Wednesday, July 18, 2018

Progress


10th May 2018  
Usually the word progress is associated with betterment. Progression is associated with forward/upward movement or growth.
My cancer has progressed: Hardly surprising since I’ve had no treatment.
I had my first diagnostic scans in the first week of December last year and my second scans in late April, 5 months later. I wanted to know how the disease had progressed, so that I can decide whether to commence treatment.
Typically, when it spreads, Colorectal cancer will go to the liver, it can go to the peritoneum and the lungs. It can then go to other organs and the bones, sometimes to the blood and sometimes to the brain.
In my case it had already spread to the liver and peritoneum. I have not been tested for spread to the blood or brain and I’ve not asked for this. I’m happy to say that it has not spread to the lungs, heart or any other organs.
In the liver, there were three lesions in December (lesion: a region in an organ or tissue which has suffered damage through injury or disease, such as a wound, ulcer, abscess, or tumour). These have increased in size and been joined by one more. For medical purposes the liver is considered to be in 8 sections. There are two lesions in section 7 (consider it the outside right forward, in olden footie terms). The largest has grown from the size of a small ladies watch to the size of a pocket watch. The one in section 6 (below section 8 – so in midfield) from the size of a ball-bearing (5mm) to the diameter of an internal water pipe (15mm). The new one is in section 3 (outside left midfield) 5mm.
In the peritoneum, as well as those in the bottom front sections (where the sharp pains occur) there are now nodules in the top left front section and increased nodules in the back sections.
For the colon, whilst nothing new is reported, the CT scan doesn’t pick these up very well. There is still an intussusception (when one segment of the colon pulls inside the next segment and is prevented from returning – in this case by a polyp), but this isn’t causing a blockage.

The main issue I have is not knowing.
I don’t know if/when the cancer will spread to other areas. I don’t  know how much it matters which organ gets more cancer first. I don’t know how I will know how the disease is spreading. I don’t know what symptoms will indicate that it’s time to get ready to say goodbye.
The doctors and nurses have a mantra – “Everyone is different” – for Hippocrates’ sake, I know that! But everyone wants to know what has happened to other people in the same situation!
I do know what the signs will be if the liver packs up. I will go yellow and age like an unread library book.
I think I know what the signs will be if the polyps in the colon grow. I’ll stop going to the toilet. I’ll vomit. I’ll stop eating.
But the peritoneum? I think that growths on here may block the bladder and/or the colon. Patients often get ascites, the accumulation of fluid that fills the abdominal cavity and causes distension and discomfort. At first the fluid can be drained but it tends to re-accumulate quickly and is hard to manage.

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