End of the First Cycle

Well, my first cycle did not have much to contribute to the state of my wellness. We had a brief discussion of the treatment and its side effects, including the chemo brain. Unfortunately, the was a screw up and I didn't get any blood tests results until until after the oncologist's visits. I'll get the blood tests results next week. In the meantime, I'll start another cycle next Monday. The chemo brain will be treated by the temodar, whether its caused by cancer or is a result of fatigue.

The best news of the week is our acquisition of "Angel," a Cairn Terrier rescue pup from a kennel in Brevard, NC.



Angel is a 3-year old female, who has had 2 maybe 3 litters, and has had no training. We'll have plenty to do to get get her up to speed, but a super-abundance of love to repay for the efforts.

Day 23: Ending the Third Week ...

Ending the third week tomorrow; I'll be seeing my oncologist this Thursday. I have something something new to talk about with her. I discovered a new (to me) side effect, which I've been informed is called "chemo brain."

While I was at a mid-day "pig pickin' party" yesterday, I found I was having difficulty recalling certain words and became hung up completing sentences. I didn't think it was drink related -- less than than three ounces of a white wine, but it felt a bit like I'd had 5-6 glasses of a 14%+ red many, many years ago, except the effects where limited to my brain. A friend told me it sounds like "chemo brain."

Thanks to the Internet, it was discovered at UCLA in 2006, but didn't really hit the public press until July 8, 2009, where chemo brain was described as "... a trend between chemotherapy and cognitive abilities, but it hasn’t identified a cause." (L. Fayed, How to Manage Chemo Brain)

At that time, the ACS estimated that about 25% of patients who show these symptoms do so because of chemotherapy, now referred to as a "cognitive deficit." Seems it that it carries over into word processing too. Doesn't seem to effect my listening and reading vocabulary.

Wonder how it will effect my golf game?

Days 10 & 11: So, so ...

Hit some golf balls yesterday and will probably got out again later today. The fatigue factor seems to have settled in at about 75%. I do well when not exercising, but tire fairly quickly doing anything moderately strenuous. I also have cold-like symptoms, many sneezes.

This morning, I took Cookie on a long walk, longer than intended when I got lost in an unfamiliar part of town. If you know anything about Pinehurst, you probably know that many of the streets are circular, which makes it pretty easy to get turned around. Eventually, I hit one of the few straight radial streets going 180 degrees from the way I thought I was walking. Fortunately, I made a good guess which way to turn and got going toward home again.

Day 9: Great Day ...

Fabulous day here - Carolina blue skies and and mild weather! As promised yesterday, I went golfing this morning. As hoped for yesterday, my stamina was not not. I did OK for the first seven holes, then the bottom fell out and I quit after nine.

I'll just keep nicking away at it and see how long it takes to come back.

Day 8: Progress ...

Feeling reasonably good today; no evident symptoms. About 10:30 AM, I went over to the golf club and hit 50-60 practice balls. Afterward, I did feel some fatigue, but not enough to prevent me from booking a tee time for tomorrow. I'll take a cart in case I feel the need to bail out.

Later, on the Internet, PLX4032 was in today's OncologySTAT with a repeat of the prior Phase I trial and a more recent article from the 2009 October 1 Elesvier Global Medical News, "Targeted Therapy PLX4032 Takes Center Stage in Metastatic Melanoma." Like Gleevec, PLX4032 requires a gene mutation, BRAF/V600. Unlike Gleevec which requires requires C-KIT mutation which occurs in about 5% of melanoma sufferers, the V600 mutation occurs in about 60% of patients.

A Phase II trial is expected to be completed by the end of 2009, with a randomized Phase III trial to begin shortly thereafter. Something to keep in mind for possible next steps.

Day 7: Fatigue ...

Well, I do have to admit to some fatigue today. I went to the Fitness Center this morning and found my normal workout to be a bit too much. I managed everything but the second set of reps came down from 15 to 12 on three of the 8 machines and I was puffing more than usual after the elliptical run.

I'm home now and will shower after finishing this blog post - feels like a return to bed would be welcome after the shower, but I'm going to to try to maintain my normal routine. It's not a nap if I fall asleep in the chair while reading, is it?

Day 6: After the Chemo...

My first day without chemo meds the night before began at 3:30 AM when I woke up with major stomach cramps, followed by five hours of distress. I'd been told to expect fatigue on the sixth day. I don't have any fatigue, unless you call voiding your bowels repeatedly fatigue - I certainly got tired of that concept quickly.

I called off my 12:30 golf game at 8:00 AM, but by noon I was thinking, well, I probably could have played. It was raining, so I didn't pursue this thought very long. I'll be monitoring progress and post anything of interest. October 19th starts the week that I should expect negative impact on my blood counts. My next doctor's appointment is October 22, 2009.

Day 5: Last Day with Temodar

Here we are, on Sunday morning. I took my last dose of chemo meds last night; no evident side effects as of 10:14 AM. Walked Cookie, followed by grooming (not her favorite event), then I went to the Fitness Center.

After lunch, we're going to the movies to see "The Informant," then home for the golf matches on TV. Tough day.

I'm waiting to see what happens tomorrow and the next day when I've been told I will feel very fatigued. If I don't, I will really wonder if I got $2,500 worth of drugs or just some empty capsules.

Stay tuned.

Day 4: Normal, normal, normal...

Sorry I missed the post yesterday. A normal day, a long walk with Cookie, then 18 holes of golf. I slopped around the front nine with three pars in the middle surrounded by 6's and 7's for a 47. I was more consistent on the back nine, which I think is more difficult, for a 44.

Renee sauteed a very nice trout for dinner and I snitched a glass of 2007 Firestone Riesling, very good at a ridiculously low cost.

Day 3: Same-o, Same-o

Again, a good nights sleep followed, today, with a trip to the Fitness Center. Still no evident side effects, although I'm feeling a little less energetic at the moment. So far, I'm finding this an interesting experience.

I've stopped aspirin - I didn't know it, but it take two weeks to get it out of your system. The third week in the four week temodar cycle is when your blood system takes the biggest hit, if it is going to happen. I'll see the doctor for tests in the fourth week to determine what's needed next.