A little Q&A on how my dad's doing lately:
Q. How is George feeling these days?
A. Whenever I ask my dad how he is feeling he always says the same thing, no matter what: "So so." Translation: "I've been better... and I've been worse." He's a stoic guy, to say the least. To look at him, he doesn't look that different from before his diagnosis. Yes, he still has hair though it is thinner, and he still looks fit and healthy but, like his hair, he is thinner than before, especially in his arms and legs (chemo does a number on muscle mass). His color is good but some of that is from the chemo glow (one tends to look a little tan during treatment). But in terms of how he is feeling, most of his symptoms are either direct side-effects from the chemo, or side-effects of the the drugs to combat the side-effects of the chemo. Some of these he battles every day, some are more acute in the week following chemo: Nausea, fatigue, mouth sores, hiccups, heartburn, minimal appetite, sleeplessness. The one symptom he battles that seems specific to the cancer is a persistent belly pain. Some days it is worse than other days, but it is a near-constant companion now. This is a change in the last couple of weeks. Before it would come and go, tending to be more painful during the treatment weeks.
He is not bedridden. He's still very active: Watering Christmas and apple trees, cleaning the pool, battling gofers, tending bees, etc. He just does these things a bit more slowly, and with more breaks and some naps sprinkled in.
In June he visited family in Tennessee, and in August he plans to visit Kyle in Coos Bay, Oregon and Dale in Coarsegold, CA
Q. How much chemo has he had?
A. Last week, George had his sixth round of Folfirinox (combo of three chemo drugs). These are the big guns when it comes to chemo for pancreatic cancer. The best they've got right now. It is rough, though, and some people are not strong enough for it. This regiment is 3 days of chemo (1 day in the infusion center, and 2 days at home), and then 11 days off. Every 14 days he's in the chemo lounge. One thing we learned: Monday is crazy busy in the infusion center, so we recently switched to Tuesdays. When I was going through chemo I learned about lidocain cream to help ease the pain of accessing the port, and that when they flush the port you get the taste of the saline in your mouth -- so sucking on a hard candy at the end of treatment is very helpful (especially since that saline squirt can kick off a cycle of nausea coming like that at the end of loading up on chemo). It's been nice sharing these tricks with my dad.
Q. How much chemo will he have?
A. There is no end date set. Because he's stage IV, he'll have continuous chemo until 1) the cancer no longer responds (i.e stops being stable or shrinking), or 2) the cons to George's health/quality of life out-weigh the benefits.
Q. What about surgery or radiation?
A. Some people with pancreatic cancer are candidates for surgery (if the mass is small, not connected to vital tissue, and localized. We thought George was one of these cases, but when the lesions were found in his liver, it was determined the cancer was too late-stage for surgery to be of benefit (an analogy the community uses a lot are dandelions -- the mass in the pancreas being the weed, and cancer spores spreading like dandelion seeds in the wind). Also, the surgery (called a Whipple Procedure) is hard core. In a sense, George was lucky they found the lesions on his liver before the surgery so he didn't have to recover from a procedure that would have altered his digestion forever considering the cancer had already spread. (Note, the Whipple is not considered to be a cure, unfortunately. Pancreatic cancer is so prolific that the surgery tends to simply buy time -- the thought is that it has usually spread beyond the pancreas but it takes a cluster of 1 billion cells before it is visible on a scan.)
As for radiation, it isn't always used in fighting pancreatic cancer because in order for radiation to work, there must be oxygen in the mass(s). Pancreatic cancer is incredibly dense with very little oxygen present. Doctors and patients use it on a case-by-case basis. In George's situation, his doctors have opted against using it.
Q. How often are the masses monitored?
A. Approximately every 3 months George will have a PET scan. He's had two so far. The next one is coming up in September. The last one showed the masses to be responding to the chemo. While they had not shrunk as we'd hoped, they were at least stable -- and no new masses were found.
I asked George if there was anything he'd add to this, anything he wanted people to know. He said simply, Thank you for all the support! I second that: Cancer fighting can be very lonely, both for patients and caregivers. It helps to know so many people are thinking about him and our family as we go through this.
Me & Nurse Ashley (who, it turns out, HATES selfies!)