Today I had my first official office visit with my oncologist (Dr. Holcomb) to discuss adjuvant (post operative) chemotherapy. It seemed fitting that it was a cold, grey, drizzly morning, because its how I was feeling inside. I met with Dr. Holcomb briefly in the hospital while recuperating from surgery. He's been Chief of Hematology/Oncology at UC Irvine Hospital for 11 years and was recently appointed Associate Vice Chancellor for Research. Basically, he is their #1 cancer guy. Here are a couple of reference webpages about him.
We reviewed my case and he pretty much reiterated what he told me before. Since there is no detectable evidence of any remaining cancer (cancer free margins on the colon resection, negative lymph node involvement, normal tumor marker blood tests), statistically speaking a stage 2 colon cancer patient like myself has about an 80% chance of cancer not reoccurring or metastasizing to other organs (ie. liver and/or lungs) for 5 years, during which time I would be in "remission" and after which time I would be classified as "cured". Oddly enough, this does not include the chance of additional polyps (cancerous or otherwise) forming again in the colon. So, there is about a 20% chance of recurrence in other "distant" organs within 5 years.
The doctor lightly recommended that I receive chemotherapy, but isn't going to twist my arm. He told me that if I were his son, he would recommend chemo. He said that I'm "young" and now is the time to do it soon after surgery. If I consent to chemotherapy, my chances for non-recurrence within 5 years increase to about 83%. Another way to look at it is that even with chemo, the changes of recurrence (~17%) are nearly 6 times greater than the chances of the chemo having any positive effect. Hmm.
Other Factors To Consider
The doc is recommending FOLFOX, which is a cocktail of three different drugs.
FOL– Folinic acid (leucovorin) - sometimes called FA
F – Fluorouracil 5FU
OX – oxaliplatin
The drugs would be administered every 2 weeks for 6 months. The drugs are given via a device called a Port-a-Cath that is surgically implanted just under the skin in the upper chest.
This website says the cost of this procedure alone is about $5,000.
Day 1 of each 2-week cycle begins with FOLFOX being administered at their "Infusion Center" for 3-4 hours, after which you go home with a small, portable injection pump still attached to the Port-a-Cath. Patients return to the facility on day 3 to have the needle and injection pump removed. Patients recover from the drugs on days 4-14 before repeating the cycle. Common side effects include fatigue, numbness or tingling in fingers and toes, nausea, and increased risk of infection or illness due to decreased bone marrow.
I figured that chemo was not cheap, but I didn't realize just how expensive it is until I asked. The doctor said that chemo costs about $20,000/month, or in other words, about $10,000 per 2-week cycle. Wow! The doctor said most of the cost is for the medicine itself. Pharmaceutical companies making that stuff must be doing quite well. And we think that a gallon of gasoline is expensive! We would probably exceed our health insurance yearly deductible and out of pocket maximum expense just having the Port-A-Cath installed.
Doctor Holcombe wants me to tell him my decision on whether I will receive chemo by next Friday, which just happens to be leap day, February 29th.
Interestingly enough, I completed my first double century bike ride one year ago this week.
Sorry about the long paragraphs.
For some reason the spaces between paragraphs are repeatedly being removed from this post.
2 comments:
We pray for you every day and have fasted many times. We'll keep doing so! Thanks for the information so we can look through it a little.
We love you Dad! We support you in any decision you make!
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