Endoscopy

Today I had an endoscopy, not my favourite procedure. Bearing in mind that 10 days ago I had a CT scan but I thought they were gathering as much information as possible before surgery. However, bearing in mind that I had a 3cm long cancer growth in the bottom third of my esophagus last November and had trouble eating and swallowing, today's endoscopy couldn't find the cancer. It would appear that my single dose of chemotherapy did it's job and got rid of the cancer. This I didn't expect but it does explain why I have been back to normal eating anything with no swallowing difficulties. When the supervising endoscopist told me this it was quite an emotional moment for me. He showed me the pictures form inside my esophagus and indeed it was clear. The initial theory is that I was probably very sensitive to the cancer drugs which is why I felt so ill and at the same time so was the cancer which helped enormously to get rid of it. I am now waiting for my care team to let me know now what the next stage is likely to be. No surgery now, I am a very lucky man. However ther is no such thing as a free lunch and there are a couple of residual issues I am still sorting out with my GP.

Update

Friday 24th.January
Last Friday I had a meeting with the surgeon who is one of the team who undertake the oesophagalectomy. He ran through the procedure, a whole day operation in which one surgeon re-configures my stomach and another who works above he diaphragm and once the tumour is removed, attached my stomach back to the food pipe. Probably 2 weeks in hospital. I have also met the anaesthetist who wants me to do a fitness test on an exercise bike next Friday. On Sunday 19th I had a CT scan and on Monday last I attended surgery school. This was a general meeting telling us what to expect after surgery. We tried out a spirometry test kit which basically is a piece of equipment to measure the inhaling lung function. I had no problem with that but a lot of the old crocs there did. One thing mentioned was the importance of exercise before the operation to improve fitness so I am trying to do 10K steps a day now. There were a few smokers and drinkers there who just didn't get it.

Looking back with Capecitabine

The Mayo Clinic in NY publish a very detailed summary of Capecitabine (Xeloda). It would appear that there are 9 common unwanted side effects reported, 90 less common effects and 57 other miscellaneous effects. So the chances are that you will get some of them, some of them can be lived with during the treatment but others are more serious. For me I had abdominal and stomach pain, diarrhea, nausea, tiredness, weakness, vomiting, chest pain, chills, cold, confusion, dark urine, decreased volume of urine, dry mouth, a low temperature, dry eyes, a crusty scalp, irritability, hot calves, red spots on the skin, sore throat, weight loss, fatigue, heartburn, trouble sleeping, muscle pain, lack of appetite and runny nose. However, looking back on it it is easy to forget how unpleasant it was at the time BUT the bonus is that I can now eat normally. Surgery is next!

After Effects

Once you stop taking chemotherapy drugs, what I hadn't realised was the side effects that come along simple because the immune system has been compromised. So apart from the rampant diarrhoea for 2 weeks, I have also got thrush, dry eyes and a constantly runny nose. According to my GP, these will get better in time. However, having got all theses issues I never bargained for, the chemo does appear to have some effect in shrinking the tumour in that  I can now eat more or less anything but some of the tastes are still weird.

I've been Poisoned

Friday 3rd January
In he early hours of Friday morning I had a couple of episodes of really bad diarrhoea so I remembered what the nurse at QA had said that I should try Loparimide and since I had not been issued with any of these pills I decided to get a GP appointment that day. However, it tuns out that Loparamide is the same thing as Immodium so I took a couple before I saw the GP. Now our surgery does not have a very high rating, there are 4 male GP's, 2 of them are reasonable, one is brilliant and the other is just plain awkward to deal with, no sympathy whatsoever and has a bad attitude problem. Unfortunately the surgery only had one appointment left and that was with him. When I eventually got to see him, he was running very late and I was feeling grim, we sat down and for 10 seconds he just stared at me, I thought what on earth is the problem but I just stared straight back at him until he finally spoke to ask me what I wanted. I told him of my problems coming off capacitabine and that I needed some Loparamide but I hadn't realised it was the same as Immodium. He said 'that's up to me to decide, I am the doctor, you've been poisoned' which I thought quite rude. Told me I could take as many as I like which I have done and the diarrhoea seems a lot better today so far. Codiene phosphate is apparently used to seal up the gut, rather than just pain relief so it does work with Loparamide in cases like mine.

Oncologist

Had an emergency appointment with oncologist today. He said that because I was so intolerant of the chemo drugs, he did not see any point in giving me more chemo so he is recommending I go straight to surgery. However, I have to get fit first and back to normal, that's not proving as easy as it sounds.

Cold Turkey

Went to my second chemo session on the 30th.December but no let up in stomach pain and diarrhoea over the weekend so on the Monday morning didn't feel great but went along to the session but realised when I got there that I was really running on empty, I was emotionally and physically very low indeed, quite exhausted. Any way they told me there was a problem with my blood that were taken the previous Friday so naturally I assumed that was my problem. The bloods were retaken and were OK surprisingly. Because I felt so bad, they would not give me any chemo. The problem has been the high level of capecitabine, 2600mg a day and it was mentioned by the nurses that not many elderly people can tolerate this drug. Since then I have been trying to get it out of my system, diarrhoea and stomach pain being the main problems. However, I am eating better now.