In Limbo...

The title says it all really...not looking for sympathy or understanding just wondering what is next...

I have had an amazing week after starting back at work full time on Monday and even though I am shattered I feel good that I have not forgotten how to be a project manager. My Boss Richard continues to amaze me with his caring and compassion...he is a good egg!

I went to an amazing wedding last Friday, staying at the venue which was about 50-100 yards from the church, Charlie looked amazing in her white dress and Chris looked perfect for her! I drank too much and danced (which I never ever do)...me and Fran had fun and our great friends Wend and Steve looked after Charlotte..

However, I feel strange and my emotions appear to be shutting down...I have been arguing with Fran and Charlotte a bit more than usual over the past couple of days and now I can barely bring myself to talk...I will make sure Fran sees my blog as finding it difficult to talk...it is certainly not anything Fran has done, how could it be :-)

I have been asking a few questions of the lovely colorectal nurses as don't feel settled with my after care at the moment.

My care with Dr K (my holistic integrative therapist) is fine and I am continuing my daily regime which consists of plenty of green juice made from spinach, lemon, apples and ginger, heavy duty supplements to bolster up my immune system,EPA (fish oil), probiotic powder, vit c, multivit drops, flaxseeds, wheatgrass shots, barley grass, E3 Live (algae), Lecithin alongside colonic irrigation and wheatgrass enemas twice a day...

My local GP surgery especially Dr P is top notch...

So whilst I am pushing hard with my body and praying harder than ever I cant help feeling a little strange. Maybe the fact that I am waiting for my next blood test and first full scan in October - I asked for a PET scan and was told that they work within NHS guidelines...I have the greatest respect for the colorectal nurse team, they do a fantastic job but I am not accepting NHS guidelines when a detection of cancer at an earlier stage can mean it will be easier to treat...at a later stage of the cancer travelling to the lungs/liver it means palliative care!

I have noted the response I received and am awaiting a further response as the lovely lady says she wants to take time to consider the response...I absolutely don't want to upset anyone and be a nuisance but the more I type the more I believe I have to push a little harder...

Our policy is to follow National Guidelines which is a CT scan at 9months if
this shows any abnormality we then address that problem which may involve other
scans including MRI and PET scan.
We never use PET for routine surveillance. I think what you have to realise that
even if a PET did pick up hot spots it doesn't mean that we can treat or cure.
The other routine process is if your CEA rises for 3 consecutive tests, we would
do a CT scan, if scan is normal, we then do MRI, if that is normal we do PET.
You could pay for a PET to be done privately but I feel you need to discuss this
a PET scan is not always the best scan but is specific to some issues, what you
have to remember is that all scans have their specific place in diagnosis,
treatment etc, there is not a superscan that replaces all the others.

I have contacted my oncologist too to ask about trials and any further ideas as I couldn't have my chemo (allergic to 5FU, it could kill me) and received the following reply...

Dear Mr Songhurst,I understand your anxiety regarding your diagnosis and have no problem with you e-mailing me with any questions. As you say the process to get referred sometimes seems very long winded and hopefully I can answer your queries more promptly in this way. Unfortunately currently the only evidence which we have regarding adjuvant chemotherapy (chemotherapy aimed at reducing the risk of the cancer returning following potentially curative treatment) in bowel cancer uses 5FU (or a derivative of the drug) as its mainstay.

Irinotecan is a drug which is commonly used in colorectal cancer in the palliative setting (aimed at controlling the disease when it has already spread). It has been looked at in the adjuvant setting comparing it to 5FU. Unfortunately all these trials have been negative and this drug has not been shown to be a benefit in this setting. So while this drug would be safe to use in your case there is no evidence to suggest that it would increase the chance of the cancer staying away.The trial looking at EPA in colorectal cancer which spreads to the liver is looking to see if this is a safe drug and can affect tumour markers.It is a placebo double-blind controlled trial which means that half the patients will receive placebo rather than active treatment (the doubleblind bit refers to the fact that neither the patient or the treatingclinician know what the patient is receiving). The fact that they are using a placebo means that there is no evidence to suggest that EPA has any activity at all. Most of the research using EPA seems to be looking at something called cancer cachexia which is when patients with advanced cancer loose weight. The evidence in this setting also seems very mixed with the larger trials not seeming to show any benefit for this agent.I therefore think that currently there is no evidence to suggest that EPA (or other supplements for that matter) have a proven role to play inthe treatment of cancer. That being said some people do feel that they would like to try to see if it can help and I have no problem with this.My only concern would be that you do not spend large sums of money on these as many web sites promise the earth with no scientific backing and charge very large amounts of money for their non-proven product.As for clinical trials the only trials which I am aware of as ongoing in the UK in the adjuvant setting are both using 5FU based chemotherapy,one is looking at the addition of bevacizumab (avastin), which has not been shown to be an advantage in other trials, and one looking at whether we can reduce the duration of chemotherapy from 6 to 3 months.I'm sorry that we don't have more to offer at this stage, unfortunately while 5FU is an old drug it still forms the backbone of many treatment regimens currently used in colorectal cancer.If you have any more questions or would like an appointment face to face to discuss these or any other issues just let me know and I can arrangethat for you.

Both team are amazing but I need more or at least help to accept there is nothing more and I just have to wait.

My staging of Dukes C2 PT4 N2 MX with 11/37 nodes gives me a 35% chance of being here in 5 years time (or so the website says http://www.patient.co.uk/doctor/Colorectal-Adenocarcinoma.htm) and whilst I am mainly half full and will be okay tomorrow or the next day I just need time to digest stuff...so please don't feel bad or offer me pearls of wisdom, there are many far worse off than I.

Much Love

Tony