"Shane Boyce's Notes" blog update:
Chemo is working too well at killing my internal cells. I had a low white blood cell count this morning so this week's chemo was cancelled. A borderline count is "1.5" I was down at "1.0" (This may be referring to my neutrophil count and not my total white blood cell count. I don't have the printout to compare, only my memory of what the pharmacist told me.). Last week was "1.51" or near there so they treated me anyway. But this week's 1.0 was too low. So I have this week off.
Next week was a regularly scheduled "break" so I won't be receiving chemo next week either. The week after that treatment will continue as normal (provided my counts are recovered). So treatment will continue two Tuesdays from today (Mar 29th is today).
I continue to have no symptoms attributable to the chemotherapy. Most are still post-surgery symptoms (digestive problems and occasional migraine) and maybe extra fatigue from having tumors in my liver. That's all.
Here's a web page that talks about blood cells and counts. I'm not sure how these numbers relate to the "1.5" and "1.0" above, but it is still an interesting read.
Regards,
Shane Boyce
Short Executive Status (Summary) -- Blog is below
Active Tumors:
» 5+ liver tumors -- largest is 7 cm by 5.2 cm (70 x 52 mm), Gold tracers inserted Nov 21 for CyberKnife x-ray 3D movement tracking. Thu Dec 1st,2011, CyberKnife planning. Dec 16th, treatment 1/3 done to whole liver. Dec 19th, treatment 2/3 done to whole liver. Dec 21st, treatment 3 failed, couldn't get tracer alignment. Dec 22nd, treatment 2.5/3 done using 2 of 4 tracers. Final 0.5 treatment was to be done Tue Dec 27th. Cancelled due to complications and hospitalization.
» 12 lung tumors -- largest is 8 mm in size (0.8 cm)
» 1 lymph node tumor -- near left renal vein & artery of left kidney (1.4 cm). Nov 14th: Ultrasound done of both kidneys and bladder area, all 3 areas are cancer free.
» 3rd-8th brain tumors -- 6 new brain tumors. Sizes all less than 5mm(0.5cm). Some as small as 2mm(0.2cm). Full brain radiation or CyberKnife TBD in Jan after 2nd MRI to see speed of growth.
Inactive Tumors:
» 2nd brain tumor -- Killed via CyberKnife Sep 29/2011, 5 mm in size (0.5 cm).
» 1st brain tumor -- Killed via CyberKnife May/2011, was 20 mm in size (2 cm). Nov 21st, still showing brain tissue swelling, but not active.
» Original Esophogeal Cancer tumor (source of everything) -- Surgically removed June/2010 by 3-field Esophogectomy. Was roughly large egg sized.
[ Note: 2.54 cm = 25.4mm = 1 inch ]
Link to 34 surgery June 2010 pictures and some post surgery shots.
» 5+ liver tumors -- largest is 7 cm by 5.2 cm (70 x 52 mm), Gold tracers inserted Nov 21 for CyberKnife x-ray 3D movement tracking. Thu Dec 1st,2011, CyberKnife planning. Dec 16th, treatment 1/3 done to whole liver. Dec 19th, treatment 2/3 done to whole liver. Dec 21st, treatment 3 failed, couldn't get tracer alignment. Dec 22nd, treatment 2.5/3 done using 2 of 4 tracers. Final 0.5 treatment was to be done Tue Dec 27th. Cancelled due to complications and hospitalization.
» 12 lung tumors -- largest is 8 mm in size (0.8 cm)
» 1 lymph node tumor -- near left renal vein & artery of left kidney (1.4 cm). Nov 14th: Ultrasound done of both kidneys and bladder area, all 3 areas are cancer free.
» 3rd-8th brain tumors -- 6 new brain tumors. Sizes all less than 5mm(0.5cm). Some as small as 2mm(0.2cm). Full brain radiation or CyberKnife TBD in Jan after 2nd MRI to see speed of growth.
Inactive Tumors:
» 2nd brain tumor -- Killed via CyberKnife Sep 29/2011, 5 mm in size (0.5 cm).
» 1st brain tumor -- Killed via CyberKnife May/2011, was 20 mm in size (2 cm). Nov 21st, still showing brain tissue swelling, but not active.
» Original Esophogeal Cancer tumor (source of everything) -- Surgically removed June/2010 by 3-field Esophogectomy. Was roughly large egg sized.
[ Note: 2.54 cm = 25.4mm = 1 inch ]
 | 5 pictures included in album | ||
| 2011_11_16, Shane in BIG CHAIR |
Link to 34 surgery June 2010 pictures and some post surgery shots.
Latest Picture
Shane - 2011_11_27, Photo Shoot lighting prep
Tuesday, March 29, 2011
Friday, March 25, 2011
Stretched
Well, I'm stretched... I was fine until my nap (around 3pm) after waking at 6pm now my throat hurts. They must have had me on some powerful pain killers after my procedure for it to last until 3pm.
So now I'm definitely on soft foods until this eases up a bit. Thanks to Kaye's mom, Ming, for making lots of rice porridge (aka congee or juk [Cantonese]).
Shane
So now I'm definitely on soft foods until this eases up a bit. Thanks to Kaye's mom, Ming, for making lots of rice porridge (aka congee or juk [Cantonese]).
Shane
Wednesday, March 23, 2011
2nd Chemo treatment - status
Well, yesterday I had my 2nd injection of the chemo drug "PACLITAXEL" aka (brand name=Taxol).
So far, no nausea from either injection. Yay! Symptoms only include (so far) an increase in migraines and possibly some side pain. But the migraines are likely due to overeating or "rough" food eating that both irritate my surgical region between my stomach to esophagus. When this area is irritated, I get radiating pain that overloads my head. Relief of the local throat pain also removes the migraine symptoms, so I know the two are related.
To try to solve the irritation of the throat region by "rough" foods and food getting stuck. I have scheduled a throat stretch for this Friday, March 26th. It is for 7:15 am in the morning, so I'm looking for someone who can get my kids off to school in the morning since we'll have to leave at 6:15am to make the appointment. I'll phone mom and dad to see if they can do it.
The more common symptoms of paclitaxel include:
-- Shane
So far, no nausea from either injection. Yay! Symptoms only include (so far) an increase in migraines and possibly some side pain. But the migraines are likely due to overeating or "rough" food eating that both irritate my surgical region between my stomach to esophagus. When this area is irritated, I get radiating pain that overloads my head. Relief of the local throat pain also removes the migraine symptoms, so I know the two are related.
To try to solve the irritation of the throat region by "rough" foods and food getting stuck. I have scheduled a throat stretch for this Friday, March 26th. It is for 7:15 am in the morning, so I'm looking for someone who can get my kids off to school in the morning since we'll have to leave at 6:15am to make the appointment. I'll phone mom and dad to see if they can do it.
The more common symptoms of paclitaxel include:
- signs of infection / fever, chills, cough --> no symptoms yet
- Low white blood cell count --> Yes. My blood work yesterday suggested my white blood cell count is low. But was high enough to proceed with a 2nd dose of the drug. So the drug is working in my system, just luckily without the nasty side effects of my last 3 rounds of chemo drugs.
- Numbness and tingling in hands and feet --> Yes. I have this in my feet, but I've had this since the first round of chemo in the spring of 2010. It has never gone away (permanent nerve damage).
- Muscle or joint pain --> No. I'm not sure if I have this. If I do, it is in the same area as my rib displacement from July 2010's surgery. As such, it is hard to tell if it is new pain, or old tissue damage complaining.
- Nausea and vomiting --> not yet.
- Shortness of breath, flushing of face --> No. I did get short of breath from the excertion of putting out the garbage and recycling last night. But some of those containers weighted > 40 lbs so I think it is to be expected.
- Hair thinning or hair loss --> not yet.
-- Shane
Saturday, March 19, 2011
Options? Few.
After the doctor's visit on Thu, it seems like my options are few.
Chemo is really my only option right now. All other possible options require me to be free of chemo and "stable" for 2-6 months. At the aggressive growth rate of my current tumors, if I left them alone that long then they would probably easily move to my lungs, and/or bones and/or brain. So I'm not going to leave them alone and will continue to attack them with chemo.
As for the other treatments, most I'm not eligible for anyway. I don't have liver cancer, which is what the liver radiation treatments are geared towards. I have esophageal cancer that has moved through my blood stream into my liver (and may continue on to other organs). So the "liver cancer" treatments aren't considered for my case. It is the pick a dandelion by the stem instead of the roots argument. With the cancer free in my blood, they cannot stop to pick the dandelion, because the roots will spread everywhere else. They have tried that in the past, and they have found that the deterioration of the patient tends to happen very quickly when the stop to treat the symptoms instead of the root cause of the tumors (like 3 months lifespan fast...). So they want to give me more time and are attempting to kill the root cause and will deal with the symptom (individual tumors) if given some breathing room later.
The only way they would stop the chemo to try something else would be if I was to become part of an experimental project, but they aren't aware of any projects for people in my unique position in Ontario right now. And then there is the fact I'd have to be off chemo and "stable" for months just like everything else.
So for now, I just have to hope that the chemo works, has an effect on the tumors that are visible (indicating that the chemo works for my "esophageal" type of cancer). Then with the tumors "under control" I may be a candidate for something else. But not unless that happens. If this chemo doesn't have an effect, then they have to try another chemo, because then I'm not under control and not stable enough for anything else. If the chemo doesn't work, then the tumors risk also becoming larger than they can do radio surgery on (something usually reserved for true liver cancer or colon cancer, so they aren't really considering it for me). Radio surgery has a limit of 3 cm tumor width as after that the dose of radiation gets too high (rises with size of tumor).
So... here's hoping the chemo works. Not much else to put my hopes on at the moment. Except my body learning how to fight the cancer itself... ya, not likely.
Having said that, I'm going to enjoy the gathering tonight with my family!
Shane
Chemo is really my only option right now. All other possible options require me to be free of chemo and "stable" for 2-6 months. At the aggressive growth rate of my current tumors, if I left them alone that long then they would probably easily move to my lungs, and/or bones and/or brain. So I'm not going to leave them alone and will continue to attack them with chemo.
As for the other treatments, most I'm not eligible for anyway. I don't have liver cancer, which is what the liver radiation treatments are geared towards. I have esophageal cancer that has moved through my blood stream into my liver (and may continue on to other organs). So the "liver cancer" treatments aren't considered for my case. It is the pick a dandelion by the stem instead of the roots argument. With the cancer free in my blood, they cannot stop to pick the dandelion, because the roots will spread everywhere else. They have tried that in the past, and they have found that the deterioration of the patient tends to happen very quickly when the stop to treat the symptoms instead of the root cause of the tumors (like 3 months lifespan fast...). So they want to give me more time and are attempting to kill the root cause and will deal with the symptom (individual tumors) if given some breathing room later.
The only way they would stop the chemo to try something else would be if I was to become part of an experimental project, but they aren't aware of any projects for people in my unique position in Ontario right now. And then there is the fact I'd have to be off chemo and "stable" for months just like everything else.
So for now, I just have to hope that the chemo works, has an effect on the tumors that are visible (indicating that the chemo works for my "esophageal" type of cancer). Then with the tumors "under control" I may be a candidate for something else. But not unless that happens. If this chemo doesn't have an effect, then they have to try another chemo, because then I'm not under control and not stable enough for anything else. If the chemo doesn't work, then the tumors risk also becoming larger than they can do radio surgery on (something usually reserved for true liver cancer or colon cancer, so they aren't really considering it for me). Radio surgery has a limit of 3 cm tumor width as after that the dose of radiation gets too high (rises with size of tumor).
So... here's hoping the chemo works. Not much else to put my hopes on at the moment. Except my body learning how to fight the cancer itself... ya, not likely.
Having said that, I'm going to enjoy the gathering tonight with my family!
Shane
Wednesday, March 16, 2011
Wed: 1st day after new chemo
Wed Mar 16th: No noticable symptoms yet. Unless you count the fact I slept for 10 hours last night?
Tomorrow we're seeing the doctor to discuss further treatment options (experimental and not) depending on how this chemo round goes. Want to keep my options open.
Shane
Tomorrow we're seeing the doctor to discuss further treatment options (experimental and not) depending on how this chemo round goes. Want to keep my options open.
Shane
Monday, March 14, 2011
Chemo moved to Tue Mar14th.
Nothing to report yet. Chemo was moved from Fri to Tue due to insurance delay. This is an expensive drug, so it takes longer for insurance to approve it.
FYI: 3 moles were removed Thu. What a pain. Not sure if it was worth it. (Yes honey, you were probably right.) ;-)
-- Shane
FYI: 3 moles were removed Thu. What a pain. Not sure if it was worth it. (Yes honey, you were probably right.) ;-)
-- Shane
Wednesday, March 9, 2011
CT scan results weren't good, some details...
The doctor said more than what I've written, but it was speculation and hypothesis. I've tried to keep this blog entry to facts.
Monday March 7th, the doctors told me that the CT scan found 3 new tumor lesions in my Liver. Surgery isn't an option, nor is organ transplant. Also, my fatigue lately is in line with what people with liver cancer experience.
There were also smaller objects present in the liver that they investigated with an ultra-sound (also on Monday) to see if they were cysts (not related to cancer http://en.wikipedia.org/wiki/Cyst) or more tumors. I don't have the results of the ultra-sound yet.
Since these new tumors did not exist after my surgery and grew during my most recent radiation and chemo treatments, they are assuming that they are resistant to that type of chemo drug. So, they are going to try me on a new type of chemo drug for 2 months to try to control the tumor growth. I'll be starting that treatment this week (likely Friday).
Side note: the ultrasound person stated that the area where the tumors are growing was outside the radiation treatment zone.
They also mentioned that if the new drug stops growth, or even better, causes some shrinkage, that they may consider a (relatively) new treatment called "Radiation Surgery". I found this short description of what that is:
"Radiation Surgery: A radiation therapy technique that delivers radiation directly to the cancer while sparing healthy tissue. Also called radiosurgery and stereotactic external beam irradiation."
Also known as radiosurgery, here is a more detailed page about it: http://en.wikipedia.org/wiki/Radiosurgery
The doctor seemed hesitant to tell me about the radiation surgery though, so it is possible I'm not currently a candidate, possibly because radiosurgery has a 3 cm tumor size limit. I also think it is expensive to perform (rare isotopes used), so they will want to be more certain it will be beneficial before using it.
-- Shane
Monday March 7th, the doctors told me that the CT scan found 3 new tumor lesions in my Liver. Surgery isn't an option, nor is organ transplant. Also, my fatigue lately is in line with what people with liver cancer experience.
There were also smaller objects present in the liver that they investigated with an ultra-sound (also on Monday) to see if they were cysts (not related to cancer http://en.wikipedia.org/wiki/Cyst) or more tumors. I don't have the results of the ultra-sound yet.
Since these new tumors did not exist after my surgery and grew during my most recent radiation and chemo treatments, they are assuming that they are resistant to that type of chemo drug. So, they are going to try me on a new type of chemo drug for 2 months to try to control the tumor growth. I'll be starting that treatment this week (likely Friday).
Side note: the ultrasound person stated that the area where the tumors are growing was outside the radiation treatment zone.
They also mentioned that if the new drug stops growth, or even better, causes some shrinkage, that they may consider a (relatively) new treatment called "Radiation Surgery". I found this short description of what that is:
"Radiation Surgery: A radiation therapy technique that delivers radiation directly to the cancer while sparing healthy tissue. Also called radiosurgery and stereotactic external beam irradiation."
Also known as radiosurgery, here is a more detailed page about it: http://en.wikipedia.org/wiki/Radiosurgery
The doctor seemed hesitant to tell me about the radiation surgery though, so it is possible I'm not currently a candidate, possibly because radiosurgery has a 3 cm tumor size limit. I also think it is expensive to perform (rare isotopes used), so they will want to be more certain it will be beneficial before using it.
-- Shane
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