Happy Halloween!

We start this week's posting with a picture of our entry in a pumpkin carving party that a friend has every year (thanks Kristi!). Our "pumpkin totem" won in the "Scariest Pumpkin" category this year. I hope that our offering to the Great Pumpkin Spirit through this totem will be bring us all good fortune, if not plenty of pumpkin pie as well.

This was my first week on the new bi-weekly treatment schedule. As a way of saving me from coming in for treatment on a weekly basis, we doubled the dose of Erbitux in my last "full-meal-deal", giving me last week off. I guess the best way to describe my impression of how it went is that I think Halloween came for me last Monday. I'll spare you the details, but I gave myself a pretty good scare when I looked in the mirror on Monday morning (more than the usual first glance fright). For those of you who saw me in person, that unusual facial coloration was not from overdoing the sun in a tropical clime. I can't say that I've ever had a "sunburn" that was quite like this one - my new best friend is a wound gel originally developed for burn patients (for those of you who are going through this, e-mail me and I'll share product info). When it comes time to do this again on Thursday, I'll have to give some serious thought as to whether the three days of pure hell were worth skipping the weekly visits. If the next few days are pure bliss, perhaps we can call it a draw. In either case, I sure hope that the cooties inside were equally uncomfortable and are now ready give up.

Nothing helps you forget your troubles quite like smashing pumpkins. I'm not talking about the musical group Smashing Pumpkins (ask your kids about the group), although some of their music isn't bad. I'm talking about the thrill of hurling vegetables with the aid of considerable mechanical force at a distant target. I'm talking PUMPKIN SLINGSHOT. We went down to Spooner Farms in Puyallup yesterday to launch punkins into low-earth orbit. We're talking VMDs - Veggies of Mass Destruction!

The attached clip is my first attempt at including video - you may need Apple's QuickTime movie viewer to play it. We didn't manage to hit the targets at the other end of the field (prize for a direct hit is a BIG pumpkin), but I think we managed to give a bunch of little punkins the ride of their lives. And not to worry about what happens to all the mushed up ammunition - the local wildlife cleans it all up in about a week. Thanks to my buddy Angela for turning us on to this little bit of goofy mayhem.

And finally, a reprise of last year's special Halloween-edition PET scan. It's a real scan of my innards, and my first attempt at learning the intracacies of interpreting radiological imaging. A bright orange color indicates increased metabolic activity, which may help identify active tumors. On first glance, the glowing stuff in my liver reminded me of a grinning Jack-O'Lantern. With a little editing, it became a "Jack-O'Tumor", and provided a wee bit of entertainment to my friends at Swedish Cancer Institute.

A year later, this image still cracks me up. And I know what you're thinking - that bright spot in my head is not a tumor. It just shows that my brain was active at the time the image was made (note "active" there means quantity of activity, not quality). And I didn't make that particular spot glow with any editing....really.

Don't put it off - get screened!

D'oh! I forgot something to include with yesterday's posting. I forgot the obvious soapbox lecture about early detection and screening. This is a perfect example of putting my money where my mouth is - had I skipped the PSA test (why would lightning strike twice in the same place - OK maybe that's not such a good phrase to use with someone who has already nearly been struck by lightning twice), this might go undetected and ignored.

This past week's news in the public media about cancer is that the number of new cases have decreased since last year by 2-3%, and especially cases of colorectal cancer (down 5%). That's great news, although for those of us already in the battle, still not quite good enough, but that will be the subject of another blog. But the key to much of the decrease is that early detection and screening can prevent cancer and can keep it from getting to an advanced stage.

So, here is the message one more time - don't put off those screening tests. Men - PSA tests, testicular self exams; women - breast self exams, mammograms, PAP smears; everyone - colonoscopies, exams for unusual moles and skin blemishes. Got any kind of family history with cancer? Be sure to tell your primary care physician so he/she can keep up with screening exams as well and maybe recommend some earlier testing than normally prescribed. And be sure to keep your family and loved ones in the loop - if you can share information, you may be able to help cancer researchers narrow down genetic causes of cancer. Still think it's too much trouble? Re-read my October 14 post ("Does cancer hurt?") and see if you still think it's a good idea to skip screening exams.

Fall colors in Stevens Canyon

I should take up smoking...

...And maybe I'll start eating red meat again, and have another glass of wine with dinner, and eat more chocoloate, and drive another mile or two above the speed limit, or run with scissors or any of a number of more "risky" behaviors. Why? Perhaps as some kind of bad cosmic joke on me, I may also have prostate cancer. As part of my last routine physical exam, I had a PSA (prostate specific antigen) test - it's a blood test similar to the tumor marker numbers that I've been routinely sharing with you for colorectal tumor growth, except that it's specific to the antigens produced by the prostate gland. Like the other marker numbers, an increase in the number may be indicative of possible tumor activity. I received the results Wednesday afternoon, after I had just returned from having another CT scan done. Surprise! The PSA number showed an increase from a previous measurement into a level that merits further evaluation. You would think that with all the chemotherapy I've been subjected to, that no tumor could possibly initiate. But you might be wrong. Is it anything to worry about? Probably not. Nothing detected on the CT scan, and really not worth the trouble at this point to have it biopsied. We can do the PSA test again in a few months with my regular blood work and keep an eye on it, or if I'm really craving entertainment, I can have another another "digital" examination performed. Prostate cancer tumors are typically slow in growth, and frankly are small stuff compared to what I'm really trying to fight right now. Now that I know that Dr. Gold checks this blog, I'm not allowed to quote him directly, but in a nutshell, it more or less amounts to "let's worry about this after we take care of the other stuff".

Another way to look at this is the memorable scene in "Butch Cassidy and the Sundance Kid, when Butch and Sundance are trapped by a posse on a high cliff above a waterfall. They are discussing jumping far down into the pool below to escape:

Butch Cassidy: Then you jump first.

Sundance Kid: No, I said.

Butch Cassidy: What's the matter with you?

Sundance Kid: I can't swim.

Butch Cassidy: Are you crazy? The fall will probably kill you.

Not to worry about possible prostate cancer, the liver tumors will probably kill you first. It's not like I've been so bored with the cancer I already had that I thought I should shop around and try out another for a test drive. Really, it would be kind of backwards to start with a Stage IV cancer with immediate life-threatening consequences, and then pick up an easier cancer to treat just for a little extra practice. Shouldn't I have done the prostate cancer as say a "starter" cancer first to get the hang of it and then graduate on to the metastatic colorectal cancer? So, in the mean time, I might as well live it up, right? OK, maybe I don't need to pick up a tobacco habit and go for the trifecta of getting lung cancer as well, but the extra chocolate probably wouldn't be too bad.

About the CT scan - really pretty unremarkable. Stable, stable, stable - no changes. My favorite phrases in the radiologist's report: "A normal appendix is appreciated" (I sure appreciate it greatly for it's normalcy), and "Skeletal structures are unremarkable for age" - unremarkable? Gee whiz, not even just a little impressive? Marker numbers this week - up slightly to 6.4, but again, nothing that I'm losing sleep over.

And about my last posting - you may have read the description of what chemotherapy does to me and went "whoa". I didn't mean to upset anyone, but for those of you who are also going through this, it's not just me that experiences this - you've been through this is as well. It's not fun for any of us, but we grit our teeth and bear with it because we'd still much rather live with it and get past it, than to throw in the towel and give in.

Snow falls in a pass in the Tatoosh Range

Does cancer hurt?

Gee whiz - the last time I wrote was September 23! Not that I haven't had the desire to sit down and write, but more that I've either been too tired to get very far and decided that a nap was a better choice, or that I've been tied up with household things (like replacing the broken dishwasher), or otherwise busy with the welcome visit of out-of-town houseguests.

A little catch-up first. The last set of marker numbers are from last week - 5.4. Up a tiny bit from the last set, but not statistically different. I will also be changing my treatment regimen this week and dropping back to biweekly treatment, but doubling the dose of Erbitux that I receive. It will make the long full-meal day just a bit longer (by about 30 minutes), but it means that I don't have to make the weekly pilgrimage to the treatment center. The double dose seems to be effective in Dr. Gold's patients who have tried it, and was the topic of discussion at a recent meeting he attended. The side effects are said to be no worse than the present ones (but not better either...dang). I'm hoping that when given with the full-meal deal and the steroids, I still get a 3-5 day honeymoon from side effects.

And about those side effects... The subject line was inspired by Leroy Sievers' blog on Friday (thanks to Leroy again for providing inspiration). He has recently undergone surgery to replace a spinal vertebrae that had a tumor and was weakened. Given all the procedures he has endured to battle his cancer - chemotherapy, radiation, gamma-knife surgery, cryo-ablation, radiofrequency ablation, vertebroplasty - that he would have been ready to address the question "Does cancer hurt?" before now. After his surgery, it's been hurting him a lot - recovery from major surgery is frequently painful, and this has been especially painful. It didn't start out that way, and from reading his blog, it's evident that the previous procedures were not without pain, but that this one has now set the bar for pain quite a bit higher. His conclusion - cancer does hurt. In my case, I couldn't agree more. The past month has been physically more challenging than anything else I've experienced - tougher than any climb I've done. Chemotherapy started out pretty easy and the pains were more of a nuisance than anything else. As time has worn on and the "novelty" of cancer has worn off, pain has been more of a constant companion. I get a few days off when the steroids are working, and I've grown to looking forward to that little honeymoon. But within a few days, the little aches and skin rashes start up. The constant itching makes me irritable (there's that Irritable Bob Syndrome again) and I end up with scratches when I wake up in the morning that invariably get infected - time to renew the standing prescription for antibiotics. Within a few more days, the skin splits open on my fingers and heels and the bottle of liquid bandage stays within reach for touch-ups. I bleed a lot - all over - I have to avoid wearing light colors that won't show bloodstains. By then, my mouth and lips start developing ulcers and eating and speaking become incredibly painful - enough to bring tears to my eyes at times. That puffy lip thing works pretty good for Angelina Jolie, but it looks like hell on me. And strangely enough, if you walk up to me and ask me how I'm doing, I'll usually say "OK - I'm getting by." Yeah, cancer hurts. It hurts a lot. And when they ask me every week if I want to skip treatment, I always say no - if I can shorten this by even one week, I'll keep doing it.

While on my last steroid honeymoon, I had houseguests from out of town. It was nice to take a little break and show off where I live. I finally got a chance to get back to Mt. Rainier to show it off to my guests. I hadn't gotten the chance to visit there since I started chemo. It was beautiful - the lower elevations were in full fall foliage glory and snow was falling at the Paradise visitors center. It was great to be back.

Silent Bob visits Mt. Rainier

The view towards the Tatoosh Range from Reflection Lakes.