A tough goodbye after four good years...

Yesterday I finally received confirmation of what was already suspected, which is that my cancer has made a return.

A few weeks ago I was mindlessly touching my neck as I looked at a very enthralling excel file at work when I felt a large lump.  I nearly jumped out of my skin and didn't want to feel it again, but I did, and there it was.  I pushed on it and it rolled away from my finger, like an olive would.  I knew it was a swollen lymph node and it was a big one.  I had the doctor take a look at it, and sure enough, Dr. Evans agreed that it felt like a swollen lymph node, and the best course of action was getting a PET scan and a needle biopsy.  (You might be wondering why all the hubbub over a swollen lymph node?  People who have colds can get them.  Well, the lymph system is a place where some cancers, including mine, like to hang out.  The cancer cells throw parties in the nodes, making them big.  As a cancer patient who has felt cancer in other lymph nodes in the past, I was pretty sure both my doctor and I were sharing the same gut feeling.  Ugh.)

I had the PET scan and needle biopsy (you'll have to read the blog about that one) and after that developed a case of shingles (again:  see blog) and today finally saw Dr. Evans.  The cancer is in lymph nodes in the left side of my neck, all around my collar bone, and behind my left pectoral muscle.  Bummer.  But great it isn't in any "important" organs.  I can live with cancer in my lymph system.  In my liver, not so much.

I knew Dr. Evans would have a plan.  She did not disappoint.  She had presented my case at the team's round table discussion last night and she was inquiring into the possibility of radiation to the area.  However, because there are so many nodes involved over such a "large" area, the treatment field (the area getting zapped) would include too many important vessels and nerves, not to mention a good part of my left lung, and there was a high risk of doing damage that might severely impact my quality of life.  So, the idea was abandoned.

What was settled upon was enrollment in a clinical trial for a drug very similar to the one I have been on for the past four years.  It does not have a name but is cosponsored by the Ariad Pharmaceutical company.  It is a phase II trial, so the dosing has been determined and some side effects are known.  There are three arms to the trial, patients who have never had crizotinib (the drug I have been on), patients who were on it and saw no response, and patients who were on it, had a response, and then saw progression (me).  As with any clinical trial, there are many unknowns, but the first six weeks of being on the drug they watch you very closely.  Lots of blood tests, EKG's, and time at the hospital.  Then, hopefully there are no side effects and a more reasonable routine of checking in once a month takes place.

This is all very similar to what I have been through before.  I'm bummed the Crizotinib is no longer working, as I tolerated it so well and it gave me so much time progression-free.  But, as I said to someone earlier today, this is what I have to do in order to live with my cancer, so I'd better get used to it.

As long as I'm accepted into the trial (pending the imaging next week and the EKG and bloodwork) the next time I'll have scans is April 22.

The shingles, in the meantime are largely bearable and are (hopefully) healing a bit each day.  I certainly do know how to party, if I don't say so myself.

Looking forward to the next big snowstorm and the cross country skiing it will bring with it.  I also managed to work the trial schedule around a trip to Arizona and another to Vermont.  Arizona is just before I start the trial med, and Vermont is just after I start it.  The nurse told me I could go as long as I know where the nearest hospital is located.  So I'd better get to gooling that...

Joking aside, there might be times that have been tough, but this one doesn't feel so terribly bad.  I got a lot of my deepest grief out of my system when I found that node three weeks ago.  Now, I want to enjoy the winter, and fight like hell to remind this cancer who's boss (not that I am, I know, but I want to scare it a whole lot!)