Wednesday, August 6, 2008

Cancer Report 01

You keep filling my in-box asking how I'm doing. Your interest is warmly appreciated but I'm afraid my answers -- doing fine, thanks. Doing okay... leave a lot to be desired. So let me use this Report to try and answer the essence of your question.

On Tuesday, the 5th of August 2008, I completed the radiation therapy. The x-rays have supposedly chopped up the tumor, killing most of it. In doing so, the PAIN has been reduced to a magnitude that is relatively easy to manage. And it's really all about controlling the pain.

After being destroyed by the x-rays the tumor doesn't just vanish. Apparently it is blasted into a soupy residue that your body must now eliminate. I'm told this will take about four weeks and will be the most debilitating phase of my treatment, in that I will be extremely weak. There is already some evidence of this. Even with two canes to ensure my stability, walking about forty feet left me too exhausted to return until I'd taken a rest break.

To facilitate the removal of the tumor residue I must force myself to drink about twice the normal amount of fluids. Doing so also serves to dilute any pain-killers you may have taken so that you are forced to keep track of what you've taken and when. Failure to do so gives the pain an opportunity to sneak up on you. If it gets you at the wrong time, you may find yourself immobilized, separated from your pills.

Chemotherapy is the hand-maiden of radiation therapy. Where the x-rays attacked the tumor in a macro fashion, chemotherapy goes after the cancerous cells in a micro-manner, seeking out each individual cell, which it either destroys of prevents from binding to a healthy cell and reproducing. The chemicals used to attack the tumor are toxic and there are a number of side-effects, such as nausea, hair loss and so forth. The chemotherapy began about two weeks ago and will continue for several months at a minimum.

Multiple myeloma destroys bone. Once destroyed, it can not be replaced except through surgery, which is successful in only a few particular cases. The damaged bone is quite fragile. There is the possibility that performing some accustomed chore such as dressing or bathing can over-stress the weakened bone causing it to fracture. There are chemicals that can bind to the damaged bone and provide some re-enforcement and I will begin taking those chemicals as soon as blood tests say the bone is ready to accept them.

So the messages ask: "How are you doing?" And I respond: "Fine; thanks for asking." But as you can see, there's a bit more to it than that. Such as the rash, a nasty side-effect of the chemo. Or the edema in my lower legs, an artifact of the tumor residues. And a dozen other little things that taken on the whole make it impossible to offer a comprehensive answer as to my condition.

Which is why I'd rather look at it from a slightly different perspective.

I'm a pretty lucky guy. I came within an ace of dying from an unsuspected tumor, recognized -- and properly treated by a superbly skilled physician who just happened to be in the ER when I was brought in. I'm doubly lucky in finding myself surrounded by people -- many whom I've never met -- who have provided support and encouragement that has served to level the often difficult path I have been forced to follow.

-R.S.Hoover
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