Saturday, July 22, 2017

My new treatment

One purpose of this blog is just to describe how cancer treatment is done – at least how it’s done in my case – and since there’ve been new developments in my treatment it’s time for a new description.

I’m no longer receiving my chemotherapy through my port – the ingenious entry-way implanted just below my right collarbone that enabled me to stop having chemo through my increasingly stressed veins. Now I’m back receiving the chemotherapy through my intra-hepatic pump – the other ingenious device that’s been implanted in me. This one is a good deal larger, and required abdominal surgery last August to install; its function is to send chemo directly to the liver.

The pump was installed, almost a year ago, with the immediate goal of putting me in a clinical trial using one drug, FUDR, via the pump and another, gemcitabine, intravenously. Unfortunately I failed out of that trial when a new tumor appeared in January, and then I went onto intravenous treatment, or rather treatment via the port, with a different set of medications, called 5FU and irinotecan. The intravenous treatment has now failed too, or at least not succeeded; that’s the import of the presence of the two or three small, new, “atypical” tumors I wrote about last week. And now, as I said already, we’re back to the pump, but not quite the same way as last time.

The process started last Tuesday (July 11) with a steroid, meant to combat side effects; that did go in through the port, but that was the only use made of the port. Then I got two chemotherapy drugs. One was FUDR, which was part of the clinical trial combination too. I’m not quite sure why we’ve returned to this drug, but I take it that the doctors think that, at least in combination with the other one I’m now getting, it can still be effective even though it didn’t succeed back in January. Anyway, FUDR went into the pump first, into a compartment of the pump from which it infuses into my liver over a two-week period, which is still ongoing. Then the nurse took the needle out – the rather big needle that penetrates the skin of my abdomen and then goes into the pump. But that wasn't the end.

Next the nurse connected up a container of a second drug, called mitomycin; this is the new drug (new for me, that is) that’s been added to the mix.  Then she – my nurse was a woman – put the needle back into my abdomen, in what seemed to me to be the exact same spot she’d used the first time! I think it was the same needle, but I admit I might be wrong about that; maybe it was another needle, equally large. It looked to me as if the needle had wound up going in in the very spot where a drop of blood had emerged from the first injection; but, again, I might be wrong, and maybe that drop of blood (only one) was new. I was a bit rattled! Anyway, even though the needle had gone in in essentially the same spot both times, the second time the nurse, in some way that I didn’t quite follow, used the needle to access a different compartment of the pump, one that doesn’t store the drug but sends it immediately to the liver. And then this drug was administered via this hook-up over a 45-minute period, during which I was told I needed to stay very still, which I did my best to do.

The alarmingly large needle hurt for a moment as it was inserted each time, but only for a moment. So the experience of having two injections into the pump during the same few minutes was actually only strange, not really painful. The whole process did require me to take a long look at my tummy, though, and since I’ve gained weight while being treated for cancer – a good thing – the esthetics to my mind left a good deal to be desired.

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