Cycle Number 6

Cycle number 6 start. Ellen is a gem. All chemo'ed-out. yuck. Some radiation recall on my butt (rash). Staggering a bit.

Today I found out that I only get 8 cycles. This is because I don't seem to have a classical colon cancer - this seems to be based on tumor location and type . In any case. I have no plans on insisting on 12 cycles. Eight is plenty bad enough - especiallly since I am going for no dose reductions. BTW, there seems to be no data on dose-response curves. Probably too complex to do with the long time delays involved. They seem to focus on cumulative dose but only relative to side-effects from what I can see. So it's a crap shoot in any case. Basically, it's up to the patient - if he complains a lot, or has some serious symptoms (myelosuppression that can't be compensated for with stimulating factors, transfusions, bad diarrhea, neuropathy to the point of not functioning, can't hold food down, infections, etc.) then they start thinking dose reduction or in some cases in-patient treatment.

Today I talked with three brothers, one of whom has metastatic pancreatic cancer. His mother also had it. They live near some toxic waste dump which was cleaned up a few years back. I'll try to bring the Professor Randy Pausch option with me next time. I might see them again. He's getting something really exotic right now. Check Pauch's blog. Link to nice article by Stephen Jay Gould.

Another guy I know with bile-duct cancer, a wife, and a new baby. He is finishing up his chemo, after having more then half his liver removed. It regenerated well (quite an organ). Now they offered him radiation option (McDonalds onc, I call it) since no data one way or the other. He is looking good on his eighth cycle. Great attitude, great wife.

Ok, bed time (sleep is optional, as usual).