Tuesday, May 10, 2011

Surgiversary number 6

Six years ago today I was relieved of one kidney, one adrenal gland, and one big tumor.  Six years... it's really receding into the past.  The scars from that procedure are barely visible on my skin anymore.  I have newer scars to look at instead, but those marks are preferable to not being able to see anything anymore.

The last couple of months have been very low-energy for me.  My last two cycles of Sutent have caused more fatigue, and brought along with them foot soreness.  I have a couple of spots on each foot that get very sore about midway through the cycle, and which return to normal during the first week off cycle.  The foot pain is not unbearable, but has definitely slowed me down a lot; to the degree that I have gained some weight due to the decrease in activity.  It also prompted me to ask my oncology NP, Shari, for something I didn't ever think I would need... namely to help me to apply for a handicap placard for my car.  So far in this journey I've been grateful to not feel like a cancer patient, to go about my life with only the disruptions caused by surgeries and scans.  However, the combination of fatigue and really painful feet really made me feel differently, emotionally.  For once I didn't feel like "mind over matter" could make me forget what is going on inside my body.  Instead, when the symptoms are at their worst, I just feel... well, kind of run over, and more pessimistic.  Don't worry, I am not giving up on myself by a long shot.  But, even at the level of fatigue I felt, a level that is far less severe than that experienced by people I know, I felt like I could understand why people let go of the fight at some point in their cancer battle.  If they feel like it's never going to get any better, they just want to stop suffering.  My dad came to that realization a few months before he died.  He had been participating in a clinical trial, not because anyone thought it would cure his lung cancer, but just to try something, to have hope.  When the results weren't stellar and he felt like crap, he decided that was it.  I remember supporting his decision vocally while inside wishing he could find it in himself to keep fighting.  But he knew that it wasn't going to help and wanted to enjoy the time he had left as well as he could.  He was admitted to the hospital for pain med adjustment, and went home with hospice care for his last two months.  During that time he was relatively comfortable, and was lucid (and fun!) up until his last week. 

I feel lucky that there are more options for me, should Sutent stop working.  Fortunately, we're not at that point yet, though my cancer continues to throw curve balls.  I had scans a couple of weeks ago, which showed some good and some not as good news.  On the chest CT report it was noted that the one nodule that they thought was necrotizing (dying) in February has in fact decreased in size.  On the other hand, a few tiny (2mm) nodules were noted for the first time.  Shari explained that these tiny dots may have been there already but weren't seen in previous scans because the cuts on the CT are 3mm so they could have been sitting in between cuts previously.  At any rate, 2mm is nothing to get excited about at this point.

The MRI of the abdomen and pelvis.  Among the pieces of good news: "No definite enhancing liver lesion identified."  There were at least four lesions in there before Sutent.  So very good!  As for the mass in the pelvis, that Dr. Drake couldn't get to last year without really opening me up, "Soft tissue mass located superior to the uterus does not enhance centrally and is further decreased in size measuring 2.0 x 1.8 cm previously 2.1 x 2.1 cm. There is decreased central enhancement."  Oh and I still have gall stones.  No news flash there.

But then there was this:  "Marginal increase in size of minimally enhancing 1.8 x 1.4 cm lesion L3
vertebral body".  In non medi-speak, that means there is a lesion on my L3 vertebra - lumbar, or lower back area of the spine.  Here's what's weird about this... a L3 lesion was never mentioned before.  Last August there was mention of something on L2, but that was never mentioned again.  I jokingly called it the 'floating lesion' but only I found that amusing.  Shari and Dr. Rini asked another doctor, a neurosurgeon who works with oncology, look at my scans to see if she thought it would be a good idea to treat this L3 thing with sterotactic radiosurgery.  Picture a really strong beam going right into the tumor to blast it away, and you have the idea.  The surgeon, Dr. Angelov, wants to wait and see what happens over the next couple of months, so I am scheduled for a lumbar MRI and a visit with her at the end of June.

Right now I should be almost through my first week of Sutent cycle #7 but another monkey wrench has been tossed my way.  Shortly before Easter, I developed a small red bump on my shin which turned into a large, angry looking red bump.  I had it looked at and was put on antibiotics, which shrunk it a lot.  Unfortunately, the damn thing still is a little bit open and so hasn't healed completely.  I can't take Sutent with an open wound because the Sutent will keep it from healing, so I am deferring my return to the 'good stuff' by at least a week.  I've been checking in with Shari every few days, hoping that soon I can tell her it's no longer a weepy little sore.  Hopefully I won't have to go back to the wound clinic, where I was treated so well and so kindly in 2009, but where I hoped never to need to return.  This delay makes me nervous but I am trying not to think about it.

Next up - the rest of my life aka non-cancer stuff.