I went for my oncology assessment meeting yesterday thinking the hilar node tumour on my left lung could only have done one of three things: got bigger, smaller, or stayed the same. The main variables were whether the radiotherapy and residual effects of the Cetuximab had any effect. There were different questions ready in my head to be asked, depending on the answer.

In fact, there is another possibility. Being focused on the ‘main tumour’ blindsided me to it. The answer to that question was that the hilar tumour is around the same size, just slightly smaller. But it has now been joined by two others: one on the left lung and one on the right lung. They are both very small (~1cm), but the one on the right has doubled in size since my previous CT scan. This is never a good sign.

I thought the conversation would probably revolve around a future pattern where I would undergo cycles of chemotherapy every year of my life. I knew that access to treatments such as Cetuximab might be in doubt because the Drugs Fund has only approved payment for one round. But reading a bit more around this today, it seems the prevailing attitude is that repeating chemo is NOT the preference. It’s seen as toxic in the long-term and probably ineffective anyway.

That might, you think, leave only the alternative option to do nothing.

But there is an alternative, and it is to be enrolled in a Phase 1 experimental trial. That’s the very first stage, where they are trying new drugs or new combinations of drugs, in order to assess how much dosage can be given and what side effects occur. And, of course, whether they succeed in keeping the growth of tumours in check.

I don’t know yet precisely what if any Phase 1 trial would be suitable for me, but I gave my consent to be considered. There’s a very good chance something suitable is out there. My oncologists would not have raised the option otherwise and I live in a city where one of the world’s best cancer research centres is located. I take heart from taglines like “Cambridge science is changing the way we treat cancer”. I believe that it will be something along Cetuximab lines i.e. drug-based ways to inhibit the rapid growth and division of cancer cells by changing the DNA behaviour of the growth pathway.

The facts of the matter are that I have come through six years now of various therapies and surgeries, and I am still in very good if not excellent condition. After five to six years there has been no recurrence of anything from the primary colorectal cancer or the liver metastasis. That’s a cure, give or take a semantic nuance or two.

For males aged 40-49 at the time of diagnosis, there’s only a 50/50 chance of surviving to the +5 year mark. And once you get to 5 years the age-standardised survival curve levels out so you have the same odds more or less of getting to 10 years. I’m one of about 250,000 people still alive in the UK who once received a diagnosis of bowel cancer.

It was also better for me that the lung metastases were metachronous (discovered later) because it may have changed the original decision to do the colon and liver resections (surgery).

The lung tumours are unwelcome but they are very small. They have a long way to grow before “tumor load” would start to affect my quality of life or cause death.

Those are the positives.

Thinking rationally, it’s slightly superstitious thinking to believe the newest drugs are the best drugs. These are only Phase 1 trials, and I don’t even know if there is a suitable one for me (yet). My immune system is crap compared to before and I’m prone to chest infections. I have to inject daily so that I don’t develop any life-threatening blood clots.

But when I tot up my scorecard, the positives today out-weigh the negatives.

Puzzled by the title? Read http://en.wikipedia.org/wiki/The_Myth_of_Sisyphus. It may be an absurd life, but it’s my life. And be grateful that I did not quote Kierkegaard instead and call it “The Sickness Unto Death” 🙂