The First Week of Treatment 11/10-13/2009

My treatment started on Tuesday November 10, 2009. I was given some idea by the doctors, nurses and techs as to what to expect. I had spent two weeks prior to the start going through additional tests and preparation for the treatment. I needed some medical tests to make sure the side effects from the Chemo was going to be tolerable. The doctor was going to use Cisplatin (the tried and true chemical for throat cancer, having been around since about 1971), which has side effects of possible hearing loss, neuropathy (loss of feeling in the fingers and toes) and severe nausea and vomiting-sounds exciting :) One of the tests I had to take was an auditory exam, which showed I already had quite a bit of hearing loss (thank you Uncle Sam) in the main speech range, so my doctor chose to 'not be the one who causes you to be deaf' and changed my drug to Erbitux, which while slightly less effective than Cisplatin, has the main side effect of causing a rash that can be quite severe and loss of energy. Additionally, I was fitted with a mask to keep my face in the same position for every radiation treatment and 3 small dots were tattooed on my chest to help the techs line me up on the table. The mask starts as a sheet of firm plastic that is soaked in warm water and then fitted to my face. Once it hardens, it retains its shape and is quite firm.

At this point my treatment is to be 30 radiation treatments given 1 time a day every Mon-Fri (and Thanksgiving off) which means I will finish up on December 22nd for this part of the treatment. My Chemo consists of 8 infusions, each Tuesday, so that will finish up on December 29th.

So Tuesday starts with 'labs' where blood is drawn and analyzed to keep track of your status for Chemo. From there it was down to the Radiation Treatment Clinic. They positioned me on the table and placed the mask on me. Then everyone leaves and a big lead door is closed. I am receiving radiation delivered to 7 locations with each location getting two doses per treatment. Each location receives its own level of radiation with the main tumor getting the biggest blast and other areas a little less. After treatment, I met with my Radiologist (Dr. Quynh-Thu Le) and she explained that I will be seeing her on Tuesday's and her resident on Friday's just to monitor my progress. Then it was time to hit the Infusion Treatment Area for Chemo. This consists of sitting in a nice recliner chair, getting comfortable and then getting hydrated with saline solution for about a 1/2 hour, then liquid Benedryl to ease the reaction of the drug and finally, the Erbitux. The Erbitux takes about 2 hours to drain into me and the whole day ended up going significantly longer than expected. We started at 8 and did not finish until 4pm.

I felt fine and we went home and then to a counseling session that Stacey and I are doing to deal with the stress and issues that we anticipate will be a part of our life during treatment.

After that, I went to meet some of the guys I had worked with at one of my old companies, but this proved to be a short night for me. About 8pm, I started to lose all warmth from my hands and feet and start to feel nauseous. When I got home, I had to get a heating pad to get my feet warm.

The next day, Wednesday, I went to radiation at 8:30 as scheduled and then was home and the cold and nausea from the night before was back accompanied by a horrible headache. I ended up putting on an eye shade and taking an ambien and going to sleep from about 10:30 to 5:00 without waking. I still felt ill after waking up, but needed to eat to keep up my weight. I had lost a whole day, it was a weird feeling. I might add at this point, that I am trying to keep working during treatment, but I will not be near as effective as I thought I would be. I am fortunate to work out of the house and have responsibility for sales in the Americas and Asia Pacific regions for a Telecommunications software company (724 Solutions), and have a good boss who is taking my condition into consideration and moving some of the responsibilities to other team mates and handling some of my accounts directly. We currently have open bids at 10 customers (South America, US, Australia, Singapore, China, India, Hong Kong, Indonesia) and all need to be worked on a daily basis, so with the amount of effort needed versus what I can give there is a gap and my team and coworkers are closing this gap.

Wednesday, Thursday and Friday's treatments were a little anticlimactic after Tuesday. Just show up and jump on the table, get zapped and done. In and out in about 20 minutes. On Friday, I did see both my Oncologist and one of the residents working for my Radiologist. Both routine, they like to check on you before the weekend because I won't be in the hospital for two days and they want to check overall condition.

All in all, I did OK this week, I started the week at 213 lbs (after fattening up on doctor's advice) and ended the same, I don't expect this to stay that way, as I am already feeling a lessening of my appetite and the radiation itself burns about 2000 calories per day. It is a dieters dream, being told to eat full fat food and try to eat about 3500 calories a day. Wednesday, the Chemo hit me hard and made me realize that this is going to be harder than I expected. The doctors and techs all say that Head and Neck cancer is the hardest to treat because the radiation causes issues with the mouth and throat and makes it hard to eat and yet you need to eat to keep you health up.

So that was all the technical stuff, what about the head? I have been nervous, but not scared coming into the treatment. The night before I started, I was just sitting and thinking and realized that things in my life will change after Tuesday the 10th. I pray that it will mean the end of the cancer in my body, but it also means a lot of changes in the physical make up of my body due to the chemicals and radiation. I feel a little melancholy over this but not a bad sadness, just a realization that life happens and the road we travel does have some pretty good curves waiting for us. I have struggled to call all the people back who have reached out to me, it is just hard to explain everything to so many people, one at a time and actually, a little depressing, in that, by having to continually explain it, I get stuck in the treatment for more time than it actually takes to receive the treatments.

I plan to make this a daily blog starting on Monday November 16th.

Thanks again for all of you out there that care and are praying for me.

I did visit with family last week and my daughter, Erika, and niece, Jamie, went out and got me an ice cream cake that said 'Cancer Schmancer' in the best Fran Dressler-The Nanny style, see below to see how beautiful both girls are and my cake :)