Home > Blog, Cancer Update > Oncology 19.1 – The game just changed.

Oncology 19.1 – The game just changed.

Last weekend I was admitted to hospital with severe abdominal pain. The pain had progressively worsened since my last round of chemotherapy (round 66) to the point where on Friday last week I had to leave work early. By the Saturday morning, the pain was bad enough that I thought I should get it checked out. At the time, I was worried about the possibility of bowel obstruction or even a small perforation of the bowel given just how bad it was. Once admitted, I soaked up a reasonable quantity of opiates in order to gain some control of the pain, and it was decided that a CT scan was in order given just how much pain their was.

By Sunday morning, the pain had improved greatly and the CT showed that there was no obstruction, just an incidental finding that there was a significant amount of growth in one of my retroperitoneal lymph nodes since the previous scan 3 weeks earlier. There was also some associated stranding around that area which means there is some kind of inflammatory process going on. It was unclear at the weekend what the significance of what that was, but it was thought I had a small bleed into one of the cancerous lymph nodes and that may have been responsible for the pain. Given that it had improved fairly significantly, I was discharged.

Two days later, after some extensive discussion between the liver surgeon looking after me and some senior radiologists, the interpretation of that scan changed, and with that change came significant implications.

That cancer has dedifferentiated and there are multiple nodes with extensive growth in the three weeks between scans…..

It has stopped responding to chemotherapy….

The pain that I have is malignant pain from the cancer, and the day I was expecting to come for a number of years now has just arrived……

This is a major game changer for my treatment, and what has become apparent over the past couple of days is that a large number of senior clinicians in surgery, radiology, medical oncology and radiation oncology have spent a considerable amount of time in creating a plan to address this new development. I’ve survived 66 rounds of chemotherapy, it is uncharted territory, and we are in the realms of best guess treatment. I have no doubt for a second that I am in the hands of some of the best clinicians in the country, and their response to this new development is aggressive.

Chemotherapy for now has been stopped. In the next two weeks I am starting on a 3 week course of radiotherapy. It is intense stereotactic ionising radiation focused on the area of the retroperitoneal lymph growth (40 gray over 15 fractions). The goal is to get that under control, and if that is successful, then start back on chemotherapy, this time FOLFOX. This is a combination of agents previously used, 5-fluoro-uracil, and oxaliplatin. And if that is successful, then we will see what can be done about the liver lesion from a surgical perspective. The potential of ablation (as we previously planned prior to this week) will be back on the table.

This latest development is somewhat bittersweet. We are revelling in the fact that Hannah and I will be parents for the first time in January, and that I have recently been offered a general surgical registrar position, yet at the same time having the bitter reality of my diagnosis rubbed into my face. It is a juxtaposition of highs and lows, one where the lows reveal just how high the great moments in life are. I find it surreal that I am already in love with a child I have not met, and the recent events in my life highlight just how precious bringing new life into this world is. This child may not know me, but I pray to God that he or she will have the opportunity to know just how special they are in his or her parents eyes.

The brutal reality of life reveals just how beautiful it can be as well; if it wasn’t for the lows, then I would never appreciate the highs as much as I do.

Despite the outcome of all these events, this child will be loved more than he or she will ever know…

Until next time….

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Categories: Blog, Cancer Update
  1. Tori
    August 2, 2013 at 5:13 pm

    My husband has Stage 4 bowel cancer. His has metatisised to his liver, lungs, and spine. He’s screwed really with tumours in his spine. However, God has been faithful to him/us and when diagnosed in November 2012 the oncologist didn’t think he would see Christmas. We are now in AUGUST! On Monday he will have his 17th FOLFOX treatment. It’s been kind to him so far, just watch out for the peripheral neuropathy from the oxaliplatin. Rob’s disease is currently stable which we praise God for, but we know how fragile life is, after a stent put in his bowel to stop obstruction, perforated the bowel wall in February and he almost died. We have been blessed with a wonderful oncologist here in Tauranga and we are so grateful for a brilliant team at the cancer centre here.

  2. Kirsty Harkness
    August 2, 2013 at 5:31 pm

    My love and hugs and prayers and thoughts are with you Jared! You are one brave man!

  3. August 2, 2013 at 5:45 pm

    No matter what happens Jared, you have already created a legacy of insights into your thinking, heart, character and soul that we have appreciated and I’m sure your family will always enjoy. Most of us have not put anywhere near the same effort into sharing what makes us tick.

  4. Alana
    August 2, 2013 at 8:05 pm

    This should come with a warning to wear waterproof mascara! Shane and I are sending much love yours & Hannah’s way.

  5. Dyana Parore-Connell
    August 3, 2013 at 1:50 pm

    Wow. You are one brave man, sorry to hear of this major setback . Fingers crossed you get through this next part of your journey. Hugs and prayers to you and Hannah.

  6. murray
    August 3, 2013 at 4:31 pm

    Love ya bro, prayer for more miracles for you. May God bless you and be with you and your family during these changing tides O

  7. Dirk
    August 4, 2013 at 12:05 am

    Jared you are one fine example of a very brave man. Many fight in wars overseas and we admire them for being so brave and here you are in our midst, the bravest of them all. May our Lord Jesus Christ, protect you and keep you and make His face shine upon you and give you His peace.

  8. Sarah
    August 5, 2013 at 5:08 pm

    Gutted about this latest news, but as always your amazing appreciation for life inspires. You and Hannah are always in our prayers. Praying the treatment will be effective.

  9. Rob Hart
    August 8, 2013 at 11:06 am

    Jared, May the Lord continue his many Blessings upon you. Because I know you see them, even in the dark times such as this.

  10. april diaz
    August 8, 2013 at 11:04 pm

    I originally followed u on twitter for your sense of humor. You are a really funny guy. I pray that your humor and strength carry you through this time. If u ever desire any treats or anything from the US, don’t hesitate to ask. Wishing u infinite prayers and blessings. April

  11. Maree
    August 12, 2013 at 11:37 pm

    Continuing to pray for you and Hannah, may the Lord give you strength and much love and encouragement from the Holy Spirit. xx

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