C2D1 - a new chemo cycle begins

This past Wednesday, I began my second cycle of chemotherapy at UCSF after having blood drawn in the morning and then an appointment with my doctor. My blood work was good -- blood counts were back up and various other chemical indicators had also returned to normal. Ah, what a week off of chemo can do. I also found out that the cancer marker that is being followed as part of the study, CA 19-9, had dropped by about 40%. While it may not necessarily mean that my tumors are shrinking, it does indicate that the chemo drug is working -- it interferes with cancer cell metabolism. It also means that I will continue to receive the single drug, gemcitabine, for this next cycle. As long as it continues to have a negative effect on the tumor cells, as measured in CA 19-9 levels and every-other-cycle CT scans, that will be the case for future cycles as well. A second drug, Avastin, will only be added to the therapy when the cancer shows resistance to the gemcitabine. You might guess that means regular blood testing, and you are right. Blood is collected for a CA 19-9 test before the first and third treatment of every cycle; this is in addition to the blood drawn the day before each treatment for blood counts and liver and kidney function. Throw in the twice-a-day injections of Lovenox, a heparin-like drug that prevents blood clots from forming, and the picture of Don, the human pin cushion, might emerge. But, I have no complaints; it's all part of what has become normal for me.

So, some good positive stuff to report -- my pain has lessened, cancer-marker concentrations are down, the chemo is so far proving to be not too toxic to the rest of me, which means I can continue to get it in the higher doses administered to date. The side effects have returned with the latest treatment, but they are no worse than before; fatigue being most prominent, followed by a loss of appetite, and mild nausea at times. But, I've still got all my hair, plus the prayers and support of a cast of thousands, a loving family, and a positive attitude. What more does a man need? And that's about as philosophical as I'll get today. Thank-you again to everyone who has added to the "synergy" of forces (chemical, medical, emotional, psychological, and spiritual) that are helping me fight this disease.

Peace,

Don