In February, 2002 I was diagnosed with colon cancer. Half my colon was removed and I underwent a treatment of chemotherapy consisting mostly of 5FU and Leucovorin.
In February, 2003 it was determined my cancer had returned but this time with a vengence. Surgery was able to remove some of the cancer but it had spread to my liver. It was inoperable.
I received treatment at Stanford Medical Center. I was in a phase II clinical trial of Iressa. Iressa was added to my other drugs (5FU, Leucovorin, Oxaliplatin).
Well, I guess the best happened as my update from 122403 indicates. The inoperable liver tumors were reduced to a point where one was left. That one was removed (ablated) in March, 2004 using a technique known as radio frequency ablation (RFA).
RFA is interesting in that a probe is inserted (in my case) between the ribs on my right side. The tumor is located using C.T.scan technology. The probe is positioned and the C.T.scanner is turned off since it interferes with the RFA generator and the tumor is ablated.
I am still undergoing chemotherapy, this time with Avastin. I am very tired and have my share of nasea. It will be worth it if it keeps the cancer down.
I am trying not to make this seem like a blog but it is starting to look that way. It is November 11, 2005 and I am retired from HP! I decided it was best for a number of reasons. First, HP were offering a very large early retirement incentive that in all likelihood would not happen again. Second, HP does a review of all employees on disability leave and will routinely terminate those who will not be returning to work. Considering my cancer situation I would most likely have been terminated.
The scariest thing was ensuring all my insurances would continue after I left HP. This all seems to be fine and I am enjoying the time when I am not sick to work on my health. My CEA remains low and all indicators are there are no new tumors. I am practicing yoga and meditation in addition to eating better and doing exercise when I am not too ill. I take chemotherapy every three weeks now. It makes me very ill for about a week but then I get slowly better.
In addition to fighting the cancer I am practicing the piano again. I may participate in a fund raiser for the Sutter Cancer Center in September. Details are still to be determined but if all goes well I will perform a Chopin Polanaise (Ab) and some jazz/pop tunes. Wish me luck!
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It's February 2006 and I have reached a milestone; four years with cancer. Everyday is a gift. My most recent PET scan shows two new tumors. One can be ablated using the ablation technique I have had three previous times. The second tumor is only visible on the PET scan. Unfortunately the technology that is used to place the ablation probe is CAT scan and the second tumor can not be seen using CAT scan. So, on February 28th I will undergo a chemo embolisation. This does not sound fun, to say the least. It will require medication be put directly on my liver through the blood vessels that feed the liver. This should provide enough contrast for the surgeon to create a roadmap for the ablation process. I am a little nervous about this procedure but I'm betting it will be successful.
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I learned yesterday, April 19th, that things have taken a turn for the worse and I will be facing a new challenge. On Feburary 28th I had a chemo embolisation to address two new tumors in the liver. Unfortunately one of those tumors has continued to grow and the other is realtively unchanged. Dr. Graves seemed a little surprised when I told him I was not having pain. This tumor is, in Dr. Graves’ words, interesting in that it is growing out and not into my liver. It has actually grown into my rib cage!
More bad news, the CT scan clearly shows another new tumor. This one is located in my lung. Remember I had a CT and PET scan in February and this tumor did not show up. Consequently it has grown fairly fast.
So, on May 3rd I return to the all too familiar Sacramento Sutter General Hospital for the ablation of three tumors. I have had tumor ablations three times before but this one makes me a little more aprehensive. First of all one of the tumors is very difficult to reach and will require all of Dr. Graves’ skills. The lung tumor will also present a problem in as much as the lung will almost certainly be punctured and collapse during the ablation procedure. I remain confident that these tumors will be removed on May 3rd.
I visited Pier 39 once and played an arcade game called “whack a mole”. A toy mole pops out of a hole and you smack it on the head but as soon as you do another mole will pop out of his mole hole. Soon you are hitting the moles as fast as you can but you are still missing many. Why do I mention this? Well I am beginning to feel like I am in another game called “whack a tumor”. I am hopeful there will not be more concurrent tumors “popping out”.
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The tumors are gone. The two liver and one lung tumor were ablated (burned off with microwaves). I really hate ablations, having had four over the last three years, but they beat open surgery and are infinitely better than death! One of the liver tumors was growing towards the skin between the ribs. That one caused extra recovery problems because the bone and skin were burned in order to ablate the entire tumor. It won't be long before the pain subsides. Soon I will begin chemotherapy again.
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Bad news: my CEA is increasing again. CEA is a marker for cancer for me and the higher the CEA the more cancer. Dr. Bobolis has changed my chemotherapy. Hopefully it will help.
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July was a very bad month: On July 9th my cousin Larry Federico passed away from complications caused by cancer. Larry was an all-American football player his senior year in college. He later moved on to a career in the nuclear industry. Larry was not only a great athlete but a smart high achiever too. He used to visit my house practically every weekend when I was a senior in high school and attended many of my football games. I have lost touch with Larry over the years but his fight with cancer resonated with me and I was very touched by his passing.
It gets worse…..
I was riding one of my motorcycles on a busy street when the next thing I knew was I was waking up in an ambulance on the way to an emergency room. Apparently I was sideswiped by a car while moving at about 35MPH. I say “apparently” because I have no memory of the crash. At the ER I was given a CT Scan and X-ray and to everyone’s surprise there were no broken bones or head trauma. The outside temperature at the time of the accident was about 110 degrees and I am ashamed to say I was not wearing my protective jacket. So, I did sustain some abrasions and contusions. I have lots of aches but I am improving quite well. I have also had a very noticeable vision change. Apparently the impact on my head detached my vitreous. This will heal but I will need a prescription change. My ophthalmologist wants to do further testing before he makes my new prescription.
Even though I did not have my jacket on I did have protective boots, motorcycle pants and my helmet. The helmet was completely scratched on the face side and the back side indicating I turned as I was sliding on the asphalt. To those of you hearing about this for the first time (I sent out a short message to some folks earlier) I know there is a certain amount of shock. I understand and I am seriously considering selling my other bike and taking up a safer hobby.
THEN….. five days later my GI track stopped working. I will spare you the gory details but I became very sick. My oncologist hospitalized me and for the next seven days I lay in hospital fighting a severe infection. Most cancer patients have a compromised immune system and I am no different. The origin and type of the infection is still unknown but through the application of a number of antibiotics I was finally able to come home to recover more fully. I have to admit I was very ill.
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Some good news! My CEA has gone down. Hopefully this will be the long term trend.
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A number of things have taken place since my last update; some good and some not so good. I have been having fun exploring the back country around the Sierra Foothills on my new motorcycle. After my accident in July I thought I would not buy another one, but I did. This bike is designed for both on and off road. Here are some pictures from two of my rides.
As you can see from the photos I am exploring roads I would never be able to take my touring bike.
On the down side I have had a set back with my cancer fight. Two new liver tumors were discovered. Coincidentally a new chemotherapy has become available. Dr. Bobolis and Dr. Graves discussed chemo versus surgery. It was decided to let the new chemo (Vectibix) have a chance. The nurses prepared me for the side effects. Just like a drug I took three years ago (Iressa) Vectibix works on what is know as epidermal growth factor receptors. The down side of this medicine is it causes rashes and breakouts. They can be mild or severe. When I took Iressa it took about 12 infusions before I could not take the pain anymore. My scalp was especially bad with blood on my pillow each morning.
Remember it took 12 infusions before I could not stand it. Well I had an infusion of Vectibix two weeks ago. Nothing happened at first so I figured it would be just like Iressa and take a few months to start affecting my skin. Well I was wrong. After 7 days I started getting pimples on my nose. Soon “all hell broke out” as I broke out with rashes, pimples and more on my entire face and chest. I will spare you the gross details. My scalp hurts just as much now as it did with Iressa and like with Iressa there is bleeding. I take a narcotic pain reliever and Ambien so I can sleep at night.
I am now scheduled to begin Vectibix again but at a 50% reduction in strength. This drug had horrible side effects but it worked! My CEA went down by 60 point. Hopefully at the lower strength there will still be positive impact on my cancer without the severe side effects.
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Well the Vectibix continues to work. My CEA has gone down even more which means my tumors are shrinking. I have a feeling the effectiveness is coming to an end. Remember you only stop chemo when it stops working or you can't tolerate the side effects. The side effects are getting pretty hard to tolerate. I continue to have skin problems although not as severe as the first dose. A visit to Dr. Bobolis next week will help me understand where I go from here.
In the mean time, enjoy some photos I took on a motorcycle adventure I took to Death Valley.
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My chemotherapy has now been changed from once every two weeks to once every three weeks. This is an effort to reduce the side effects of Vectibix. In addition Dr. Bobolis is adding Avastin to the mix. I have taken Avastin previously but on its own it stopped working. We are optimistic for the combination of Avastin and Vectibix. I have had one infusion and it has been a week without the severe dermatoligical side effects. On the other hand, the new chemo "knocked the mickey out of me" (as my Irish friend used to say) with severe fatigue and constant nausea. The fatigue and nausea seem to be subsiding after a week. So I look forward to two good weeks. I am taking Oxycodone twice a day to help manage the pain and it does a great job. I see Dr. Bobolis this week and she will review my CEA numbers with me. I remain optimistic. (March 7, 2007)
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It is May 21,2007 and I am experiencing a lot of issues with my skin as a result of the Vectibix. My last CT Scan provided great news. Since December 2006 my liver tumors have reduced in size by 50% and the marker (CEA) for my systemic cancer has gone down. This was the news I have been waiting for. I am now fully engaged in preparing for the ride of my lifetime. Read all about it here:
http://www.dellfields.com/ArcticCircle.html
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It is August 16, 2007 and the "glow" of the Ride for Cancer Patient Awareness is dimming. I am proud of this accomplishment because Doug and I rode over 9,000 miles on our motorcycles through some of the most challenging conditions a motorcyclist can encounter. My goal of reaching the Arctic Circle on the Dempster highway was accomplished. We were able to show that even with cancer a patient can still live a full life. In addition we raised money for the Sutter Roseville Cancer Center.
On the down side my tumors grew but we remain hopeful the Vectibix and Avastin combination will continue to work for me. If you would like to learn more about the ride please follow these links:
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The good news is my CEA has decreased from 172 to 96. As I have written before CEA is a marker for my kind of cancer; the higher the CEA the bigger the tumors. This means that since I restarted chemotherapy after returning from the Arctic Circle my tumors are most likely shrinking. For cancer patients reading this I am still taking Xeloda, Vectibix, and Avastin once every three weeks. The Vectibix is taken at 50% of the recommended strength due to the severe side effects it causes.
The side effects are not too bad at this time. My skin is like a snake's skin in some places, ouch but there is very little bleeding and scalp problems. There are rashes that itch especially in those places where a good itch in public might get you arrested. I consider this a small price to pay for my ability to live a fairly normal life.
I was able to deliver a talk to an audience at Sutter Roseville about the inspirational people I met on my journey to the Arctic. I am proud of the message of my talk and I am glad it was well received. The message continues to be cancer patients can live a full life with care and proper planning.
I have given up on being cured of cancer, howerver I have not given up hope. I have hope for a long life with cancer being managed like many people manage other chronic diseases. It is not the life I would have chosen but it is what I've got and I am enjoying making the most of it.
Oh yes, one more thing. A few weeks ago I rode one of my motorcycles to the house in Burlingame. As soon as I arrived felt very ill. Eventually I had to leave the bike behind and my brother, Les, drove me back to Rocklin where I was hospitalized. I had another blood infection. I was only in hospital overnight but the recovery has been very slow. I am feeling pretty good today as I write this.
OK, enough about me. Joan Lim, my wife and caregiver had an article published recently in the Colon Cancer Alliance Newsletter. She also received a "scholarship" to attend their recent conference in Baltimore. She is an active member of the Alliance's Buddy program where she does phone meetings with other caregivers around the country.
Here is Joan's article:
October 17, 2007
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Today is December 18th and I go for chemo tomorrow. My CEA has climbed a little which leads me to belive the chemo is not as effective as it was previously. I am still covered with rashes and breakouts (a sign this type of chemo is working) so I am not too worried. In January I will have another P.E.T. scan to see how the liver tumors are doing.
My biggest complain is I am so fatigued and feel like I have the flu all the time. I always have a runny nose and often will have chills when it is just the slightest bit cold. I am told this is normal but I don't like it. I haven't ridden my motorcycles much lately because I am just a little weak to feel I am in control. Remember, one of my bikes weighs over 600 lbs and the other over 800lbs.
So not really much to report. I made an entry because I had another cancer patient write me the other day to say he worried because there were no entries after October.
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It is January 10, 2008, I am sitting in the clinic receiving my chemotherapy (I was pleased when Sutter Roseville became a free WiFi hotspot) as I type. I am saddened by the death of my friend Carol Whitaker. Carol and I have a lot of similarities: we both worked for Hewlett-Packard, she just turned 60 and I will in 3 weeks, and we both have colon cancer. I knew the end was near when she told me in December she was entering the hospice program.
Whenever I spoke to the press or in public I always made a point that cancer patients can lead an active and full life with proper planning. Carol was a great part of my motivation for that statement. She loved to travel and when she told me she was taking a China cruise I wasn't surprised. She planned carefully and enjoyed her trip. She enjoyed family and friends and frequently had get-togethers. She was a woman of great dignity and grace and has shown me how to deal with my own cancer.
Since January 1st I have had a stomach ache; not a little one but at times so bad I vomited. I had a P.E.T. scan yesterday and next week will see three doctors to get to the bottom of this. I am relieved that the stomach ache is only mild at this writing but I will feel better when it is gone.
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I am writing this update from my hotel room in Singapore. We have had a great trip. We celebrated the wedding of my brother in law, my birthday, Joan's aunt's birthday, and the Lunar New Year. I have done well with the normal fatigue. The stomach problems are not gone but they are not too bad.
When I return to the States I will be faced with a change in my chemotherapy. Before we left for Singapore new lung tumors were seen on a P.E.T. scan. The plan is to increase the dosage of my chemo. I am a little nervous about the side effects. If the chemo does not work it will be back to hospital for more ablations. I will try not to think about that and just continue to enjoy the visit to Singapore.
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June 2008:I have been home from the hospital for a couple of weeks now. I had a setback recently. After I was relieved to find my heart was strong I was hospitalized a week later for an intestinal blockage. After a CT scan we discovered that I have more tumors on my liver. Unfortunately they are in a location that prevents surgery or ablation. This was shocking news because previously when we heard this type of news we always had surgery to fall back on if the chemo didn’t work, now there is no alternative. So, basically if the new chemo fails it will be over for me. Of course I remain optimistic there will be a new advance in medical science that will help me.
Let me switch subjects for a minute. Through an incredible series of events I was visited at my house in Rocklin by Tibetan Monks. The monks chanted and prayed for me. It was a lovely ceremony and even though I am not a Buddhist I am very grateful for their visit. I was very touched by the fact that these men had been exiled from their own country and somehow found themselves in my house over 9,000 miles away to pray for me.
