A CT scan on 1 May 2015 showed "a mixed response", the solid tumors in my left lung had shrunk but a new metastasis to my left shoulder muscle that has been causing me much pain in my left armpit. I had to take 2 panadols every 6 hours to ease it. Dr Nagrial consulted his colleague the radiation oncologist Dr Roland Alvandi who recommended radiation to ease the pain. I had to withdraw from the Trial that I was undergoing to do this radiation - so no more Docetaxel. Cancer pain is when the cancer cells hit nerves. Radiation is to shrink the cancer cells to pull them back from the hits. It is not a cure but a relief. I had that in my hip bone metastasis in September last year - see my blog. Radiation relieved it, and the recent CT scan showed it was under control.
I had increasing pain for the past few weeks but it got really bad in early May. Just before that some close friends visited me. Here are some.
Two old friends Pheng Beh and Margaret Chum with me and Yokelin about late April when my pain began increasing.
This is Ernest Menezes, an old St Johns alumnus and me.
What is metastasis?
I had increasing pain for the past few weeks but it got really bad in early May. Just before that some close friends visited me. Here are some.
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Two old friends Pheng Beh and Margaret Chum with me and Yokelin about late April when my pain began increasing.
This is Ernest Menezes, an old St Johns alumnus and me.
What is metastasis?
The radiation is for 10 sessions, from 7 to 21 May except for Mondays. On 13 March I have had 3 sessions - the pain has eased some and I can sleep better.
Who says cancer pains needs to be borne stoically? I can understand if there is no pain relief that cancer patients prefer to just die! I have prepared instructions, witnessed by my GP and a Power of Attorney of how no heroic measures be taken to prolong my life when the time comes. This is the document I had to fill.
Advance Health Care
The New South Wales Heathcare is excellent. I am being treated in Westmead Hospital, a Sydney Uni Teaching Hospital as a public patient. For ongoing Brain MRIs I see radiation oncologist Dr Nitya Patanjali at another Sydney Uni Teaching Hospital, The Royal Prince Alfred, where my elder son Kerwyn is also a radiation oncologist. but of course he cannot treat me.
At Westmead I have Dr Phillip Lee and his colleagues in pain management, They are excellent. I thought I would just die from pain, but Dr Lee and Dr Albandi have given me hope that the pain will be relieved.
Pain Relief
Here I say something about pain relief that may help patients not to give up.
The easiest is 2 panadols every 6 hours. It does not give absolute relief but dulls the pain. You need radiation to really ease the pain, and I am getting the 10 such sessions to my muscle metastasis. On top of that I take the anti-inflammatory Dexamethesone and the nerve medicine Lyrica (both need prescriptions).
There is the oral morphine based medicine dilaudid that I once took for my pelvic radiation and it was effective to control pain, but for this muscle metastasis it did nothing so I stopped using it. Human cancer cells are complex indeed!
By Friday 15 March I would have had 6 sessions of radiotherapy - it has helped! That together with the medicines allowed me to sleep better. Thanks to the Registrars of Dr Albadi (Dr Lucinda Morris) and Dr Lee (Dr Claire Zachulski) for their care and advice.
Palliative Care is what the specialty of pain relief and quality of life is about. Many people believe palliative care marks the beginning of the end of life. But here is a quote from the previous website.
"Palliative care is about living for as long as possible in the most satisfying way you can, within the limits of your illness. It’s not simply about dying. While some people may only use palliative care services for a few weeks or months, the number of people receiving care for several years is increasing.
Because improved treatments can help stop the spread of cancer and relieve side effects, cancer may be considered a chronic (long-lasting) disease. You can have palliative care while you are having active treatment. One reason that some people don’t access palliative care services early – or at all – is because they have the fear or misconception that by doing so, it will mean they have given up hope or are going to die soon.
The reality is that some people do die from cancer. As people draw closer to death, the end-of-life care aspect of palliative care becomes important."
The radiation allowed us to have social life with old friends in Eastwood today, Saturday 16 May:
Prof Doan Hoang and his wife Bich Nguyen.
Social life is important for rehabiltation. If a score from 1 to 10 means 10 is the worst ("might as well die") and 0 means no pain, I am now at level 4 daytime and level 3 night time. I can now sleep better.
Pain management today is much better than 10 years ago. It is now a medical specialty in its own right - The decrease in my pain 1/2 way in my radiation is good. I ate a lovely vegetarian omlette today Sunday 17 May with my younger son's family in the Topiary near my house. They stayed over in our house last night.
This is the dish I had.
The Topiary is where I meet my friend John Hill for lunch monthly where we talk about ethics, philosophy and religion.
It is quality time. We don't miss it until we do not have it.
The New South Wales Heathcare is excellent. I am being treated in Westmead Hospital, a Sydney Uni Teaching Hospital as a public patient. For ongoing Brain MRIs I see radiation oncologist Dr Nitya Patanjali at another Sydney Uni Teaching Hospital, The Royal Prince Alfred, where my elder son Kerwyn is also a radiation oncologist. but of course he cannot treat me.
At Westmead I have Dr Phillip Lee and his colleagues in pain management, They are excellent. I thought I would just die from pain, but Dr Lee and Dr Albandi have given me hope that the pain will be relieved.
Pain Relief
Here I say something about pain relief that may help patients not to give up.
The easiest is 2 panadols every 6 hours. It does not give absolute relief but dulls the pain. You need radiation to really ease the pain, and I am getting the 10 such sessions to my muscle metastasis. On top of that I take the anti-inflammatory Dexamethesone and the nerve medicine Lyrica (both need prescriptions).
There is the oral morphine based medicine dilaudid that I once took for my pelvic radiation and it was effective to control pain, but for this muscle metastasis it did nothing so I stopped using it. Human cancer cells are complex indeed!
By Friday 15 March I would have had 6 sessions of radiotherapy - it has helped! That together with the medicines allowed me to sleep better. Thanks to the Registrars of Dr Albadi (Dr Lucinda Morris) and Dr Lee (Dr Claire Zachulski) for their care and advice.
Palliative Care is what the specialty of pain relief and quality of life is about. Many people believe palliative care marks the beginning of the end of life. But here is a quote from the previous website.
"Palliative care is about living for as long as possible in the most satisfying way you can, within the limits of your illness. It’s not simply about dying. While some people may only use palliative care services for a few weeks or months, the number of people receiving care for several years is increasing.
Because improved treatments can help stop the spread of cancer and relieve side effects, cancer may be considered a chronic (long-lasting) disease. You can have palliative care while you are having active treatment. One reason that some people don’t access palliative care services early – or at all – is because they have the fear or misconception that by doing so, it will mean they have given up hope or are going to die soon.
The reality is that some people do die from cancer. As people draw closer to death, the end-of-life care aspect of palliative care becomes important."
The radiation allowed us to have social life with old friends in Eastwood today, Saturday 16 May:
Prof Doan Hoang and his wife Bich Nguyen.
Social life is important for rehabiltation. If a score from 1 to 10 means 10 is the worst ("might as well die") and 0 means no pain, I am now at level 4 daytime and level 3 night time. I can now sleep better.
The Topiary is where I meet my friend John Hill for lunch monthly where we talk about ethics, philosophy and religion.
This is now Wednesday 20 May of my radiation.Tomorrow is the last session. Finally I am well enough to accompany Yokelin to The Top Ryde Mall where I feasted on Donuts and coffee.
It is quality time. We don't miss it until we do not have it.
Dr Lucinda Morris has arranged for me to go back to my medical oncologist Dr Nagrial in the first week of June. I hope that he can find a chemo that will hold the tumors - eliminating them is not yet possible in the current treatments. So palliative care will be needed.
People have asked me how my mental attitude deals with a chronic cancer that does not go away.
This website has answers, including the now broadened idea of palliative care. It is known that cancer patients who receive palliative care early have better quality of life. Some patients move in and out of palliative care as their situations change.
Added on Friday 22 May: My pain is now only 2/10 daytime, and 1/10 night time when I sleep. Apparently it takes a week or two for the radiation to have full effect. I still take Lyrica at the dosage prescribed by Dr Claire, and panadol, but now much less of the latter, twice a day. It is good to feel much better!
Added on Thursday 4 June: Pain is now 1/10 daytime, almost none at nighttime. Still taking Lyrica but only 2 panadols with breakfast. Drinking more water seems to help.
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