CA125 = 12.5: Wednesday, June 3, 2009

I'm just back from another *fun* visit with Dr. E. And just like last time, there is great news and a bunch of new business on which to report.

First, the good news: As you've probably figured out from today's post title, my CA 125 level, which is just one kind of antigen and is therefore not 100% predictive of the prevalence of cancer in my body, has dropped from 26 to 12.5 since the last time it was measured. If you'll recall, anything under 35 is in the normal range but Dr. E wanted my CA 125 to drop below 20 during the course of my treatment. So, needless to say, both of us are thrilled to see that I'm responding so quickly after just two rounds of chemo. And regardless of the questions that remain about additional cancer in me, which won't be answered until we get the pathology back from my next surgery, I firmly believe that this result means that there is no cancer left in my body at this time. Yay.

In addition to my great CA125 level, Dr. E was thrilled to see that my tumor is 92% estrogen and 79% progesterone responsive. What does that mean? It means that by putting me on anti-estrogen meds (either Tamoxifen or Femora) for the rest of my life (I'm not jazzed about a life-long medicine so we agreed to discuss it again at my five-year wellness check-up), that should hamper the development of any additional estrogen-based cancer in my body. Again, even though I know I should be, I'm much less jazzed about this news than Dr. E since it means more drugs in my body.

Next, the new business: I filled Dr. E in on the details of my meeting with the genetic counselor. He agreed that it was a good approach to do the micro satellite instability testing (MSI) and immunohistochemistry (IHC) on the tumors removed during my first surgery in order to determine if further blood tests are necessary to see if I have the HNPCC mutation (or Lynch 2 syndrome as it is also known). He also seemed to agree that the likelihood of a BRCA 1 or 2 mutation is unlikely given that there is no breast or ovarian cancer on my mother's side of the family and that the only possible genetically-linked breast cancer on my father's side is my great grandmother's, who was post-menopausal when she developed it. Given that my risk for colon cancer seems greater than any other, due to the presence of it in my mother's family, Dr. E also wants me to meet with one of the leading colorectal surgeons in the area to have a colonoscopy (woohoo!) with her before my next surgery, which is scheduled for Thursday, July 9. That way, if she finds anything suspicious, she can be with him during the surgery to take care of what needs to be done to my colon. Kind of like a tag team WWF match, right?

What else? Oh, so I told him that I ignored the chemo nurse's orders to curb exercise due to my low white count and he was surpisingly supportive of that decision. He agreed with me that I shouldn't act sicker than I feel but to watch what I do in the heat of the summer months. No shit, Sherlock! I might be a little defiant but I'm not a complete idiot.

So, that sums up the latest. I guess it was a good appointment but it has left me emotionally drained. There is this nagging little voice in my head that is 100% confident that this thing has already been beat down by the first surgery and first rounds of chemo and that with the right attitude, my new diet, exercise, and Eastern medicine (accupuncture), I could leave all my parts as they are and live a healthy, happy life from this point forward. But I know that Dr. E, my parents, and probably many others would throttle me if I changed course now so I guess I'll shoulder on.