6.4 Last of the Pre-treatment Planning

No Halloween costumes at Mayo this time, and no goody bags of Halloween candy. (Suzy always steals all my chocolate anyway.) Everybody is down to business. I went to the Physical Therapist Monday to improve the range of motion in my neck.  Radiation will create scar tissue, so they want me as flexible as I can be to start with.  In my case, that’s bad because my range of motion is already impacted.  My left side is where they want it to be after the radiation, and the right side is well below – not good, due to past shoulder issues.  (And evidently I tilt my head to one side a lot.) The physical therapist told me there are 17 muscles that connect to the shoulder blade. He manipulated each one, and now I have a plan to not lose too much movement once the radiation starts. Like everybody at Mayo, Richard is amazing!

We’re heading into the last of the pre-treatment planning with the Medical Oncologist, who takes care of the chemo.  Although I’m looking forward to getting treatment, chemo scares me.  There are so many side effects – both short- and long-term.  More on that tomorrow – election day.  The only thing that can take the focus off an election is a serious medical issue like cancer!

The Medical Oncologist consultation went well.  The most-used chemo for my kind of cancer is Cisplatin.  However, I already have hearing loss (I wear hearing aids) and Cisplatin has a high chance of making me deaf, so on to Plan B.  I’ll be getting a combination of two drugs – Carboplatin and Taxol.  These are actually just fine for my cancer, for a few reasons — it’s a relatively small tumor, and the purpose of my chemo isn’t really to kill the cancer, it’s to increase the effectiveness of the radiation. (Another medical thing we don’t really understand.) The most common long-term side effect of these drugs is numbness and tingling in the hands and feet.  I guess there aren’t many good choices when it comes to chemo.  At least now, I’ll have an excuse when my golf game is not up to snuff.

In the time of corona, Suzy and I have been careful and quarantining pretty religiously.  With chemo, I have to be even more careful.  The only risk we take now are with a few medical appointments that we’ve ignored during the pandemic, and the treatment at Mayo.  I’ve been tested four times already and I am sure I will be tested regularly throughout my treatment.

Tomorrow, Thursday, I’ll be getting a port inserted in my chest to use anytime they need to deliver drugs or fluids to me, or to withdraw blood for testing. Just recently, nurses have had trouble putting in IVs or drawing blood. With the port, that won’t be a problem.

The good news is the that the chemotherapy is scheduled to start 5 days from now, and will be done before the end of the year.  The bad news is the chemotherapy will be starting just 5 days from now.  It’s very daunting. I’m so lucky that Suzy will be able to be with me when the chemo is administered.  I know she’ll be there to support me, but at the same time, I wish she didn’t have to witness this.  I am sure the room is filled with a lot of pain and suffering, and it’ll be hard to feel anything but sadness in there.  The nurse told us that it will take 3 to 4 hours for each chemo treatment.  It’s hard to tell how I will react to the chemo, but the most common near-term side effects are nausea, aches and pains, and digestive tract issues.

The plan is chemotherapy once a week for seven weeks and radiation five times a week (35 sessions) for 7 weeks.  Each week, I will meet with the Radiation Oncologist, the Medical Oncologist, a Speech Language Pathologist, Physical Therapist, weekly blood tests, and more as needed.

The expectation is that I’ll start out 2021 cancer free and will be able to concentrate on recovery.  April 1^st, plus or minus, I’ll have a PET scan to see if the cancer is gone. 

And then back to the golf course with my built-in excuse!