January 5: Dex, more drugs, another hole…

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Monday 7 January 2013

Well, the same hole, really. It now seems the osseous trapdoor in the side of my head will be swung open once more to let some crack medical stormtroopers flush out some recalcitrant cells which have grown back after last year's drubbing.

Oddly enough, I feel pretty good about this.

It's not just the mood-enhancing effects of the dexamethasone (my steroid of choice). I'm over that now. But since I found out on Christmas Eve that this year's pressie was some new tumour (next year, a card will be fine, thanks) I've been aware there were different ways forward from this. Now, since I went back to the Beatson on Hogmanay for a long chat with one of my oncologists, it seems I'm in line for the best one. That's very encouraging.

The best route, it seems, would be surgery to hook out the new growth, preceded and followed by a new drug the Beatson is trialling (called a PARP inhibitor, which is funny in itself) plus a slightly different regime of the same chemo, Temozolomide. This seems to be best because the bad stuff gets scraped out, the chemo is the kind I coped with well last year, but I get it for longer, and I get to do another medical trial, which won't interfere with the standard treatment but might well enhance it. PARP inhibitors have been used successfully against other cancers, and they've now proven that they can get into glioblastoma (something many drugs apparently find difficult) and the oncologists are "very excited" that they can do so effectively. I'll be one of the first to find out if they're right. There is a big part of me which looks at stuff like this and breathes, "Oooh! Science!" When people with "ologist" in their job titles tell me they're "very excited" about a treatment I might get, I do have to slow myself down to make sure I read all the paperwork before signing it. It's not my fault, I'm a geek. But, having done that now, the route it appears I'm likely to follow seems to be the best available. The trial might help me, but even if it doesn't, I still get the gold standard treatment and the data it provides should help others. Since I need treatment anyway, it's hard to see the downside. So, yes, I am embracing the combatant metaphor pretty whole-heartedly: "Research has beaten polio, research has beaten smallpox, research is beating HIV. And, one day, research will beat cancer." The other reason I felt so much better on leaving the Beatson on Monday was the length of time they took to explain it all to me. Despite it being Hogmanay, and despite the fact that he was undoubtedly busy, the oncologist took great care to explain as much of the detail and implications of what I'm facing to me, and to answer all the questions Clare and I had. Even when I pulled out my notebook full of them. Information is all, and that kind of care and attention from highly-trained specialists makes it all so much easier. Next week I get a similar session with the neurosurgeon who will be going in (assuming he agrees to, and it looks like he's keen). I don't know the exact day yet, but I'll let you know how that goes. Then there will be scans, blood tests, a chest x-ray – all stuff I've had before – and a further clinic with the oncologists. Once that's all sorted out and everything's as hoped-for, we can get a date fixed and the cutting starts. Should be sometime this month. But, again, I've had brain surgery before, I remained a smart-arse, and I was back on my feet in hours. Sure, I'll be in hospital for a few days after that just to make sure I'm OK and nothing's running out my ears, but that's a good place to be in the circumstances – it's where all the doctors are, for one thing. So I don't expect 2013 to be a particularly easy year. I'll be off work for a few weeks post-surgery, and the chemo is a bit debilitating, but that's mainly just fatigue, and I've coped with that pretty well in the past. I avoided the other major side-effect, which is nausea, and I imagine I'll do so again. But there's no radiotherapy to take this time since I've already had my maximum 60 gray (a gray being the SI unit of absorbed radiation, which doesn't come in shades and has nothing to do with handcuffs, and anyway, you get ten more) and that was the biggest exhauster. It shouldn't be any worse than 2012, and I dealt with that. Never bothered to read 50 Shades, though – life's really too short. Right now I feel strong, healthy, and optimistic. There's good science out there to help me feel that way as much as possible. So let's go.

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January 5: Dex, more drugs, another hole…

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