness is something that is generated internally. You can be happy or unhappy. It’s up to you and it has nothing to do with the external things that are going on around you. Along with that belief I have always felt that when things go bad you have a right to go into a deep blue funk, but that deep blue funk should last about two hours. During that time you can cry, feel sorry for yourself, grieve, whatever, but when the two hours is up get up off your duff and do something about it – that is if it is something you can control. If you have no control over the situation then quit worrying about it and get on with your life. Trust me, with cancer you have little control, all you can do is go with the flow and do what the doctors tell you.

However, I have learned that you can take control of your body as far as its physical strength is concerned and so now I am exercising regularly, lifting weights and walking as often as possible. BTW I have a couple of companion beliefs that go along with my philosophy of life. “never drink when you’re feeling sad”; “never drink to celebrate a major victory.” Bad things nearly always happen when you do either.

Update

Well it's the second day after my first treatment with the new drug Alimta. I felt pretty good yesterday, with only a little stomach ache, but I'm feeling pretty puny today. We'll see how the day progresses. I plan to exercise regardless of how I feel so we'll see how that goes. So far, though, I think this may be easier than the first treatments. They are not giving me Nulasta (sp?) so at least I don't have the bone pain.

And We Have the New Taken Away

I went in for my first treatment today with the new drug, Alimta, and also fully expected the begin with the clinical trial of drug of MKC-1. However, I was told that I am not eligible for MKC-1 because the previous treatment was working and the only reason I am going to a Stage Two treatment is that the carboplatin and the Taxol were too toxic and were causing numbness in my hands and feet. The MKC-1 clinical trial is limited to those people who did not improve with their Stage one treatment. Sounds a bit strange to me. I would think that they would want to know if improving patients can gain even more improvement with their new drug. However, I also realize that clinical trials have very specific purposes and they usually only deal with one issue at a time so that the results don't get confused. However, the Alimta is supposed to be very effective on its own so we are hoping that it will be the case and that our improvement will continue. I did have my first treatment with Alimta and so far I feel fine. The side effects usually show up on the second day so I'll let you know how I feel in a day or two.

We've Added Something New

Well, we have added a new element in our little adventure into the unknown. My doctor called yesterday and asked if I would be willing to participate in a clinical trial with a new drug which has not yet been named, but is identified as MKC-1. This is an experimental drug that has shown some promise in enhancing treatment when paired with Alimta. As with anything else there are some risks, but the potential benefits seem to outweigh the risks. I will be monitored closely (twice a week) during this process and will have blood tests at least twice a week. So, if at any point undesirable results are detected we will stop the treatment with MKC-1. The drug is taken as a pill, twice daily for a period of 14 days. There is a 7 day rest period and then the cycle begins again. The Alimta treatments will be once every three weeks, so the MKC-1 is on the same cycle. The clinical trial is sponsored by EntreMed. You can get information off their web site and there is also information on ClinicalTrials.gov. We'll keep you posted.

We know a little bit more now

We had our CT scan yesterday and the good news is that the tumor is continuing to be reduced in size. However, we will continue to have treatments for the next two to four months. The drug is going to be changed to something called Alimta. The scientific name is pemetrexed. The carboplatin and the Taxol that I have been getting has caused numbness in my hands and feet and to continue those could lead to a permanent condition which would not be a good outcome. The new drug will have most of the same side effects that I have been experiencing, but it won't include numbness. The doctor seems confident that this new drug will be effective and will probably be a little less burdensome in terms of the side effects. But, as they always say, "everyone is different" so we won't know for sure until we have the first treatment. That, BTW, is scheduled for next Monday. One good thing is that the treatment will only take about an hour as opposed to the six hour days we had previously. So that's it for now.

What's Next?

We don't know for sure what's next. I go in for a CT scan on Monday and the results of that will determine what we do. We'll either continue the treatment we have been getting, change the treatment or stop treatment. I'm pulling for the third option, but have no unrealistic expectations. I'll let you know what happens Monday.