Into a siding

3 minute read time.

I have often compared having metastatic cancer to being on a train journey. Once you are told your cancer is incurable, you have boarded the train. You know its final destination. You don’t know the route it will take or how long the journey will be.  You hope for a slow journey, meandering through the countryside, with lots of stops, You hope for plush, comfortable seats, and that it will not be a bumpy uncomfortable journey.

I boarded my particular train in February 22. I didn’t initially know that it was the Hotel California type of train, the one you could check into but never leave. That became apparent within a matter of months. My journey has so far been relatively smooth but with deteriorating comfort of late. Readers of this blog will know that my treatment with Pembrolizumab last year had a really good effect on my cancer, but also unleashed a set of life changing consequences via an immunotherapy related adverse event. Good and bad all mixed up in one drug. I definitely don’t regret taking it (more of why, later), but it’s undoubtedly made life hard (more of that later too).  My second liver ablation was also not without consequences as the probe exploded in my liver and left me with internal burns and shrapnel in place for life. But again, I don’t regret going through this.

Yesterday was my regular oncology review, mostly to check progress of my immunotherapy induced symptoms, but also to feed back on the outcome of my recent scan, taken 3 months after the second liver ablation.  I could almost see my oncologist beaming through the phone when she told me the results of the scan. The ablation sites are clear and healing well with no recurrence. There are no new cancer deposits visible anywhere on the scan. In short, there is no evidence of disease and she described me as being in remission. So to return to my metaphor, my train has gone into a siding, one where I hope it will stay for a long long time.

This is the best news I could have had, and one I could barely contemplate in advance, as I didn’t want to be let down. In truth, I knew there was a good possibility this would happen as the pembro had enabled my immune system to not only significantly shrink my two liver mets and destroy the satellites forming around the larger one, but had kept them dormant for the 5 months between me having to stop the treatment, and the ablation taking place. It’s reasonable to assume my immune system will also have cleared up any rogue cells floating elsewhere. Without getting ahead of myself, the pembro might have enabled a sustained remission. It’s developing a good track record for this in other cancers where it has been used for a while (it is fairly new to breast cancer). So I had gone into the call with the usual mix of hope and fear familiar to anyone with cancer. Or probably any fan of sports for that matter.

Prior to the call, I had spent too much time thinking through the negative scenarios, and I am now in the slightly strange position of letting go of the grief and anxiety that had been building since I had the scan. Unfortunately there are plenty of remaining treatment side effects for me to spend my worry energy on. My gout keeps recurring. I can probably see my GP to get some better help with that.  My energy levels are poor and I am stiff and achy, however I have been told my adrenal function is ok and this will resolve over time. I still have neuropathy, particularly in my left foot, but not sure anything can be done about that. It’s probably not surprising given the amount of taxane chemo I have had over my time in treatment.

So, I am going to spend some weeks trying to rebuild some health and fitness. I will try to keep away from this site as using it reinforces my feelings of being a cancer patient. So entries in this blog may become less frequent, unless of course I am jerked back out of that siding and into further progression again.