It has been two fantastic months since my last radiation treatment. Lately I’ve been feeling better than I have in seven or more years. So much has happened in these couple of months. The biggest thing was that I traveled 30 or more hours there and back again, to upstate New York for my Mom’s 80th birthday celebration. I got to make the whole trip with my sister, and it has been so long since we have had a chance for long conversations together, with a bonus of singing and music sharing. She is such a perfect travel companion!

I had a happy time visiting relatives there who I love so much, and I tried my able best to eat an entire amazing strawberry rhubarb pie my aunt R. made for me!

We also celebrated our 29th wedding anniversary in high style, going to a mediterranean restaurant we hadn’t visited in 20 years. The food was so good I had to wonder why we haven’t been back there in so long, the food was always the best!

I took road trips to visit some of my best friends in Richmond VA and Hope Mills NC, literally smelled the roses, walked many miles, ate in more fantastic restaurants, and enjoyed being 12 weeks off chemotherapy. I hoped I would be free of chemotherapy and cancer forever!

The cancer community uses the word scanxiety to describe the feeling of unease before a day of scanning, and it is perfect. I have been a bit anxious for the last few days. Today I was scheduled for my first CT scan since the radiation, to gauge the effectiveness of the treatment. The blood work showed my liver enzymes were comfortably in the desired range, but my CEA was 10, up from 5.1 on May 3rd. That value doubling in 3 weeks is not a good sign. When I met with my oncologist I could tell there was something bad in the CT results, because he had tears welling up in his eyes. The scan revealed two peritoneal tumors, one 1.7cm and the other 1.9cm, and several additional suspicious nodules, all appearing since the previous CT. This is pretty aggressive growth in the 12-week absence of chemotherapy.

This is not an operable condition, there are just too many nodules. Our best hope is to use chemotherapy to slow or reverse the progression of disease. There are studies we might be able to enroll in, that use novel immunotherapy approaches, so that is one path to explore. Otherwise we do FOLFIRI + Bevacizumab chemotherapy and hope for the best. I asked the oncologist, with treatment how long I might expect to live and he answered, about two years is the median so some much less, some much more.

There was good news from the radiation oncologist. Even though this CT was done earlier than is usual after the radiation treatment, the liver tumor appears to be stable and the scar tissue left behind is shrinking as the liver heals better than expectations.

Another bright ray of sunshine is that Natera agreed to sequence my tumor and develop a blood test showing the amount of circulating tumor DNA in my blood samples. This can be used to determine whether a chemotherapy regimen is working to reduce more metastasis.

I’ve been reading a book about starving cancer and I’m wondering if I can help the chemotherapy work better by feeding the cancer ketones instead of sugar, fasting to activate autophagy, cutting all sugar out of my diet, and eating more cruciferous vegetables. Of course, peritoneal cancer comes with side effects of malnutrition, so it is something that would have to be realistic and monitored. And I learned the hard way in the last chemotherapy rounds, that an empty stomach was a nauseated stomach. So far today it has worked well, my blood sugar is 90, I made cast iron roasted chicken, a bit of stir-fried broccoli on the side, and drank lots of water to expel the iodine contrast medium.

And so I am sorry to say, it’s pretty grave news I have to share today. I’m doing pretty okay with the news though. After two heart attacks and now three kinds of cancer (colon, liver, and peritoneal), I’ve gone through all the emotions and stages I think I can go through already about my own mortality. I’ve developed a dark sense of humor about it that gets concerned looks from my family. Most of my worries right now are about the people I leave behind.

We all have a finite number of days ahead of us. My situation is no different, just with some fewer days. I resolve to enjoy it more, appreciate the little things, and live my life with gratefulness and joy for all the gifts I’ve been given.