Diagnosis

Options

In bad news, the surgeons weren’t able to reverse my ileostomy last Friday. Instead, they gave me a new and improved one. It splutters somewhat more than Bilbo did. I have named it Krakatoa.

In more bad news, the supplemental exploratory surgery did not end well. The cancer has definitely recurred, and it has recurred so soon that the prognosis is . . . not good. I don’t mind telling you that we shed some tears.

I will be cogitating this week, while recovering from surgery under the redhead’s loving care, about how to move forward. We have four options.

Option #1 is to pursue no further treatment and to let nature take its course. Okay, this sounded idiotic even as I was writing it. We’re not anywhere near there yet. So let’s move on to Option #2. 

Option #2 is to participate in an experimental drug trial. This sounds like it might be fun. 

Option #3 is to start different chemotherapy with two drugs in a combination recently approved by the FDA, with promising results. One drug happens once per month, and the other happens twice per month. Already, this sounds more user-friendly than the weekly dense-dose smackdown that turned the tide last year. There’s a catch, of course. The second drug has some potentially nasty side effects. But like the experimental trial, this regimen has a real chance of extending my life. And oh how I do love life.

Option #4 is to start with Option #3, and if it’s not working, then switch to Option #2, provided it’s still open.

Hmm. I may need a spreadsheet. 

In good news, though, all of the options come with wine.

We are up at our mountain cabin in Angel Fire, processing all of this and making our decisions. Love and hugs on this beautiful summer day.

Diagnosis

Good news

The reviews are in: Five stars from everyone except one crotchety radiologist.

In a wonderful test result, my CA-125 blood marker is within normal range for the 4th reading in a row. It even went down a little, to 16.1. It’s still not single digits, but I’ll take it, because for now, NO MORE CHEMO! Oh the joy!

I want to be bouncing up and down and shouting the word “remission” from the rooftops. However, it appears we can’t pop a cork just yet. The CT scan showed a few small “spots.” My surgeon believes that they are simply scar tissue from November’s major surgery. (Go Team Surgeon!) The killjoy radiologist is calling the spots “nodularities,” which is jargon for “I have no idea what these spots are, but I’m not signing off on remission until I’m darn sure they aren’t cancer.” I can respect that. The radiologist wants to repeat the CT scan in 60 days, which is the time period necessary to confirm the spots are stable and not growing. I won’t be able to use the “r” word until Team Radiologist gives the go-ahead.

It’s true that the redhead and I would like to have a more definitive and immediate sense of closure, but hey. Even if they say the magic word, the reality is that recurrence will always be a possibility. Right now I’m looking at 60 days of chemo-free life outside the bubble. I’m looking at easing back into the office to do work that I love. And in a few weeks, I’m looking at some beach time with the redhead. Life is good.

Speaking of the redhead, he has asked me to thank you from the bottom of our pea-pickin’ hearts. I have no doubt that your prayers and positive energy have been helping steer this ship for the past eight months. We are blessed beyond measure at the wealth of friendship and support that you continue to give us. “Thank you” doesn’t really cover it, but it’s all I have right now, so THANK YOU!

And also for now, please know that no news is good news. I hope very much to see you soon. Prepare to be hugged.

Diagnosis

Lab results, glasses, and doughnuts

I realized the other day that I have been saving a fortune on hair care. So I sprang for some snazzy new glasses.

The medical team moved me to Mondays for chemo, and yesterday was a double dose, which is generally a 5-day buzz-kill. However, the lab result contained such good news that I have bounded out of bed at the crack of noon today to share it.

As you know, my prognosis depends on the CA-125 ovarian cancer marker, which is determined by a blood test. To recap: Normal range is zero to 35. The marker is calculated every three weeks. Back in late July, I started with a 608.1 – essentially, near death. Three weeks ago, I got a 22.3 – normal.

Well, friends, yesterday I got a 15.1 – normal again. If I get two more normals in a row over the next six weeks, I will officially be in remission!

Better still, the trend appears to be headed downward. I continue to aim for Lucky Number 7. Thank you for your support on the road to get there.

Just FYI — no matter how messy it is, a celebratory doughnut tastes even better when eaten with the fingers than with a fork.

Enjoy your week!

Diagnosis

I miss wine

I miss wine. It does not play well with chemo.

Last week was a double dose, so I have been hunkered down. I spent the weekend in slug mode with pajamas, the couch, televised football, and the BBC.

Have I mentioned that I miss wine?

In great news, I received the results of a recent blood test for the CA-125 ovarian cancer marker. The normal, non-cancerous range is zero to 35. I started this adventure back in early August with an astronomical readout of 608. After bouncing around quite a bit, my marker is now at – drum roll, please – 22.3. Normal range! If I can get it all the way down to a single digit, though, statistics say that my chances go up dramatically that it will stay there, indicating remission, and for a longer time. I’m aiming for a 7. Please be thinking Lucky #7!

To increase my chances of getting to Lucky #7, the medical team has tacked on more chemo sessions, through February. Fine with me. Welcome, in fact. Bring it on.

And finally, to the tune of the chorus of “My Boyfriend’s Back,” by the Angels circa 1963 (please refer to the chemo side-effect referenced in a prior post):

“Yeah, the BUMMER’s back, it’s gonna need some medication
(Hey-lah-day-lah, the BUMMER’s back!)
I really need to take a tropical vacation
(Hey-lah-day-lah, the BUMMER’s back!)”

Have I mentioned that I miss wine?

I want to thank everyone who has ordered my book. The response has truly lifted me up.

Thank you! – and happy MLK Day. Have a wonderful week.

Diagnosis

How did I just skip to Stage IV?

All is well. I have been successfully avoiding chemo nausea with a strict daily regimen of Zofran (anti-nausea medication) and Blue Bell (cookies ‘n cream). Next chemo is Monday, followed weekly thereafter for another couple of months.

Friends have asked me whether I had any warning signs of cancer, or whether a routine check-up should have picked this up. The answers are nope and nope. My particular version of this cancer has special and challenging characteristics (more on that later, because of course I think I’m special and challenging). However, it is essentially Stage IV ovarian cancer. Only about 20% of ovarian cancer is caught in early stages.  That is, almost 80% of women who present with ovarian cancer are already in or very near Stage IV. This should send a chill up the spine, girlfriend.

At Stage IV, there is no cure. There is a great probability of remission for a satisfying period of years, but there is no cure.

A couple of months ago, I started noticing some fatigue (but I’m getting older and still working 10-hour days, so not unexpected, right?); some bloating in my gut (constipation?); some shortness of breath (need to get back on the treadmill?); and that was it. Figuring it was time for a colonoscopy anyway, and since I was having some throat issues as well, I made an appointment with a GI doc.  She duly performed an endoscopy/colonoscopy, top to bottom. All was well with my digestion, but she found a significant stricture of the colon at one spot, and in light of that and the now-unexplained bloating, she ordered an MRI for the following day. Literally two business days later, I had a diagnosis of Stage IV ovarian/peritoneal cancer and was hustled immediately into the care of a surgical oncologist.  So soup to nuts, the time between initial vague symptoms to diagnosis was maybe 3 weeks, max 30 days. Cancer had been growing for many months, and probably for several years. By the time I noticed anything at all, it was waaayyy too late.

I have Googled this conundrum to death and conferred with my docs and the redhead. There is no good answer for early detection.  Genetic testing is not a bad idea – with the caveat that a positive hit does not necessarily mean cancer and may give you a lifelong “preexisting condition” for insurance purposes. There are some blood tests that can identify cancer markers. These are not routinely done in blood work and would have to be requested specially – again, with the caveat above. Even a hysterectomy is not necessarily the solution, because the same cells that are present in female reproductive organs are also present in the abdominal lining (peritoneum) – hence, the same exact cancer can just grow there instead.

Friends, if you have any knowledge or insight into this issue, please post forthwith. Otherwise, this is all I got: Hug often, live joyfully, and value time as a gift beyond price.

Diagnosis

Core biopsy and paracentesis

In addition to another paracentesis today, the fine folks at UTSW Interventional Radiology performed a core biopsy.  Although I have already received a diagnosis of peritoneal carcinomatosis, the core biopsy is intended to allow the oncologist to fine-tune the chemo cocktail to be as effective as possible.

By the way, today’s paracentesis makes a total of just over 6 liters of fluid drained from my abdomen — 5 liters last week, and 1.25 liters today. For the last couple of months, as that fluid built up, I was thinking wow am I old and fat.  (Now, of course, I’m thinking wow I have advanced stage cancer.)  But draining all that fluid, which was shoving up against everything, including my lungs, certainly has made it easier to breathe and work.

Diagnosis

Dear Extended Family, Law Firm, Friends, and Colleagues:

As you know, I received the unwelcome news from my doctors last week that I have Stage IV peritoneal/ovarian cancer. The purpose of this blog is for me to be able to communicate my status without being intrusive.  That is, you can check here whenever you like, and I won’t worry about how often would be too often to communicate with you directly.  (I don’t want to be a bore.) Plus, who knows, perhaps someone out there with a similar diagnosis will feel connected. In any event, I will be posting updates and cancer ramblings here periodically, so you will know I’m still alive and kicking.

Barring unforeseen complications, this will be a marathon. Best case is 3-5 months for treatment (chemo, followed by surgery, followed by chemo), with a great chance of remission thereafter. My law firm has very generously allowed me to take an extended leave of absence to concentrate on treatment and recovery.

This is not my first rodeo. After surviving breast cancer in 1991, I have received 27 bonus years, and those years have been glorious. Please know that if my time is up now, I’m okay with that. However, the plan is to throw everything at this that medical science and I have at our disposal, and to achieve many additional bonus years (is that redundant?) with my sweet redheaded husband, and with my wonderful family, law firm, and friends. As I have said to all, the highest probability is that I will be back in action by the end of the year, with no hair and a terrible attitude.

If I become temporarily unable to post, the redhead says he will take up the slack.  As unlikely as that would seem to actually happen, I know his heart is in the right place.