October/December 2019 - Post-surgery chemotherapy

The first few cycles of post-surgery chemo brought in a new rollercoaster. As usual, before starting, a blood test is performed to make sure that chemo can be safely administered but also to check the tumour marker.

After coming back from Germany, the level of my CA19/9 was at 30 kU/L, i.e. below the 35 kU/L threshold and, therefore, perfectly normal.

The blood test on the day of the first chemo cycle was a bit higher, at 37 kU/L. I didn’t like that of course, but my oncologist reassured me that this type of small fluctuations in the marker is very common and that what we should worry about is a clear upward trend.

That explanation sounded quite convincing, and it did succeed in putting my mind at rest. Until the next cycle.

Indeed, two weeks later, I went back to the hospital for the second round and the blood test revealed a further increase to 47 kU/L – we are still talking about relatively low values of course, and nothing that could be even remotely compared to the almost 3500 kU/L I had earlier in the year, but I would lie if I said I didn’t panic. Could the cancer have already come back within such a short period of time? Or maybe it actually never really went away from areas like the liver, where the original tumour had spread so aggressively? In short, was the disruptive journey to/from Germany and the huge surgery I underwent just a complete waste of time?

I phoned the oncologist and asked whether we could arrange a CT scan to assess the situation. Although he tried to reassure me that the further increase was not necessarily caused by the recurrence of my cancer, he kindly agreed to my request and managed to sort it out for the following morning.

I do not think it is necessary to further describe how I felt during the remaining hours of that day, and the night was even worse. None of the attempts at switching my mind off appeared to work so I quickly resigned myself to a virtually sleepless night.

The following day, however, brought some very good news. A few hours after performing the scan, my oncologist kindly called me to let me know that the CT had not revealed any sign of cancer recurrence. He added that some liquid in the pelvis was found, which was probably caused by the surgery and which could explain the slight increase in the tumour marker. If that was the case, we should expect a decrease back to normal levels over time.

That did not happen at the following cycle, where a further very small increase from 47 kU/L to 50 kU/L was recorded but, eventually, the marker did start to come down, first to 48 kU/L (4th cycle), then to 46 kU/L (5th cycle) and then to 39 kU/L (6th cycle).

My last chemo of 2019 began, very conveniently, on the 24th December, and ended on Boxing Day with the disconnection of the pump. I was hoping for a Christmas present in the form of a further reduction in the tumour marker but that did not happen: the CA19-9 level increased to 42 kU/L. A tiny rise, which did not raise concerns from a clinical point of view, but I was a bit annoyed nevertheless.

The Christmas break was quite relaxing - we spent a lot of time with Jane's family as well as with my sister Ilaria and my nephews Andrea and Alessandro. Unfortunately, my parents could not make it due to health reasons but they still managed to plan a visit in early January. New Year's Eve was a bit emotional: we were up until midnight and, whilst watching the London fireworks, I welcomed the New Year wishing myself an uneventful 2020 and hoping that there will be many other years after that.