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Today, we successfully took another step down the long road. The iron treatment went well. As for the diagnosis, there was some good news, some confirmed bad news, but thankfully no new bad news. We also know what the protocol will look like if we stay at UT Southwestern for treatment.
To begin with, a significant reason for thanksgiving is the fact that I did not have any allergic reaction to the intravenous iron treatment. We had a choice of the get-your-blood-levels-up-in-weeks version or the get-your-blood-levels-up-in-months version. The "weeks" version is what I need to move on to chemo, but it has far more serious side affects including very serious allergic reaction (even death, it says in the drug book). Still, we chose the "weeks" version given my need to get moving on chemotherapy. They began by giving me two steroids and benadryl via IV to prevent or mitigate allergic reaction. Then, they gave me a very small dose of the iron to see if my body reacted. It did not, so they gave me the full amount. In all, I received about 1/8 the amount they estimate I need for my body to get its red blood cell level back to normal. The great news is that I had absolutely no effects from the iron at all. This means I can go back and get a higher dose later this week, and perhaps after just a couple more treatments next week, will get the blood levels up to normal and regain my strength, which is still seriously lacking.
As for the diagnosis, oddly, we were all (Christine, my mom, and I) actually relieved... mostly because there is no more bad news. It just seemed like every time I met with a doctor in the past week there were more problems. First I heard colon cancer. The next visit I heard I had colon cancer spread to "many" lesions all over the liver. Then it became colon cancer plus many liver lesions plus a cancerous mass in the bladder. It seemed to me that things were really getting out of control. The PET and MRI halted the spiraling bad news and confirmed the following:
(1) I have a single large colon cancer tumor, near the liver
(2) This has spread to metastatic (medical firends - is this even a word?) cancer on the liver, probably via the blood flow
(3) There is only one lesion on the liver - however it is very large (apparently, this is better than lots of small ones, which we originally thought was the situation)
(4) The PET scan, which exposes any cancer activity in my lower torso, shows no other regions besides these two. This means no signs of cancer in the lymph nodes, the bladder, the intestines, the love handles, the beer (coca cola?) belly, nada. Dr. Perkins actually thought this was a good sign because with the time required for the liver tumor to grow so big, it is remarkable that there are no other places in my body where the cancer has spread.
The protocol:
The liver lesion is too large to surgically remove. Pending the second opinion from MD Anderson, which I hope to get in the next week, the plan of action would be as follows. Take three proven colon cancer drugs together intravenously as an outpatient one day per week for eight out of nine weeks (I would get a one week break half way through). Then get a CT scan and hope that the tumor has reduced in size. When it is small enough, go to surgery and in one operation, take out the colon mass and shave out the liver lesion. Incidentally, I have learned that the liver is the only organ that regenerates itself. Cool. Then, maybe take some follow-up chemo to clean up any microscopic activity.
One encouraging thing to me about this plan is that the chemo sounds much better than what I had for bone cancer 20 years ago. At that time, I was completely out of commission the week of chemo as an inpatient for at least four days. With the colon cancer drugs, I do not need to stay in a hospital and it seems like I will be back at work a day or two later. I will be very glad to be able to continue with "normal" challenges of life in parallel with cancer treatment.
So that's the scoop. Bottom line is that we need to shrink that ugly liver lesion. That's my big prayer request right now, in addition to guidance as I make the decision whether to get treatment in Houston at MD Anderson.
The across-the-board statistics aren't that great for this stage of colon cancer - around a third are "cured". But Dr. Perkins seemed relatively positive given my condition. His experience is that for those in my condition, cancer seems to respond well to chemotherapy. As someone who deals with mathematics every day, I know that statistics are funny. They can deceive and can never can take into account all the factors. And I'm just one sample. Better still, as Carl says, with God all things are 100%. His plan is perfect and his will cannot be thwarted.