Alexandria

The worst news from yesterday’s appointment with my oncologist was my blood pressure: 137/84. My oncologist, though, was unconcerned about the prehypertension level numbers.

“For some reason,” he said, “all my patients have high blood pressure readings.”

Indeed, if the fact that I was seeing an oncologist hadn’t raised my blood pressure that morning, the drive across county to see him would have. After a quick breakfast of mooncake and avocado and a walk for the dog, I found myself stuck in a traffic jam on the 405, with no idea whether I’d get to my appointment on time (this after prudently giving myself an hour to get there in case of problems with rush hour traffic).

Anyway, here’s the scoop from the appoinment. I have finished my scheduled treatment: full hysterectomy followed by “sandwich treatment” of three cycles of chemotherapy, five and a half weeks of radiation, and three more cycles of chemotherapy. I have not been placed on the optional additional year of consolidation chemotherapy. Now, a week short of seven months after my diagnosis, what I have to look forward to, assuming my scans are good, is follow up. First, though, to be sure I’ve truly graduated from cancer patient to cancer survivor status, I need to get some further tests.

I have two slips of paper. One of them has two boxes checked, one for BMP and another for CA-125. That is the sheet for the blood tests. BMP means Basic Metabolic Panel (you can Google this one and find an explanation at approximately a million sites). CA-125 is a cancer blood marker for gynecological cancers. It was elevated in my case when tested right after surgery (at that point it was 44), and has dropped to below 6 (normal) when last tested. It needs to stay normal.

The second sheet has the words “CT PET” on it and three boxes checked. One is for CT chest, one for CT abdomen, and one for CT pelvis.

I am to get the blood test, and then wait for a call from the oncologist about the scans. They need to get approval from my insurance company before proceeding. Then they will call me and tell me where and when I will get the scan. If the scan looks good, I am through with treatment.

Every three months, I am to see my oncologist (I also have a follow up visit with the radiation oncologist at the end of October). Every six months, I am to get my blood tests and scans. My Portocath will stay in place for two years (the first two years are the time period when most recurrences happen), and will need to be flushed with heparin every few months during that time. I will get regular follow up for five years.

I also need to see a genetic counselor and get tested for Lynch syndrome, a genetic condition that increases the risk of colon cancer.

I asked my oncologist a few questions about how long the treatment side effects would last.

Q) How long will it take for my blood counts to recover?

A) It could take as long as 6 months. The treatment does a number on your bone marrow.

Q) How long till I can give blood again?

A) Check with the blood bank.

Q) How long will the fatigue last?

A) It could last as long as a year.

Q) How long will the neuropathy last?

A) Any neuropathy that you still have a year from now will be permanent. More likely, though, it will all wear off.

That’s it. My Stanford class reunion is this weekend, and I’m missing it because I knew there was no way I could do it a week after the end of chemotherapy (it’s all I can do now to be back at work, so driving from Southern to Northern California would be too much). My college friend Matt is organizing the reunion for Columbae and Synergy, Synergy being the coop house where I spent my sophomore through senior years, and he knows why I can’t make it and says he’ll try to do something to let those of us who are remote connect to the people who are there, by Internet or webcam. For the rest, I guess I’ll just need to check with friends later by email and see how the reunion went.

I managed, with much diligent effort at adding calories to my diet, to end chemotherapy at my pre-cancer weight, 130 pounds for 5’5″. I can now stop trying to regain the weight I kept losing, and go back to my normal mode of trying to make sure I don’t gain middle aged spread. And make sure I pay all those remaining cancer copays.