Archive for August, 2011

18 miles…done.

August 28, 2011

y wife and I did our 18 mile run yesterday. The marathon program called for 12 miles, as a recovery week, because the previous weekend (August 20) we did 16 miles. But I told her instead of cutting back our miles we decided to go 18 miles and recover this coming week. That was painful. You see I have chemo this coming week. If I have to run 18 miles after doing chemo, I would crawl all way to complete it.

Yes, it is that time again: Tuesday, August 30. It will be the last one prior to the October marathon. The plan was stop my monthly treatment and to observe the six nodules in my lung.

I feel like a science experiment. Hmm….

Will the nodules multiply or increase in size once my monthly treatment is stopped? I can almost imagine the nodules talking among themselves.

 “Hey look. The chemo guards left.” Said one nodule to the other. “Quick, wake up the others.”

“Why? Maybe it is a trap.” Replied the to other. “Why hurry when we are being fed for free here? Besides, you are forgetting the antioxidant snipers.”

Whatever. I will let them talk among themselves. I can’t worry about what my nodules are going to do. It is what it is. I have been often asked if it is wise to stop my chemo maintenance. I think the underlying question there is if I am scared of my cancer and its deadly potential.

The short-answer is: yes.

I have seen the end stage of cancer and perhaps some of you have. I wish it was different but the important thing is not to stop living or appreciating what life has to offer. It is about relationships with friends and family. They are the ones that keep me going. I intend to keep going and ‘run’ my way to remission.  It is just taking time but I will get there.  I know I will.

I told my wife this mileage building exercise is not about preparing for the marathon.  I know I will finish the marathon.  This is about the bigger challenge of finishing six-months of chemo therapy if my nodules multiplied or grew.  So, what else is there to do?  Why worry about something I cannot control.  Everything will be fine, right?


P.S.: Do you know Al Roker, the NBC weatherman? He ran the Chicago Rock n Roll half marathon last August 14. My wife and I beat him by about 20 minutes (2:43 vs 3:03). Ha! He brightens my day each time I see him in TV.

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The plan.

August 13, 2011

ore than a week ago, my wife and I met with my oncologist to come out with a plan for my disappointing PET scan. Still not convinced about the threatening presence of the six nodules in my lungs, he wanted to observe them first.

“The nodules are less than a centimeter. It is difficult to determine if they are cancerous. However, I had consulted with another radiologist and he seems to agree that it is metastatic cancer.” Dr. M said.

I sense his dilemma. He sees me as healthy with no outward sign of lung cancer and yet he cannot dispute the scans. My tumor counts or CEA level are within threshold levels too. He asks about my recent trip to the Philippines if I had cough, fever, and lost weight.

 “I lost weight due to traveler’s diarrhea and had coughs due to my allergies.” I replied. He wants to rule out if it is fungal in nature.

In any case, after thinking it through he suggests the following;

  • Continue with my monthly chemo maintenance this August but remove Avastin from the series. Avastin inhibits the growth of new blood vessel that chokes off blood supply to cancer tumors. I need to be weaned out of Avastin in case I undergo video-assisted thoracic surgery (VATS), otherwise I can have bleeding complication.
  • For September, skip the chemo maintenance to see if the nodules grow in numbers and size.
  • In October, we do another CT scan of the chest to determine if there are any cancer activity. Should there be cancer activity, we put you on intensive chemo for six-months.

The idea of another six-months of chemo did not exactly go done well with me. I hate this poison. I hate it. I hate it. Its bad enough I had to do it once a month but to take it weekly or every other week for several days is not exactly exciting.  And oh, the side-effects is another one: the vomitting, nausea, chills, diarrhea, constipation, and others. You think after going through this twice for six-months and once a week, I would get use to it. N-O. No.

Did I tell you I hate it.

And yet I would do it again, if needed.  It is all for you. It is for a chance to still be here and enjoy another day, run another marathon, a 5k or a half-marathon.  Yes, I would do it again for the third time.

Tomorrow, I will run the Chicago Rock n Roll Half-marathon and get to see some of my American Cancer Society friends and athletes. For the next three hours I forget I have cancer. It will be another adrenaline rush moment and the plan is to enjoy every painful moment of it. Ha!


Notes:  Surgery is not an option because the nodules are present in both lungs.  You cannot take out both lungs.  Radiation carry a high risk of damaging good tissues since the nodules are small, less than a centimeter in size.  The best option is systemic chemo.

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Its not there.

July 29, 2011

he words I was looking for were not there. I wish I can say with certainty that my cancer is gone or in medical terms ‘no increased metabolic activity’. The absence of these words along with a recommendation for a video-assisted thoracic surgery (VATS) procedure tell me my cancer refuses to let go. The suspicion now is that it is my lungs this time.

“Hon, you should not interpret it that way.” My nurse-wife argued.

“We need to see Dr. M (my oncologist) since Dr. B (the radiologist) discussed it with him. Perhaps, Dr. M does not consider it significant or it is nothing. The good thing is it says there is no suspicious increase in metabolic activity in your liver anymore.”

Silently, when the report uses words such as ‘new nodules’ or suggest a VATS procedure I take notice. Sometimes my profession gets in the way when I read reports like this. I am keen to subtle usage of wording or absence of key words. I compared my previous PET scan report which was done by the same doctor, Dr. B. last April 1,2010, and reads different: very positive. I even received a call from Dr. B. (see related post ‘Early Easter for me: Halleluiah‘)

This time the tone of the report is different.  Alas, even after a 13-mile group run over the weekend did not put my mind at ease. It was a painful run in high humidity with hot mid-morning temperatures (80’sF). I was trying to gain a sense of peace by masking my fears with the shearing pain from my knees, legs, and hips. I have left my wife two miles back, increasing my pace on the return.

My heart rate is stressed at 157 bpm as I continue to push myself to the limit. I concentrate on my pacing as my mind drifts back to the PET scan results…

…interval development of at least 6 different 6 mm to 9 mm pulmonary nodules…

Come on lazy legs it is the last mile, stay with your pace, zone out the cramps.  I caught up with a group of young runners yapping away about their busy lives while I struggle painfully with their pace.  Why do I make it difficult?  Let’s go old man.

…these finding are consistent with interval development of pulmonary metastases…

There it is…the word ‘metastes’.

I see the cricket hill coming up, I broke off from the group and attack it with total abandon swinging my arms hard. My legs are heavy, my thoughts in a haze, and still kept running up the hill with every ounce of energy left in me. Let me go, cancer! Argh! I hate you.

I felt spent…angry but not beaten.  I waddle back to the hydration station where all the others runners gather after their run. There were high-fives and congratulations around for it was a tough day to run.  But what is tough?  I wait for my wife and still thinking. This cancer has already taken a portion of my colon, most of my liver, and it now threatens my lungs. I no longer ask why.

I thought about my friend Kristin McQueen (see my related post ‘Cancer conversation‘), who struggles to be a cancer survivor since 2003 and a stubborn tri-athlete. She said she does not have time for ‘pity parties’. Me too. So when I see my oncologist this week, I only have one question: Can I still run the Chicago marathon in October?


P.S.: Will have my chemo maintenance tomorrow.  How is your day?

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