The last couple of weeks have been exhausting from a physical and emotional standpoint. There is a lot going on and quite frankly, it drains one. Sometimes there is no energy left for reasoning, analyzing, sorting, rationalizing, you name it, if it requires logical thought progression it can be a challenge. Emotions, especially powerful ones like fear, despair, anger, frustration, can take away the ability to think things through clearly. That’s kind of where we have been and are – it’s mostly the emotions of fear and despair that colour our world right now and so I have hesitated to write too much of anything. Not because there’s nothing to write, just because what I would write about would reflect a fleeting state of mind and be based on feelings not on fact.
In the interim, we continue down the path of chemotherapy and have just finished the second treatment with Docetaxel. So far so good, no major concern about nausea or vomiting so far – it’s only been about six hours though. We continue to pump the fluids and I am staying ahead of the nausea by giving my hubby an anti-nausea medication on a regular four hour basis. I will do this for today and again tomorrow and then we will reassess on Saturday. It’s been a tough couple of days though. He spent yesterday in Emergency for chest pains. Luckily it wasn’t his heart, but unluckily it was the bone in his sternum – which he has already had radiated once for his bone cancer. The sternum is too thin for any more treatment, but we will visit the radiologist next week to see what solutions she may come up with. The last round of radiation was physically brutal as it was accompanied by significant pain, nausea and vomiting, however, in the long run it did work wonders in pain management after everything settled down. If he elects to have more radiation, my husband will be well prepared for what he will experience.
It’s taken a few days for me to process the results of my husband’s bone scan. It was, and still is, a devastating result.
At the meeting with the Oncologist and prior to having his most recent chemotherapy session, my husband complained about the persistent pain in his left shoulder. In early January he had been for an x-ray and CT scan to access his progress. The Oncologist had reviewed the two scans and in our meeting stated that it appeared that the issue in the shoulder was arthritis. As the conversation continued the Oncologist stated that although nothing had “popped” on the CT scan he could, with the simple click of a button, order a Bone Scan – if that was what my husband wanted. This is how the Bone Scan came to be.
We had met with the Oncologist on a Tuesday, and a Bone Scan was set for the following Tuesday. Two days after our Tuesday meeting with the Oncologist my husband had his chemotherapy treatment using a new chemo drug, Docetaxel. This chemo drug can act as a bone marrow suppressant (http://www.cancernetwork.com/oncology-journal/radium-223-vs-ebrt-multiple-painful-bone-metastases-data-favor-radium-223). “Because docetaxel is a cell cycle specific agent, it is cytotoxic to all dividing cells in the body. This includes tumour cells as well as hair follicles, bone marrow and other germ cells.” (ref: Wikipedia) Four days later he went for his Bone Scan freshly juiced with Docetaxel. I can’t help but wonder if this influenced the results.
At our meeting with the Radiologist she showed us pictures comparing my husband’s first Bone Scan (in July) with his second Bone Scan (in January). Prior to viewing the pics I asked the Radiologist if I would be shocked – her simple reply was “yes”. I was, we were, the image highlights (hotspots or growth) were so widespread that I couldn’t fathom how my husband could be sitting upright in a chair and not writhing in agony. Anyway, we were at a loss for words and just got through the rest of the appointment. In retrospect I wonder if we should have discussed the timing and type of the chemotherapy my husband had just received. I don’t know that the radiologist was aware of this aspect of my husband’s treatment, I would hope so, but I have learned never to assume anything.
As a result of our meeting with the Radiologist my husband was advised to have some radiation to address the pain in his shoulder/neck area and a subsequent appointment was made for today. However, we cancelled the appointment based on our concern about the veracity of the Bone Scan as well the risks identified with the selected radiation spots. We also have learned that Paget’s Disease runs in the family. We plan on waiting until Monday when we can have a meeting with our GP to discuss all of our concerns before we decide on any more radiation. We also need to ensure all information is conveyed to our Oncology team (including the Radiologist) so they are making the best and most informed decisions for my husband with respect to his treatment.
That’s where we are at. It’s confusing and frustrating because we just don’t know what to do next. Now my sister-in-law is another story, again complications and frustrations all around. She deserves a full blog on her issues – which I will work on getting out today.