The plan

December 30, 2021. I made it through my first 2-week, twice daily dose of Xeloda with quite a few side effects that I wasn’t expecting so soon into the treatment:

• tender mouth
• fatigue
• neuropathy in my fingers
• poor appetite
• weight loss
• sleeplessness
• sunburn-like stinging face
• dry eyes
• dehydration

It made me wonder, “Why am I taking Xeloda in the first place?”

After all, I took Xeloda for 9 months as adjuvant therapy (therapy applied after initial treatment for cancer, especially to suppress secondary tumor formation) in 2020, and the cancer came back. How does it make sense to take it now to treat a secondary tumor that is inoperable? Yes, the dose is higher this time and it’s taken for two weeks with a week of recovery rather than one week on/one week off. Still, I really struggled to make sense of it all.

It also sucked that I had to start my second round on Christmas Day. So, I gave myself a little present and didn’t take the morning dose. We were having friends over for an early dinner. I wanted a clear head and a glass of champagne with dinner. It was delightful to be a little bit naughty.

On Tuesday, December 28, Steve and I made the trip to UCSF for labs and a 1:00p appointment with Dr. Rugo. It was an easy drive down, and Rugo was on schedule, so not much waiting around.

I shared my concerns and list of side effects. She told me the sunburn-like irritation was from past over exposure to the sun. Apparently Xeloda can bring out sun damaged areas causing irritation. Who knew?

Next, she measured the mass, and remarkably it is slightly smaller! Wow! After just one cycle of treatment. The little voice in my head is saying…”I guess taking Xeloda again isn’t so bad after all.” Still I questioned the logic of it, and Rugo explained that the goal is to control the disease with the least amount of toxicity. “We aren’t going to eradicate it. We are just trying to control its growth.”

The plan is to go back to one week on/one week off to see if it will ease the side effects. If it does make a difference after one cycle, then she might up the dose a bit going forward. If the Xeloda doesn’t continue to control the disease after three months of treatment, other therapies will be considered.

Steve and I left feeling hopeful. For the last month it has felt like we were living under a dark cloud, but as we walked out the doors of UCSF that cloud had lightened up. It was a good feeling. Really, really good.

And then there was a bit more of good news. The lab results of the tumor marker for the Carcinoembryonic Antigen posted to my chart yesterday at a value of 8.9. The standard range is <5.1. But, the value on November 10 was 9.6. I honestly had a hard time believing what I was seeing. I think Dr. Rugo was surprised too because she posted a note to the test result today at 12:30a (that’s not a typo) saying, “Nice to see the decrease in the tumor marker so quickly!” I thought so, too, but her remark really confirmed it for me. The cloud continues to lighten.

Who knows, my friends? Maybe this is a good sign for 2022. It could be magical and miraculous.

Happy New Year!

You only live once, but if you do it right, once is enough. —Mae West