Scan day.  The news is not great, but neither is it dire.  It appears that there’s an increase in the cancer, but it’s not a huge increase, and the tumor activity is still confined to the areas where it was originally discovered.

This is vaguer than it might be because the report from the scan had only just reached the hospital by the time of my appointment, so the oncologist was reading the report during my appointment, and had not himself seen the images yet.  (So, of course, I wasn’t able to look at them.)

He believes that the Gemzar is no longer effective.  He’s confident that it was effective initially, but the effectiveness stops eventually.  (I knew this.  I didn’t know whether the effectiveness was likely to taper off or to stop suddenly, and it’s apparently pretty suddenly.)  He said there are two options:
A. Do nothing
B. Try another (somewhat harsher, perhaps less effective) drug (with a less convenient protocol)
He said he recommends doing nothing to patients who don’t feel well, whose vitality and activities are limited, and so on.  He wants me to start a new “drug” (actually, three different drugs and a vitamin: it’s called FOLFIRI (I’m not sure whether or not that’s actually an acronym).  It’s administered every other week; a three hour infusion after which I leave with a pump still connected (there’s a small bottle that I carry in a waist pouch); I have to return to hospital forty-eight hours later to have the pump disconnected.  Because the infusion is so much longer, it’s harder to find a chair for me, and the earliest appointment I could get was for next Monday.  That’s February 6.  So if you’re following closely you’ll realize that the second infusion, fourteen days later, would be February 20, at which time I was hoping to be back in Florida. Dr. S. said to book the trip and we’d schedule around it.

I spent some time staring at a calendar, and I’ve pretty much decided that I’ll stick to the schedule and go to florida after the disconnection on Wednesday, 2/22.  We’ll just aim to celebrate the weekend afterward.

I wasn’t really surprised at what he said.  I was pretty sure I was no longer improving.  I have less energy than I had at (official) Thanksgiving, but enough energy to lead an almost normal life.  The pain under my ribs is a little sharper and a bit more persistent than it was before Christmas, but it’s still intermittent and very tolerable.  I’d hoped I was holding my own, but I’m not doing badly.  Of course, it’s still to be seen how well I tolerate the new drug, and how effective it is for me.

And we will set up a consultation for a second opinion.  Dr. S mentioned that other doctors will sometimes recommend more aggressive drugs, and those are more toxic.  He gave me a rundown of the most common, and why he’s going with the one he’s chosen, just so I’m prepared to listen to another specialist in an informed way.

After the consultation, we came home, and had lunch.  I did some work, had a rest, and now I’m back.  This is a little early for me, but I’d rather enter it now.  My sweetie has his Gilda’s Club meeting tonight; I’m glad of that– and of much else.  Happy Thanksgiving.