Friday, 1 May 2009

An afternoon with an oncologist

So went over to Mount Vernon (hospital just north of London) yesterday to meet my shiny oncologist-the dude who's going to be in charge of all of my chemo and treatment from now on. Was really impressed- not only was he really positive and straight talking, he's also mastered the rare art of being able to use the word 'cool' despite being 50+, without inducing cringeeeeee. Think this has earnt him the right to be referred to as dr. cool from here on in...

Treatment plan is as follows:

- Chemo with 3 drugs.

2 are the standard ones used for this type of cancer: Oxaliplatin and Capecitabine. Have no idea how to pronounce either...

The oxaliplatin is IV, and i'll have a line put in just above my clavicle which will stay there throughtout the treatment, for it to be fed thro each time. Main side effect with this one is tingly fingers and toes (peripheral neuropathy) which i didn't think sounded that bad, but apparently can be unbearable. We shall see!

The capecitabine is an oral tablet which i'll need to take once a week, but can take at home :)

The third drug is the rather fancy one, which thankfully the private health insurance is covering! They need to do some genetic testing before confirming this one (to see if the cancer is positive for k ras). It's called Cetuximab and is a monoclonal antibody. It basically targets the cancer cells by recognising a particular protein on their surface, and stops them from replicating. All very clever... and totally over my head, but sounds like good stuff. This will also be given every 3 weeks with the oxaliplatin.

So the wicked news re. chemo is that i'll only have to go into hosp once every 3 weeks and apparently i won't lose my hair! The only bad news is that the major side effect with the cetuximab is that you get a rash on your face that makes acne look like a mere pimple :s Twisted part is the worse the rash, the better it's working- so need to get in the mindset to celebrate the unsightly! hmmmm, might take some logic adjusting...

-Liver resection

This part is so cool/clever! After a few cycles of chemo, if the tumours have shrunk sufficeintly, i can go to Hammersmith to have this mental surgery done. Basically they remove half the liver, block the blood supply from the other half (with a portal embolsim?!) and wait for it to regenerate. Few months later, they then do the same with the other half- and voila, new liver! Just like that...


Will be having another CT in the next week or so, as the last one was before the colon surgery to see where we're at.

Dr. cool was also keen to get a PET scan done once chemo has started. This is a very fancy scan that's the gold standard (as i understand it) for picking up cancer. Reason it can't be done at the moment is inflammation confuses it, and wound hasn't fully healed yet. Mass confusion would ensue.

-Fertility bits and pieces

Basically looks like going to leave it in the hands of the gods! Egg harvesting etc takes 3 months, and as we're hoping to start the chemo in the next 3 weeks, really wouldn't want to put it off that long. Complications also include the fact that embryos freeze better than eggs, so would have to go on a sperm quest...i thought this sounded like quite a lot of fun-we could have organised a sports day, with wheelbarrow races and mini obstacle courses and things! But sadly not to be...

There's no evidence at the moment that these treatments do affect fertility, but as dr. cool pointed out, they're rarely administered to women of child bearing age and even more rarely to those who haven't already had their kids.

Another consideration is that this whole cancer situation probably cropped up due to something being slightly skew-wiff genetically, and i'll probably need genetic councilling before conceiving anyway.

Whole thing bit of a mind f**k as do desperately want kids one day, but at the same time not really top of priority list atm and i think ONCE i'm thro this i'll be so grateful it won't be nearly such a big deal. Plus i'll believe anything is possible :)


  1. I agree, anything is possible, and this time next year you'll look back on this as something you've dealt with humour and positivity and be back to life as you know it. take care.

  2. wow!! self-replicating liver?! Doctor Cool sounds like James Bonds' Q of Doctors. Love it! :o) Looking forward to seeing you very soon my dear. x x x

  3. Hi Claire, good to hear from you. If you need a gamete or two then just let me know and I'll put something in the post. Here's hoping your face is soon quite an eyesore (that's a good thing, yes??) A x

  4. or, hoping your face is MORE of an eyesore. (haha, i actuallay laughed out loud when i thought of that). This liver idea is amazing.

  5. Hey Claire, loving the blog! Probably best that the sperm sportsday didn't go ahead - would have been a bit messy! Keep up the good blogging work, am thinking of you