Posts Tagged ‘chemoembolization’

I thought I escaped.

October 27, 2011

n my mind I thought I escaped by leaving for Atlanta, but in the end I think it was just taking a detour to the same destination: chemo treatment. The results of the CT scan still bothered me so I called up Dr. B, the radiologist who read my July 28 PET scan.

I had gotten to know Dr. B when he did my chemoembolization(or targetted chemo) December 2009 (see related post ‘At the starting line with Dr B‘).  He is a very warm and caring doctor who is thorough with his work. He said he was disappointed when he saw my July 28 PET scan showing the suspicious nodules in my lungs.  I told him the reason for my call.

Dr. B, can you tell me which of six nodules discovered last July 28 grew when compared to the October 20 CT scan?  The October 20 report just said ‘representative nodule’ measures 1 cm,” I asked nervously.

He ticked off the growth of each nodules with a professional tone:

6 mm to 7 mm

8 mm to 10 mm

9 mm to 11 mm

3 mm to 5 mm for the nodule on the right.

Each time he gave me the comparative results, it felt like a stab to my heart.  Breathe. I lost count.  It was like pounding nails sealing my faith, forcing me to accept reality: it is back.

It is conclusive, Bo.” He solemnly said. I thank him for his openness. Also, he does not think another PET scan will be helpful.  He just advised me to have a discussion with Dr. M on my treatment plan.

It is back to chemo for me. It is like, I am being told to go back to the back of the line because you have not learned. I maybe missing the point of this lesson this time or it maybe just hard to see it at the moment. Do you get it?

What my muscle memory tells me is just to stand up, move, and never give up until I finish this challenge.  But chemo treatments are not marathon races.  They are unique by itself. There are no endorphin highs or no medals to show.  There are even no winners or finishers, just survivors. In the end, there are just those who are with us or those who are not.

I will commit myself to this again.  What else is there to do.  I will be at the starting line again on November 8.  Please come with me again.


P.S. I entered a half-marathon race this Saturday, October 29, here in Atlanta.  It is called the Silver Comet.  Let’s see what they have here in Atlanta besides peaches.

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Our last dance…school’s out!

July 26, 2010

omorrow, July 27, is my last chemo treatment.

I have mixed feeling about tomorrow. I should be happy that my treatment which started January 12 (see related post ‘First day at school…chemo school‘) will soon be over. After 12 cycles of chemotherapy, a chemoembolization procedure (see related post ‘At the starting line with Dr. B‘), a right liver lobectomy, and many sorts of imaging scan and medical test, I am about to cross the finish line. The last mile.

Graduation day is almost here!

But how come I am not feeling elated?  I have this lingering feeling that after all I have gone through my cancer may comeback.  Nobody can tell me that I am cured or it will not be back. I try not to think about it and stay positive. I just need to focus on what is given to me and make the most of it.

I will not be wearing a graduation toga like before, instead I will make it an ordinary day. You see, cancer has taught me that ordinary days are special days.  It is what you make of it.  I may not be wearing my toga tomorrow but I know the importance of tomorrow. Tomorrow is a gift of life.

Let’s do our last dance tomorrow. Bring on the nausea, the chills, and the sweats. Let’s remember our moment together my demon-friends. Let’s make it special. Let’s do it for those who are no longer with us and for those who continue to hope for a cure.

I will run before our dance, go to the hospital, and I will be there waiting for you. After we are done, I will enjoy my special day.

Hit it Alice…let’s rock!

“Out for summer out till fall

we might not come back at all

school’s out forever….” – Alice Cooper


PS: My wife and I did 12 miles over the weekend (2:55:19@14:23 average pace).  Man, that was painful but sweet.  This weekend is 13 miles but may have to skip it until fully recovered from chemo.

To support me in my running for ACS, please follow the link below;


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At the starting line with Dr. B

December 22, 2009

I did not recognized him when he walked in that Thursday morning, December 17.  Dr. B, my radiologist, was in a surgical outfit.  It was different when I first met him last November 23 in his professional white smock.  (See related post, The long road ahead, November 28)

“Are you ready?” He greeted me.  I was going to be awake through the chemoembolizaiton procedure and I was already all prepped up by his staff, and was cold.  Have you notice how cold these operating facilities are?  They say it is because of the machines they have to keep cool but how about me?

I hear in the background the nurse reading my name, my birthday, telling the doctor why I am in there, and my vital signs.  I look at the clock and it was almost 9:30 am.  My day started at 5:00 am with my normal morning rituals, except for breakfast or any liquids, so I was hungry.

“Yes, I am ready” I replied.  He signals the nurse, who has been steadily infusing me with antibiotics and fluids for an hour now.

“Mr. Alvarez, I am going to give you benedryl to make you feel sleepy and relax.” Said Eunja, one of my nurses.  Whoosh!  I felt a rush go through my head and body.

“Wow.” Eunja heard me and asked “Did you feel that?”

She did not intend to give me give me any discomfort.

“I tried slowing the push but high volume of your IV to your port-a-cath seems to have carried the medicine fast.”

Oh well, I thought.  I could not blame her she means well…all of them.  The port-a-cath I have is inserted into the jugular vein which then goes to the heart, so you feel the medicine surge faster instead of infusions from the arm or peripherals.  The implant device is convenient for cancer patients to avoid being poked regularly during chemo session.  (Note:  Veins deliver the inward flow of blood to the heart versus arteries which deliver outward flow of blood from the heart.)

I felt a pinch in my right groin.  It was the local anesthetic Dr. B administered.  He feels for the femoral artery and marks it.  He makes the incision then slowly threads a wire going to my liver.  No pain there.  He stops and tells me he needs to map his way to the liver.

Map?  Don’t tell me you lost your way?  I should have brought my GPS.

But he has something better.  He puts a catheter over the wire and says:

“I am going to inject a dye contrast to map your artery.  You are going to feel radiating heat.” I felt the warmth radiating in my stomach.  He takes an image and there is our map.  Whew!  Smile liver.

He repeats the process inserting different types of wires, catheters, etc, moving ever so closely to the tumors.  With him in the room was Dr. F, another radiologist, and they discuss the careful approach to my liver.  They need to find the right artery to deliver the chemo then embolize or shutdown the artery to lock the medicine in.  One of the tumor was located at the edge so it took them time to position the wires.  He repeats the procedure until he is close to all three tumors.  Satisfied, he locks in the catherter and ask the pharmacy to mix the special chemo concentrate for me.  Houston, we are locked and loaded.

Dr. B tells me it is this time when his patience is tested because of the wait for the chemo concentrate from the pharmacy.  I guess you got have them fresh, right?  Nothing beats fresh chemo in the morning.  I love the aroma of fresh chemo.

When it arrives, Dr. B and his staff were in a flurry of activity.  He delivers the first chemo concentrate with embolized particles.  Panic breaks out among my cancer cells.  What the f#$%k!  Incoming….. boom!  Another concentrate, another, another, and another. I lost count but Dr. B came out firing on all cylinders.  Die, sucker!  Rat-tat-tat.  Shots fired.  Shotgun, machine gun, AK, cruise missile, kitchen sink… Welcome to Chicago.  Do you feel lucky, punk?  There’s a new sheriff in town.  Get out of town by sundown and don’t let the door hit you on your way out.  Ka-boom!

Cloud settles and I all feel is blouted pain in my abdomen.  As if somebody hit me in the stomach several times.  Raw.  But it is over.  Well done, Dr. B, with your help my journey has begun…again.


My wife, me, and Dr. B "The New Sheriff"

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November 22, 2009

“Hope.  It is a lot to ask of you right now.”  My good friend Karyn of Palm Coast, FL began her card to me.  I received it yesterday.  I have received similar messages during the week when others like you have learned of my new challenge.  They all express the same sentiment; hope, prayers, and comfort.  Thank you.  I really appreciate them.

Hope is a very hard to come by when you know you will be spending the rest of your life doing chemo.  It still resonates in my mind when my wife and I met with my oncologist last week to discuss the results of my liver biopsy.

“Your liver biopsy did not tell us anything different from the PET scan.  It confirmed the cancer.  Since the tumors are in two areas of your liver, we have ruled out surgery, instead we suggest going with chemoembolization or targeted chemo.  This treatment is not a cure but intends to shrink or kill the cancer tumor in your liver. We follow this with six-months of chemotherapy similar to the one you had last year.” Dr. M explains.

Ok, so far so good.  I have accepted the fact that I will be doing chemo for a second time.  This time I hope (there is again, hope) it will be my last.  I have met people, Karyn or SallyC, who have conquered their disease and I wanted to be counted among them—a cancer survivor.  I tried my best.

Then Dr M continues “once you have completed your six-months chemotherapy, we need to put on chemo maintenance.” He intentionally left it open and saw the anxiety in my face.

“For how long?” I asked holding my wife’s hand.

“For the rest of your life.” He drops the bomb, then adds.  “We need to do this because of the type of cancer you have which is aggressive.  We can arrange it in such a way you can continue with your normal life.”

There it is again.  This disease has totally changed my life.  I had convinced myself that the finish line is after my six-months chemo and I can do this.  Now it is gone.  My new normal life, after all this is done, is a monthly or bi-monthly chemo session to contain my cancer for the rest of my life.  It means I am tethered, limited, or chained by cancer.  It means I cannot travel for an extended period of time for work.  It means I limit contact with people to avoid getting sick when my immunity goes down from chemo.  It may also mean no more marathons.  What more can I say.

I took up running two years ago to contain my blood pressure problems and got myself weaned out of blood pressure pills.  I was on track to take the pills for the rest of my life.  Then, I try to eat properly to avoid diabetes, only to be caught by cancer.  Since when has cancer become a chronic disease in the same category of hypertension and diabetes?  I can already imagine the conversation during my class reunion in the future.

“So how many pills you taking, bro?”  “Oh yeah?  My chemo trumps your blood pressure or diabetes pills anytime.  See this gadget on my hip, it is not an over sized iPod, ya kno.” (That is how my kids called my portable chemo pump).

So Karyn (and everybody), I am not losing hope.  To lose hope is not to live.  I don’t like that.  You and others remind me that hope is out there, I just have to dig harder to find it.  I still have my lottery entry to NYC marathon for November 2010 too.  This time around I no longer aim to win it because my blood will be tainted with chemo and will not pass the required blood test.  😮 As my colleague Tim said “I just heard a collective sigh from the Kenyan runners when they heard you are out.” But I will be back.

Anybody for liver sandwich or foie gras on crackers?


PS:  This week I meet my new Interventional Radiologist to discuss when he can schedule chemoembolization.

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