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Good News! As Arnold might say, "It's not a toomah!" [1]

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Date: 2022-12-23

It’s not a secret I’ve been battling stage IV colon cancer now for over a year and a half. I had major surgery early this year to remove any known tumors (the main one, I’m told, was the size of a baseball, and they ablated away seven tumors on my liver), and I’m currently on my 3rd type of chemo (new tumors were found on my liver via MRI back in August).

I’ve been getting evaluated for a relatively new treatment (FDA approved in 2020, but not very many hospitals have a program set up for them yet — I’m actually one of Mayo’s first patients for their program, which just started this fall) called a Hepatic Artery Infusion Pump.

Basically, a small pump is surgically implanted in the abdomen that pumps small but constant doses of chemo directly to the liver via the hepatic artery. This allows lower doses of chemo to be used but potentially with greater effect because the chemo is going directly to the organ affected, instead of just blasting the patient’s whole system with chemo hoping enough gets to the tumors to do it’s job. Bonus — because lower doses are used, side effects are much reduced.

The downsides — first, it requires surgery to implant the pump, and second, the pump needs to be refilled with chemo medication every 2 weeks — which means I’ll have to travel 3 hours each way every 2 weeks to get the pump refilled. But hey, if it keeps me around longer, sounds like a fair trade. And there is a risk of liver damage, but hey — I’ve already got tumors there doing their best to kill me, right, so...

Anyway, a hiccup occurred during my evaluation that could have thrown a wrench into the whole plan.

I had the most detailed MRI I’ve had yet a couple of weeks ago. It found a nodule on my left side, in the peritoneum (the membrane that holds your innards together). If it was cancerous, well — the pump only works on liver tumors so it might have led to cancelling the whole thing because it would evidence that 1) my cancer had spread beyond the liver and 2) my chemo is not working as well as we’d like.

So, earlier this week I had a biopsy to see what this thing was. I got the results yesterday.

It’s not a tumor!

Woot! Turns out it was a nodule of necrotic fatty tissue (a pocket of dead fat cells) that was probably damaged during my previous surgery earlier this year. The key thing is — it’s not malignant, and not cancer.

So now we can keep moving forward on my evaluation. Next step is a laparascopy next month to take a visual look in my abdomen for any signs of cancer outside the liver.

If that checks out ok, the next step is surgery to implant the pump, and as part of that they’ll ablate away any known tumors they can target. Then six months of treatment using the pump, having it refilled every 2 weeks (I expect a lot of audio books and podcasts are in my future).

But I have to admit, the last couple of weeks wondering about that nodule were rough. If that thing had been a spread of my cancer, it would’ve been a sign that my chemo wasn’t working and I’m already on my 3rd type of treatment (as my oncologists explain it, they start with what they believe is the most effective treatment, then the 2nd best, and so on. Eventually you get to treatments that either have reduced effectiveness and/or worse side effects). And unfortunately, so far at least, my particular type of cancer has no immunotherapy treatments available.

Then again, when I was first diagnosed they gave me a 50/50 shot at making it 2 years and 21 months later I’m still here.

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[1] Url: https://www.dailykos.com/stories/2022/12/23/2143439/-Good-News-As-Arnold-might-say-It-s-not-a-toomah

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