The New Scrawl

There is a new focal hypermetabolic lesion in the left neck at a level II or III cervical lymph node basin. Its maximum standardized uptake value (SUV) is 7.3.

The following lesion has increased in size since the prior study. There is an irregularly-shaped cluster of multiple lesions in the left medial supraclavicular region with a maximum SUV of 7.8. There is a hypermetabolic lesion in the right prevascular region of the mediastinum with a maximum SUV of 10.6. There is a hypermetabolic lesion in theleft upper quadrantof the abdominal cavity in the stomach bed. This is now associated with a central negative defect consistent with necrosis. Its maximum SUV is 11.4.

There is a hypermetabolic lesion in an aortocaval lymph node at the level of L1/L2, with a maximum SUV of 7.6. This has not changed significantly since the prior study.

IMPRESSION:

Findings are consistent with extensive neoplastic disease at multiple sites associated with progression at most of the aforementioned sites since July 3, 2009.

So I now have a fifth tumour. I was once told that if I only got one new tumour a year, I should consider myself lucky. Obviously I am not so lucky, but then again, what else is new with this thing? Clearly luck will not save me. It's not on my side, so I will have to rely on something else.

Going in, I knew that the radiation that I had had was basically a bandaid solution. It might work for existing tumours for a while, but does nothing for new ones waiting in the wings. And I already mentioned the issues I have with the type of chemotherapy that I have had. Here's another one that I was not aware of till today. I haven't had chemo in a year, but while my blood tests have indicated that I am not neutropenic, I am not exactly a champ with respect to neutrophils, either. They are still lower than normal.

My choices were to do a standard drip-chemo for three days in a row, then wait two weeks and do it again. Then again. Since I can't face that, the other option is to take Etoposide. Sounds like a killer, doesn't it? Well, it's supposed to be very mild, with few side effects. This is exactly what I have heard before. I told my oncologist this, and he seemed a little surprised that my memory was so good. I might even be able to continue working with this therapy. I don't know. It's 10 days on, and 10 days off, three times. Some side effects:

• Nausea (almost certain)
  
• Loss of appetite/weight loss (almost certain)
  
• Taste alteration (hello, sugary treats! Unless sugar tastes like sweet death, which has already happened to me.)
• Diarrhea (very unlikely)
• Constipation (almost certain)
• Tiredness (certain)
• White blood cell count drops/neutropenia (certain)
• Platelet counts drop. The guide says that I should avoid constipation. Yeah.
• Mouth sores (50-50)
• Hair loss (50-50)

Fun. I can taste the metallic saliva already.

One good thing happened: I got my H1N1 shot. And because of the morphine, I can barely feel the pain in the arm. And my pivot nurse reminded me that I should be getting my portacath flushed. I have been forgetting to do this since December. And of course, the damn thing is blocked, so I have to go in and unblock it on Monday, the same day I intend to start this chemotherapy. But at least I can still drink in moderation. Says so right on the information sheet.

All this, and I left my phone in a cab on Tuesday, and he won't fucking bring it back even though he has my address. I am tempted to call that guy a cocksucker.