April/May 2019 - More good news after cycles 5 to 8

On the 16th April I went to the hospital for my fifth chemo cycle. My mood was mixed. On the one hand, I had to feel optimistic given the very positive results delivered by the scans the week before. On the other hand, I was worried about the tumour marker since so far, it had always increased. Would a further increase somehow cast doubts on the scan results? It seemed like a crazy thought but I found it difficult to get it out of my head.

Luckily, Sarah, the nurse in charge, brought me good news: the CA19-9 marker had decreased for the first time. From the peak of 3344kU/L reached at the fourth scan, the marker now measured 2864 kU/L, a reduction of 14%. I was very relieved.

The next two cycles delivered even larger reductions. By the end of the 7th cycle, the marker had fallen to 1394 kU/L. This was still way above the threshold of 35-37 kU/L but the improvement was clearly very noticeable.

On the 28th May, I had my eight cycle. I approached this cycle knowing that it would be the last one before the next set of CT and MRI scans, which were due the following Monday. For this reason, I was particularly nervous about what the blood tests would reveal this week. Specifically, a good result would have made the wait for the next scan much easier to bear. A bad result, i.e. an increase in the tumour marker, would have made the rest of the week a nail-biting event.

As usual, I was not alone during the agonising 2 hours between 9am, when the blood test takes place, and 11am, when the results normally arrive. My old friend Marco, who studied with me in Florence, came to visit to be in the room with me. In Florence we were extremely close, he was very popular with girls being particularly good looking and extremely prone to falling in and out of love. To the external observer, it would have been difficult to track down the state of his love life at any point in time. Not for me though since we spent a huge amount of time together, whenever he was not busy with the next girl!

Now, despite the fact that we see each other very rarely (he lives close to Geneva), as is often the case between very good friends, you can just pick up from where you left it off, as if the last get together had happened the day before. It was simply great to have him there at this critical time.

And he was not alone – my friends Steven and James also came over. They live in London, we have been friends for more than 20 years and we have this great passion in common, tennis. We used to play every Saturday, together with two other close friends, Juliet and Emily, until I got diagnosed.

And, needless to say, Jane was at the hospital all along too. As always.

All of this made the wait much more bearable, even though on several occasions, I did find myself switching off and panicking about what results the blood tests would deliver.

Luckily, at roughly the usual time, Sarah brought me some good news. All the blood tests looked fine, which meant I could go ahead with the chemo as planned, and crucially the CA19-9 marker had gone down from 1394 to 827, a reduction of 41% compared to two weeks before. I was over the moon and so was Jane and the other friends present in the room.

I immediately shared the results with my parents and my sister. We all agreed that we could legitimately hope that, on the basis of the evolution of the tumour marker over the last four cycles (as shown in the chart below), the new set of scans due the following week would deliver further good news.