Saturday, August 4, 2007

A chronology

If you'd have asked me on January 4, 2004, I'd have told you I was in the best shape of my life. I'd spent the previous several months living cheap, and eating well (in quality if not quantity). In August of '03, I'd started graduate studies in philosophy at the Catholic University of America (CUA). I'd secured a stipend from the physics department, doing bits of analysis with the nuclear physics group, but $1000/mo (before taxes) doesn't go that far in Washington, DC. I was walking everywhere, playing ultimate frisbee twice per week (football when the weather turned), eating low fat (pasta and rice are cheap) with lots of fresh fruits and veggies (surprisingly cheap, certainly compared to frozen entrees and the like). I'd lost a few pounds, could run non-stop for a week, and was feeling great. Then everything changed, literally overnight.

During the night of January 4, I'd started feeling sick -- pains in my lower right side, combined with a nasty queezyness. As things got worse during the day on the 5th, I called 911. As they brought me to the hospital, it became clear that I had appendicitis. I'd wake up in a few hours after a routine surgery, spend maybe 2 days in the hospital, then go home to continue studying. I woke up early morning on the 6th -- much later than the couple hours I'd expected -- and was told I had adenocarcinoma of the appendix. My cancer started in my appendix, but by the time we'd discovered it, had spread throughout my abdominal cavity, growing on the surfaces of my organs. They could remove the primary tumor and several of the larger chunks, but there were too many smaller tumors (not to mention the unseen microscopic elements) to hope that the emergency room surgery could leave me cancer free.

From here I'll just hit the highlights: in mid-February, I started a chemotherapy regimen called FOLFOX. I took three months of this, with a one-month break before undergoing cytoreductive surgery with hyperthermic intraoperative intraperitoneal chemotherapy with Dr. Paul Sugarbaker of the Washington Cancer Institute (coincidentally, just down the street from CUA) on June 30, 2004. The short of it is, Dr. Sugarbaker cut me open, then spent approximately 8 hours over my wide-open abdomen, meticulously stripping my abdominal lining (the peritoneum) of any visible aspects of cancer. Then, before sewing me up, he poured chemotherapy into my open abdomen, heating it so that it might penetrate more deeply into my organs. In this way -- and only in this way, according to what was then (and presently) known -- was there some hope that my cancer could be completely wiped clean.

In August of '04, as I recovered from this surgery, I began a second chemotherapy regimen, with a drug called irinotecan. I took this for three months, before seeing Dr. Sugarbaker again in mid-December for a "second look". After this "second look" surgery, all signs looked good -- in Dr. Sugarbaker's experience, I should have had something like an 80% chance of full cure.

In September of '04, I interviewed for a position in Munich, Germany. A return to philosophy was out of the question, as I needed work that would provide insurance to cover future medical expenses, and would also likely finish '04 with extensive medical bills. When given a positive outlook for recovery, after the struggles of '04, I figured a European adventure would be fun, while also getting myself back on a career track. I left for Germany at the end of February '05.

In May of '05, during a routine staging/check-up (consisting of blood work and a CT scan) we discovered that my cancer had returned. This time, inside my liver and lung -- once the cancer appears inside the organs, we are beyond the reach of surgery. And for that matter, beyond the reach of a known cure. From this point, I take chemotherapy and seek other treatments to keep the cancer at bay, to maintain some quality of life, and hope, in the meantime, that a cure presents itself (and, as a man of faith, I welcome a cure either by natural or supernatural means). Starting in June '05, I began a chemotherapy regimen in Munich with the drugs carboplatin and taxol. I took this regimen through November of '05. My disease stabilized, and I was went till June of '06 before any new growth appeared.

In August of '06, I underwent a 4th abdominal surgery to clean out some particularly troubling tumors, then began chemotherapy again, with irinotecan plus the anti-body erbitux. In January '07, I returned to the US, beginning work outside of Washington, DC. Through April of '07, I continued with this same chemotherapy regimen. A mid-April staging suggested that my tumors were again growing, motivating a return to the carboplatin/taxol regimen. Shortly after beginning this new/old regimen, I made the move to Knoxville, where I am today. A recent (June) staging suggested that, while the treatment was working on some of my tumors, it was not working on others -- in particular, the tumors in my liver (the more dangerous of my tumors) were still growing.

And that brings us up to date. There remains one last untried "standard" treatment option (xeloda), which I expect to begin in the next week. There's really no telling how well it will work. While I hope that it can arrest the growth of my cancer, perhaps even stabilizing it to where I can get an extended break away from treatment, there are no guarantees. Regardless, my personal ambitions really don't (or at least, they shouldn't) change. That is to be a good man, a virtuous man, a man of constant, humble, prayer. I'm far from being such a man, but I'm giving it a shot, so long as I have one.

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