Steve's August CT scan confirmed some disease progression since his last scan in December 2009, at the end of the Velcade drug trial. The good news is that the mesothelioma is still confined just to the right lung and there is no sign of metastasis elsewhere. However, the pleural thickening in the affected lung has increased in depth and is more widespread, and the meso has now started to grow into the chest wall, on his right side. The doctor was surprised he hasn't had any pain as a result of the chest wall meso, but thinks this might be due to the very slow, gradual rate of growth of the cancer.
There was some discussion about the pros and cons of having chemotherapy, with the all attendant side effects and inherent risks, while Steve is still feeling good and able to enjoy a good quality of life. However, whilst he is pain-free at present, that's likely to change if the cancer continues to grow, especially into the chest wall. I think that factor was the determining factor in reaching a decision that the time has come to attack the cancer again.
So we are off on the chemotherapy merry-go-round in about three weeks time; a combination of pemetrexed (Alimta) and carboplatin (rather than cisplatin, at our request). This will be given as a hospital day patient once every three weeks, along with steroids, vitamin B12 injections and folic acid tablets (by the GP practice nurse) to counteract the side effects of the pemetrexed. Hopefully, another six cycles of chemo will stop the mesothelioma in its tracks or, even better, whack Leo back a bit so that Steve can continue to enjoy life without symptoms for even longer.
Steve will get his first dose of vitamin B12 and associated meds next Monday afternoon, so that they will be in his system for a couple of weeks before chemo starts. Our flu jabs have been booked in for 29 September, to reduce the risk of catching something nasty while his immune system is compromised by the chemo. Just waiting for the appointment for the first cycle now and then we can start pencilling in future sessions on the calendar to work round over the next five months or so, assuming he has the full six cycles of treatment.
When Steve was on the Velcade drug trial in 2009, we had to go to the hospital twice a week for two weeks for chemo, then every other third week for a scan. It felt like we lived there! At least this time round, Steve will have two clear weeks between sessions to relax, recover and hopefully enjoy a bit of "normal" life. Plus the side effects of carboplatin are known to be generally less severe than those associated with cisplatin.
Even so, we know it won't be easy, but at least we have a better idea of what to expect this time around and how to manage the side effects and other limitations of chemotherapy. And if the chemo does its job, we will have something extra special to celebrate in 2013 (and an excuse to enjoy a second Christmas/New Year when the side effects of the drugs have worn off :-)
Although we have been dreading this news, now that it has happened we have switched into action mode and somehow feel calm and focussed on the fight ahead. The energy we have been putting into galavanting around europe and the UK over the last couple of recent years will now be directed into fighting back. We will be following in the footsteps of other meso warriors and their partners and we know that they will be there for us when we need them, along with our family and friends, who have given us such great support since June 2009.
Love you all xxx