My latest ERCP

We resumed systemic chemotherapy treatments on July 18th. Here is an update on how things are going. Thank you for your prayers.

CEA

 

One of the things that will trigger our decision to restart chemotherapy is a rise in my CEA. CEA is a blood test that measures active growing cancer. A measurement under five is considered normal. This chart shows what my CEA was doing in early July. You can see that it was within the normal range and then began a slow rise. At some point cancer really started to grow and it took off. It is important to note that CEA does not always serve as a good marker for active, growing cancer. At some point, it may stop being an accurate reflection of what is happening. In my case it has remained a pretty consistent marker of what is going on inside my body.

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Reverse Course

The highest point is right before we started chemotherapy. The decline in CEA is an indication that the treatment is having some effect on my cancer. It is encouraging to watch the numbers change so dramatically. This is not the reality for many people. I continue to be humbled by the way my body seems to respond to chemotherapy.

Scan Results

A few weeks ago we did some scans. The scans serve as another source of information regarding how the treatment is going. My latest scans showed,

• LIVER: Wedge-shaped area of hypoattenuation in segment 7 has diminished in size measuring approximately 5.8 x 3.0 cm, previously 6.8 x 3.7 cm. There is no evidence of diffuse disease. No new focal hepatic lesion.

• LYMPH NODES: A upper abdominal aortocaval node is mildly prominent on the prior exam, previously measuring 0.9 cm is now 0.5 cm short axis.

It is important to understand that different techs are measuring these lesions. They do not measure from the same place each time, so it is reasonable to expect a certain amount of discrepancy in their measurements. However, anything that shows decreasing size, or stability is a good sign.

My Quarterly ERCP

Ever since the hepatic artery infusion pump did damage to the bile ducts in my liver I have been dealing with significant issues in my liver. Every three months I need to have an ERCP where they go in and swipe the stents in my bile ducts to ensure everything can flow clearly. Many people have asked how they accomplish that.

It is an outpatient procedure that uses a scope which goes through my mouth and ends up in my liver. Kind of crazy, huh? Once we get going the whole thing takes about thirty or forty minutes.

What amazes me is how different I feel immediately after the procedure. In the days and weeks leading up to an ERCP my liver is not able to get rid of the waste it normally does. This causes me to be tired and I end up with brain fog. It is hard to do much of anything. There are several symptoms that let me know the stent is getting clogged, and then infected.

Again, we watch the results of a few blood tests to serve as markers. My ALT is one of them.

In the graph on the left you can see my ALT spike. This is one of those times my stents were clogged and infection was raging in my liver. We were able to treat it with antibiotics that time.

I watch these numbers very closely. They, along with how I feel give me an idea of what is going on with my liver.

I am very thankful for all the doctors and nurses who help take care of these things.