Mel and I went in person today to meet up with my chemo oncologist. He told me that trying to physically assess me was useless and difficult. I am so scrawny and his cold hands make it very difficult to feel around as I am quite tense and his hands are quite cold. On the bright side, we have discovered why I am throwing up more now, but it is not news that is great. Mel is not really handling this all that well and she is concerned with the way that I am handling all of this. The doctor asked if we wanted to talk to a social worker and she said no, but I said that we should. What the doctor told us was that the surgery and radiation were just the tip of the iceberg. The cancer has spread to the lining of my abdomen. It is referred to as peritoneal carcinomatosis. It is now on the inner surface of the abdomen instead of forming a single mass it is spread in small nodules, making this much more difficult to remove. The oncologist said that this is not curable and I think that this is the part that is stressing out Mel the most. Because of this growth, the fluid buildup called ascites is causing pressure and impacting my ability to eat. The scans have indicated that this fluid is increasing and there is now small cancer deposits in the fatty tissue that sits over the intestines. The good news is that the cancer has not spread to any major organs and is just in the abdominal lining. The issue is how do we control this as it is highly complex and radiation is not an option. Chemotherapy was not effective in the past, but we will need to figure out what options there are. We will look into some clinical trials in Toronto and any other sort of treatment that is possible. I may need to travel down to Toronto for treatment if I am part of the trials. In the mean time we will begin preparation for me getting some treatment in Sudbury. They will insert a port into my chest to help deliver the drugs as the doctor thinks that will benefit me now.
Mel was quite distraught and she is a bit upset with my reactions to this. She is not sure if I am being foolish, delusional or in denial of things. I told her that I was not stressed out too much about this because we have options. This does not mean that I am going to die within the next week or two. It is scary to think that this is uncurable. Uncurable does not mean that we can not control this and live. It does not mean that life ceases to exist. I think she is concerned about seeing me struggle and go through all of this. I can understand that, but I think we can figure out something to manage this ok. I am not ready to die as there are things that I want to accomplish. The first time I was diagnosed I do remember her being mad as she always thought of us growing old together even though I can drive her crazy at times. The kids have picked up a lot of my traits and they will be able to drive her crazy even without me around. I think that it is important that we talk to the social workers and that we tell the kids what is happening and we prepare them.
Mel is also thinking of all the things that we can not do and she wants to do things together as a family before things get difficult and we are no longer able to do it. There are a lot of things that we need to make sure that we take care of and I do want to make sure that I can do things with the family. The doctor mentioned that some of the treatment options may not be covered and may be costly. That is always a big concern as well, is it worth spending all of this money when the outcome might not be guaranteed and the results inevitable. I suspected things were getting worse because I am familiar with ascites and what that means. I should have eaten again, but it is difficult to want to eat when i have some of this news. This is going to change the way we do things I think for the next couple of months. There are things that Mel wants to do as a family and I am not sure how we should go about doing it.
Having time to ponder things a bit more, the fact that it is not curable is stressful to Mel as what it translate to is that I will need to undergo chemotherapy until it overcoems my system. My quality of life will decrease at some point and then we need to decide what to do then. I will be getting a port inserted within the next couple of weeks in anticipation for the start of treatment. By the sounds of it i will be getting chemotherapy treatment every two weeks. If it is effective I think that I keep on getting that until someone comes up with a method to cure the stomach cancer. I think that I am more calm about this than Mel is that I have had time to think about this for a while and I had a suspicion that this was going to happen based upon some of the symptoms and the lack of a pattern that was easily recognizable. The only other option then was that the cancer was still there and not removed. The prognosis is the scary part as this is quite advanced, the prognosis is dreadful and measured in terms of months and not years. This is mainly due to complications from lack of nutrition and inability to digest food. If I can respond to treatment we can end up delaying the inevitable and the end result can persist to longer than year. A very small portion can live longer with systemic therapy and supportive care. I beat the odds the first time and got through the second round. This third instance will be a bit more challenging.
The positive is that I have a great support system to help out with all of this. My coworkers whom I have told about this all offered any sort of assistance as soon as I told them about this. I appreciate how awesome of a support system I have around me and how they have helped me out with everything. There are a lot of things that I will need to prepare for in the event that I decline rapidly and I will need to do that all while I am capable and strong mentally. I think right now that my body feels worse and sickly because of some of the news today. One day at a time and we will figure out some way to beat this.
Quoc Hao