Today I had a long discussion with the consultants on the next steps for my treatment. At the core of this is the decision wether or not to have radiotherapy treatments. Fortunatly the USA Journal of Onocology has just published an editorial reveiw of this subject as it has been a "hot" topic over the last year in the expert community. In the end they have recommended that combined chemotherapy/radiotherapy using the moderen system and a dosage around 20-30Gy. After discussion today that is exactly what we have agreed to progress with as there are two critical facts which are pretty fresh (1) the disease free progression rates seem to be coming out as around 84% without and 93% with radiotherapy added, (2) the long term cancer risk historically was as high as 16% but modern treatments at lower dose are now showing no significant long term risk of fatal consequences (though there are a range of non fatal issues).
So overall the balance of risk, or the least worst option, is to proceed with the radiotherapy.
This means that I have two weeks now to recuperate from the chemotherapy, so that inflammation etc is stabilised and the radiotherapy will run from the 18th July through to about the 2nd of August. This is a daily treatment at the hospital so will consume a few hours per day getting there getting changed and getting back again. I will need to start to build up my physical fitness as well as my immune system over this time, the chemo is toxic to both heart and lung function so I get breathless even taking the shopping in from the car at the moment. The good news is that the danger from infection is not nearly as serious during radiotherapy and side effects are not expected to be too severe (just a bit of sleepyness). Once the radiotherapy is done then the treatment is finished !! So hopefully given about 2-3 weeks recovery time working part time from home I will graduate to full time working in the UK from about the last week in August and then be ready to travel again from around mid september. While it will be nice to see colleagues again I am not looking forward to seeing Heathrow, six months away has been a great break.
The follow up scans etc do not happen until about three months after the treatment has finished and then continue over the next five years pretty intensivily as the relapse rate is about one in ten, hopefully with the radiotherapy and my general fitness and risk profile I will be on the right side of that line. In any case the mean time to relapse is about 18 months so I will charge back into normal life in September and deal with any other outcome when and if it happens.
I plan to sit down with Lee tonight and try to organise a few weeks camping in Scotland and a visit to my mums house in Donegal for a week to get a proper break from computers and email in effect a proper summer holiday, with treatment and some conference committments we will have to squeeze this in as we can around the kids summer holidays and activities, but its nice to finally be able to make a plan.
Cheers
Gerry
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2 comments:
Hello Gerry
I'm sorry to hear that you have a couple more laps of this race to run. I'm sure it's the right decision logically but it must be tough all the same. Keep on keepin on my friend
Doug
Hi Karen and Doug,
This time I am actually OK with the decision and happy that the final treatment has been agreed and I can get my head around how long it will take and fit in some family time.
We will be heading to the cottage in Aberdeen where Kevin and Nate visited for a week and will have a week in Donegal (one to put on the list Karen and Kevin beautiful beaches and mulligan family holiday cottage to take advantage of!) so all in all it should be an OK time.
I am planning to take my bike to the radiotherapy so that I start to build up some fitness which has reached pathetic lows in the last month thanks to the systemic degradation of the chemo. Thankfully the next stage of treatment is much more locally targeted so my nails will grow back !
Hope you all have a great summer break, my reflection from the last year is really make the time for that sort of memorable stuff as we all do not know how much time we have. Easy to say now being on the right side of the line, but for some time that was not a given.
Cheers
Gerry
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