In 1493, Columbus sailed the deep blue sea ...!

For some unknown reason, when posting on Blogspot using my iPad, after I've typed a few paragraphs, the editor stops scrolling and there's no way for me to get to the bottom of my post to add anything further, since there are, of course, no arrow keys ever to be found on an Apple keyboard (one of the many fascinating facts I've gleaned from reading Walter Isaacson's very interesting and well-written biography of Steve "An Enlightened Being Who Could Be Incredibly Cruel" Jobs)!  So, I've given up on Blogspot's fairly useless editor and am using Pages to generate the body of my blog post!  I hope you're satisfied, Google!

Anyway, getting back to the storyline, needless to say, we were all pretty dejected yesterday after our meeting with Dr. Mansfield!  Oh, to finish up my ruminations about why it's probably a blessing in disguise that another round of Cytoreduction/Debulking/HIPEC surgery is not in my immediate future, I doubt that very much of the 2/3 of a colon that I have now would survive the next round of surgery, especially if there were lots of appendix tumor cells plastered all over it!  Another source of gloomy thoughts revolved around the expectation of inevitable eventual bowel obstructions, some of which could be treated surgically, but which also seemed inexorably to point to the need for "nutrition by veins" at some point in the future, basically being fed intravenously forever after, bypassing the taste buds and the whole digestive system entirely, saving you some money on toilet paper, but nevertheless a somewhat unsavory prospect, all the same!  Oddly enough, if I understood Dr. Mansfield correctly, even though appendiceal adenocarcinomas are treated almost exactly the same way that colon cancers are treated generally, colon cancer patients don't seem to get much of a benefit at all from "nutrition by veins" in terms of increased longevity and decreased mortality, whereas appendix cancer patients do!  Even so, I'd still rather not go there unless I absolutely had to!

Today (pretending that it's still Friday, October 12, 2012, Columbus Day), we met with my wonderful colorectal oncologist, Dr. Imad Shureiqi, and came away much more encouraged, mainly because there are still many chemo options available to us!  As a first step, we're going to go back to a regimen of FOLFOX, which is like FOLFIRI, except that Oxalyplatin is used instead of Irenitecan (or "I ran to the can" as some of the chemo nurses call it because of one of it's more notorious side effects!), and which I had for my first 5 chemo treatments last year before my HIPEC surgery.  The FOLFOX was quite effective at stopping the appendix cancers from growing last year, helping to make me a good candidate for HIPEC surgery in the first place!  We only switched to FOLFIRI after I'd recovered from my surgery last year because of the peripheral neuropathy that Oxalyplatin caused in my toes, especially those on my right foot!  The neuropathy due to Oxalyplatin is cumulative and may well become an issue with my new chemo cocktail!  Oxalyplatin was also used (and perfused!) during my HIPEC surgery, after which the numbness and tingling in my right toes in particular became much more evident.  The one additional factor that will be added to my FOLFOX treatments this time around will be the Avastin, which I wasn't able to take during last year's FOLFOX treatments because of my broken left arm, the one I broke idiotically the day after Christmas in 2010!

Hopefully, the FOLFOX plus Avastin will successfully stop the appendix cancer tumors dead in their tracks!  We'll find out after my next CT scan, which will probably occur in mid-January 2013 at the earliest!  In the meantime, we'll also continue to monitor the CA19-9 and CEA tumor markers in my blood work!  In the event that the FOLFOX and Avastin also prove to be ineffective against the appendix cancer tumors, fortunately there are other chemo agents to try, some of which have either just been recently approved for use by the FDA or are very near to being approved by the FDA!  So, as it says in big beautiful letters on the front cover of The Hitchhiker's Guide to the Galaxy, "Don't Panic!"  All is not lost, yet!  I'm still not dead, thank God, and I don't intend to be for quite a while, indeed, God willing!  Thanks again so much for all your wonderful and life-giving prayers for us!  This sickness is not unto death, but is for the greater glory of God, in order that we sons and daughters of God may be glorified through it!  Amen!