Thursday 29 November 2012

Cancer Treatment


Diary of Cancer Treatment

2010

Aug 04             Saw Jenni Koch, my GP, re irregularity (but no pain or bleeding), referred to Dr Dinh.

Aug 30             Dr Dinh, gastroenterologist at Mornington, arranged colonoscopy.

Sept 08            Colonoscopy and biopsy at Springvale.  Rectal tumour, suspected malignant.

Sept 13            Confirmed malignant.  CT scan to reveal extent, plus blood tests.

Sept 15            Jenni Koch explained treatment, involving never-ending appointments, etc.

Sept 23            Mr Tilan Beneragama, surgeon of Mornington.  Large tumour, stage 4 metastasis, spread to lymph glands and spots in lungs, treatment still possible.

Sept 27            MRI scan at Frankston Private.

Sept 28            Oncologist, Dr Vinod Ganju.  Aggressive cancer but responds to treatment, more tests ordered inc PET scan to gauge spread and indicate chemo treatment of stage 4 metastasis.

Oct 06             Dr George Quong, radiation oncologist, to supervise radiation to reduce tumour size before operation by Mr Beneragama.

Oct 07             PET scan at Moorabbin.

Oct 08             At Frankston Hospital, tattoos applied to torso for aiming radiation beam.

Oct 12             Ganju confirmed PET scan showed cancer presence in bloodstream and 3 lung spots.

Oct 19             At Frankston Hospital, PICC line inserted in right arm and infuser bottle of  Fluorouracil  attached (chemo to assist radiation).  First radiation treatment.

Oct 20             Radiation continues 5 days per week at Frankston Private, chemo infuser and PICC dressing changed weekly at Frankston Public chemo unit.  Weekly appointment with Dr Quong and fortnightly with Dr Ganju at Frankston Private.

Nov 24            Saw Mr Tilan Beneragama.  Operation fixed for Jan 24, allowing for recovery from chemo and radiation (and family holiday at Skene's Creek).

Nov 26            Last radiation treatment.  PICC removed.

Dec 16             CT scan shows tumour has shrunk nicely for operation.


2011

Jan 04              Pre-op session with stoma nurse, dietitian, theatre doctor, anaesthetist.

Jan 24              Admitted 7.00am. operation at 9.30am, returned to ward at 2.30pm.  Mr Beneragama happy with result, got all tumour and lymph nodes, no spread to prostate, etc, created stoma.

Feb 02             Home after bowel movement and all-clear from stoma nurse.

Feb 03             Stoma nurse visit, all OK.

Mar 11             Scan and PICC line inserted prior to chemo.

Mar 16             Frankston Public chemo unit - chemo treatment, hardcore to treat lung growths, inc oxaliplatin, which produces nausea and peripheral neuropathy.

Mar 17             Sore bum.  A pinhole caused by old stitch working its way out.  Beneragama removed with tweezers as in rabbit from hat.  Soon healed.

Mar 18             Chemo bottle removed after 2 days, treatment fortnightly.

July 11             Completed heavy chemo.  Shows lung growths have shrunk, cancer markers in blood down from 11.5 to 1.6.  No spread elsewhere, so onto milder treatment.  Fingers and feet beginning to show effects of oxaliplatin, tingling, numbness, loss of nerve endings.
Aug                  Continue new treatment of Evastin infusion at Frankston Public Chemo unit once every three weeks plus Xeloda tablets for two weeks then one week off.

Aug 31             Dr Ganju happy lungs spots are small.

Sept 07            Mr Beneragama review.  Sensation of mass between cheeks is normal, scar tissue settling down over time, allow 12 months.

Nov                 Review of chemo treatment, all OK.

Dec                  Ditto


2012

 Jan 30             Dr Ganju review.  Cancer marker test 3, up from 2 but anything under 5 is good.  Continue with Evastin and Xeloda.  Nexium for nausea or reflux when required.

Feb                  Mr Beneragama check up.  All OK.

March              Stoma nurse.  Have hernia protrusion affecting the fit of bags, ie smell occurs.

April 23            Stopped treatment. Dr Ganju says current chemo no longer working, cancer has become resistant.  Proposed clinical trial of new regime, administered at Frankston Private, but all free.

May 01            Biopsy taken of lung tumour by Dr Stuckey to determine type for trial.  Very painful.

May 02            Met Albert Goickman, nurse running Gain C trial - will mean lots of weekly treatments, appointments, paper work, etc.

May 23            First treatment of trial, cetuximab to be administered weekly.

May 28            PICC line inserted by Dr Stuckey ready for main treatment.

May 30            Main treatment, fortnightly, of cetuximab, fluoruracil, leucovarin, irinotecan plus anti-nausea etc by drip in PICC line (collectively called Folfiri), plus take-home bottle of fu5 for 2 days.  See Dr Ganju every fortnight for review.  Parking at Frankston Private much easier than at Public!

June 04            Side effects - dry, pealing skin, some nausea but controllable.

June 18            Review with Dr Simone Steel.  All OK.  Antibiotics to prevent skin infections, vitamin B6 to aid nerve reconstruction in fingers and feet, moisturiser for skin.

June 27            No Folfiri due to white blood cell count below 1.5 (now 1.3).  Cetuximab only.

July 09             Review with Dr Ganju.  Reduce strength of drugs to ensure white blood cell count stays OK.

July 23             Bad reflux.  Daily nexium and pantoprazole, also gaviscon liquid.  Three days following big treatment, pill count is 9 in am and 7 in pm!

Aug 09             Saw stoma nurse re bag fit.  New bags plus hernia belt to use as required.

Aug 22             Seventh  cycle.

Aug 30             Scan, ECG and blood for review.

Sept 05            8th cycle.  Review OK, will continue trial till 12th cycle.

Oct 24             12th cycle - last one of chemical trial using Folfiri.  Weekly cetuximab will continue as part of the trial, at least for time being.

Nov 07             Had PICC line removed as cetuximab can be infused safely through a temporary canula in the back of the hand or wrist.  Treatment only takes 60-90 minutes instead of most of the day.

Nov 14             Dr Ganju happy with things - lung spots have stabilised and he feels cetuximab may keep it all in check (some people go for a year or more on cetuximab on its own).  Only pernicious side effect is skin peeling like the aftermath of sunburn but continuous.

* underlined dates show start and end of treatments

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