1/ Shortly after my initial diagnosis I inevitably turned to the internet in an attempt to find further information on my condition + ended up punching in an array of search words. It however didn’t take long for me to realize that unfortunately there really is a plethora of information + disinformation located in cyberspace – to this extent I will document my journey in the hope that – perhaps > just perhaps, someone finding themselves in the same / similar circumstances / predicament might just be able to gain some usefull info.
2/ It also allows me to deliver the message to multiple friends and family instead of one on one – which in itself can be quite time consuming.
Using the Blog format allows the reader to visit and return at will digesting at their own speed the information that they encounter.
However if Rule number one isn’t working – STOP 🛑 – reassess and tweak the plan accordingly
In this instance I am referring to pain management – my team and I had a pretty watertight plan / system in place ….. but unfortunately my Cancer is spreading and as such hitting new 🎯 targets in turn wrapping its claws around new pain sensors and nodules.
Suffice to say since departing hospital and going home 🏡 over the weekend – I merely took the pain meds and decided to weather the storm ☔️ – hiding below decks.
Unfortunately my family sometimes places too much faith in my ability to make the right call and forgetting that sometimes these calls might need some reconsidering especially when ones judgment is clouded by said pain and lack of 💤 😴 sleep and in the absence Of professional medical staff monitoring you in hospital …… I slipped into a dark abyss.
Luckily this was only for 2 days as my scheduled dictated that I return back to Oncology to commence another cycle yesterday
As is the norm prior to getting hooked up the team sits together and we take stock of where are we – I realized how bad it was when this consult came to an immediate halt and I was promptly given Morphine injections to bring me back to a haze free sense of reality.
My pain treatment plan was re-evaluated and revised accordingly and then we moved onto the chemotherapy infusions.
By the end of the day – I was physically and mentally drained – but we once again had a functional plan in place and I slept 🛏 like a log
It took me 47 years until I received my 1st chest drain…… by the time I was 49 years and some change ……I had already chalked up a grand sum of three. As such I consider myself to be somewhat of a veteran – having had them gain access to the chest cavity / pleural space through the left chest wall / right chest wall and now the latest one through the right anterior pectoral chest space.
There is nothing glamorous about them – in fact they are primitive and medieval…… but THEY WORK and anybody who has gone through the process will nod in agreement.
The main reason why they are indicated is to relieve pressure – whether it be from fluid or air – and the benefits are instantaneous.
It’s amazing how we take things for granted – being able to breath without thinking about it being a prime example ….. and it doesn’t take very long for the stark reality to set in once this luxury becomes labored as a result of ones lung collapsing.
So here I am 5 days later and the follow up X Ray looks good and everything is coming along nicely …… I am still in hospital and will be for the immediate future as we are waiting for the flow-rate of fluid draining out of pleural space to diminish somewhat
We also have the next round of chemotherapy coming up …… scheduled for the 4th Dec- – updates to follow🤠
As per the above – we once again have fluid buildup in the pleural space of the right lung …. pretty uncomfortable needless to say and a bit of a setback – but then again …. all we can do is roll with the punches
Back to Vincent Pallotti hospital – so my favorite surgeon can put in another chest drain
Monday 13th November arrives and so we start all over again.
Unfortunately the last sessions of chemotherapy did not prove positive results and as per the previous doctors report posted on the BLOG it was found that the cancer had spread and now officially CLASS IV stage.
My team has drawn me up a new cocktail of chemo and hopefully this time round we have better results
The process / schedule is as follows – 2 days of infusions followed by 21 days of nothing …… we then repeat.
Staging helps describe where a cancer is located, if or where it has spread, and whether it is affecting the other parts of the body. Doctors often use tests to determine a cancer’s stage. Staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor:
How large is the primary tumor? Where is it located? (Tumor, T)
Has the tumor spread to the lymph nodes? If so, where and how many? (Node, N)
Has the cancer spread to other parts of the body? If so, where and how much? (Metastasis, M)
Listed below are the general descriptions of the TNM staging system. However, each type of cancer has a separate TNM system. Learn more specific staging information for each type of cancer.
Tumor (T). The letter “T” plus a number (0 to 4) describes the size and location of the tumor, including how much the tumor has grown into nearby tissues. A larger tumor or one that has grown more deeply into the surrounding tissue receives a higher number. For some types of cancer, lowercase letters, such as “a,” “b,” or “m” (for multiple), are added to the “T” stage category to provide more detail.
Node (N). The letter “N” plus a number (0 to 3) describes whether cancer has been found in the lymph nodes. It may also describe how many of the lymph nodes contain cancer. Lymph nodes are tiny, bean-shaped organs that help fight infection. Regional lymph nodes are located closest to where the cancer began. Distant lymph nodes are located in other parts of the body. Most often, the more lymph nodes with cancer, the larger the number assigned. However, for some tumors, the location of the lymph nodes with cancer may determine the “N” stage category.
Metastasis (M). The letter “M” indicates whether the cancer has metastasized, or spread, to other parts of the body. If the cancer has not spread, it is labeled M0. If the cancer has spread, it is considered M1.
Cancer stage grouping
Doctors combine the T,N,M results to determine the stage of cancer for each person. Most cancers have four stages: stages I (one) to IV (four). Some cancers also have a stage 0 (zero).
Stage 0. This stage describes cancer in situ, which means “in place.” Stage 0 cancers are still located in the place they started and have not spread to nearby tissues. This stage of cancer is often highly curable, usually by removing the entire tumor with surgery.
Stage I. This stage is usually a small cancer or tumor that has not grown deeply into nearby tissues. It also has not spread to the lymph nodes or other parts of the body. It is often called early-stage cancer.
Stage II and III. These stages indicate larger cancers or tumors that have grown more deeply into nearby tissue. They may have also spread to lymph nodes but not to other parts of the body.
Stage IV. This stage means that the cancer has spread to other organs or parts of the body. It may also be called advanced or metastatic cancer.
In addition to the TNM staging system, your doctor may use other information to help determine the chance of recovery and decide on the best available treatment. This may include:
Grade. The grade describes how much cancer cells look like healthy cells under a microscope. It also helps predict how quickly the cancer will spread. A tumor with cells that look more like healthy cells is called well-differentiated or low-grade. A tumor with cells that look less like healthy cells is described as poorly differentiated, undifferentiated, or high-grade. Different types of cancer have different methods to assign a cancer grade.
Tumor markers. Tumor markers are substances found at higher than normal levels in the blood, urine, or body tissues of some people with cancer. Doctors and researchers have been discovering tumor markers for many types of cancer that can help determine the best treatment. For some cancers, certain tumor markers may be more helpful than stage in predicting how well a specific treatment will work or the chance that the cancer will spread. Learn more about testing for tumor markers.
Tumor genetics. Many genes in cancer cells may help predict if the cancer will spread or what treatment(s) will work. Recent research studies have found ways to determine the genes involved in many types of cancer. In the future, this information may also help doctors target treatment to each person’s cancer.
Other Staging Systems
The TNM system is mainly used to describe cancers that form solid tumors, such as breast, colon, and lung cancers. However, doctors use other staging systems to classify other types of cancer, such as:
Central nervous system tumors (brain tumors). Because cancerous brain tumors do not normally spread outside the brain and spinal cord, only the “T” description of the TNM system applies. Currently, no single staging system exists for central nervous system tumors.
Childhood cancers. The AJCC does not include childhood cancers in its staging system. Doctors stage most childhood cancers separately according to other staging systems that are often specific to the cancer type.
Cancers of the blood. The TNM system does not describe leukemia, lymphoma, or multiple myeloma since they usually do not form solid tumors. Each blood cancer has a unique staging system.
The stage of a cancer does not change over time. If the cancer comes back or spreads to another part of the body, it has the same stage as the first diagnosis. The more recent information about the size and spread of the cancer is added to the stage.
Sometimes, a doctor might restage a cancer to determine how well a treatment is working or to get more information about a cancer that has come back after treatment. This process uses the same staging system described above. Usually some of the same tests that were done when the cancer was first diagnosed will be repeated. After this, the doctor may assign the cancer a new stage. The doctor then adds a lowercase “r” before the new stage to show that it is different from that of the first diagnosis. However, this is not common.
Some information extracted from the National Cancer Institute
What Is Metastatic Cancer
The main reason that cancer is so serious is its ability to spread in the body. Cancer cells can spread locally by moving into nearby normal tissue. Cancer can also spread regionally, to nearby lymph nodes, tissues, or organs. And it can spread to distant parts of the body. When this happens, it is called metastatic cancer. For many types of cancer, it is also called stage IV (four) cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
When a new primary cancer occurs in a person with a history of cancer, it is known as a second primary cancer. Second primary cancers are rare. Most of the time, when someone who has had cancer has cancer again, it means the first primary cancer has returned.
Cancer cells spread through the body in a series of steps. These steps include:
Growing into, or invading, nearby normal tissue
Moving through the walls of nearby lymph nodes or blood vessels
Traveling through the lymphatic system and bloodstream to other parts of the body
Stopping in small blood vessels at a distant location, invading the blood vessel walls, and moving into the surrounding tissue
Growing in this tissue until a tiny tumor forms
Causing new blood vessels to grow, which creates a blood supply that allows the tumor to continue growing
Most of the time, spreading cancer cells die at some point in this process. But, as long as conditions are favorable for the cancer cells at every step, some of them are able to form new tumors in other parts of the body. Metastatic cancer cells can also remain inactive at a distant site for many years before they begin to grow again, if at all.
Where Cancer Spreads
Cancer can spread to most any part of the body, although different types of cancer are more likely to spread to certain areas than others. The most common sites where cancer spreads are the bone, liver, and lung. The following list shows the most common sites of metastasis, not including the lymph nodes, for some common cancers:
Common Sites of Metastasis
Main Sites of Metastasis
Bone, liver, lung
Bone, brain, liver, lung
Liver, lung, peritoneum
Adrenal gland, bone, brain, liver, lung
Adrenal gland, bone, brain, liver, other lung
Bone, brain, liver, lung, skin, muscle
Liver, lung, peritoneum
Liver, lung, peritoneum
Adrenal gland, bone, liver, lung
Liver, lung, peritoneum
Liver, lung, peritoneum
Bone, liver, lung
Bone, liver, lung, peritoneum, vagina
Symptoms of Metastatic Cancer
Metastatic cancer does not always cause symptoms. When symptoms do occur, their nature and frequency will depend on the size and location of the metastatic tumors. Some common signs of metastatic cancer include:
Pain and fractures, when cancer has spread to the bone
Headache, seizures, or dizziness, when cancer has spread to the brain
Shortness of breath, when cancer has spread to the lung
Jaundice or swelling in the belly, when cancer has spread to the liver
Treatment for Metastatic Cancer
Once cancer spreads, it can be hard to control. Although some types of metastatic cancer can be cured with current treatments, most cannot. Even so, there are treatments for all patients with metastatic cancer. The goal of these treatments is to stop or slow the growth of the cancer or to relieve symptoms caused by it. In some cases, treatments for metastatic cancer may help prolong life.
When Metastatic Cancer Can No Longer Be Controlled
If you have been told you have metastatic cancer that can no longer be controlled, you and your loved ones may want to discuss end-of-life care. Even if you choose to continue receiving treatment to try to shrink the cancer or control its growth, you can always receive palliative care to control the symptoms of cancer and the side effects of treatment. Information on coping with and planning for end-of-life care is available in the Advanced Cancer section.