2014-02-15: 23 - A Victory

我与癌 (23-马到成功) 自2011年3月的再次复发到今日已近3年。这3年来，我的五脏六腑犹如中国被污染的山山水水，虽然治理不断，却还从脚下漫延至漂浮的雾霾；一轮轮化疗的狂轰滥炸葬送无数癌细胞，但其中极其顽强者可以经变异产生抗药性而存活，并无限制繁殖。 2013年底的PET-CT结果显示，有旧肿瘤已缩小，也有新肿瘤出现，有点此起彼伏的阵势。说明我的癌为了能于我共处，不惜千变万化，与我同甘苦共患难，还要置我于死地不可。殊不知，我去了，我的癌也会随我而去！ 我采用Avastin作为组和之一也已近3年。 因它是抗体，相比其它化疗药物，副作用要少好多，但其中特别明显的是会引起药物性高血压。自己觉得以练功54法为主，针灸加饮食为辅成功推迟高血压的发生近一年。2013年3月血压从原先的110/70 增至160/98时，便开始服用Amlodipine tab 2.5mg成功控制血压在120/90上下。 2013年8月起 Abraxane+Gemcitbine+Avastin 至同年底5个疗程的治疗，又开始渐渐失效。以为停用Avastin后，血压也许会慢慢回归正常。可事实上没有像 5 月份因肠梗阻停药后，血压复原那么简单了。那就继续服用，正好提前对付医生K 将给我上新药的副作用之一，凑巧也是高血压。 终于驱车前往与同事聚会了，也观赏了2014年 春节联欢晚会。在我Ca125达到700左右，医生K决定这次给我上的是口服化疗药Pazopanib+Cyclophosphamide，饭前1小时或饭后2小时服用。我先试了睡前服，希望副作用不会影响白天的活动。第一晚没有同时服用止吐药，结果不仅我的胃强烈反抗，3天后，我的天哪，血压冲达200/100, 我晕晕乎乎，悠悠恍恍。加降压药，结果是血压没怎么下降，两下肢开始浮肿，连脸部都摊上了。哪里还有生活质量可谈。 这次见医生K，我一反常态，开始谍谍不休的抱怨。因为我恪守，我不想死于治疗肿瘤的副作用。知道没有标准的切入点（Thresh hold), 我也没有任何经验，个体差异也较大。就慢慢学吧，我旨在生活质量，而非数量。该努力时会尽力而为，该放手时决不拖泥带水。只有病人自己平和接受，家人应该会欣然认同。 这让我想起开博以来收到素昧平生网友们的鼓励，关心。尤其是W和Y的热情好客，我感激之情，无以言表。我宣布，我走后，只希望您们惋惜我，不用可怜我；然后渐渐忘记我。不管在天堂还是转世，我更愿看见泪光后的笑靥。不好意思，我是否有点煽情的可疑？正巧拉长情人节的尾巴，应该没有大碍吧？一些话，一些事，在世时交代清楚，可以给后人省掉不少麻烦，减少很多不确定性。 言归正传。医生K果断决定化疗药减半（静滴化疗药用量按体重计算，而片剂却没有），和换降压药同时挺进。3天后，我又基本能正常好好学习，天天向上了。 Ca125 还是上涨，FDA批准的化疗药，我的选择已有限。Clinicl Trial 却如雨后春笋，层出不穷。该出手时就出手，但愿我能进入对我有效的临床试验，马到成功不敢奢望，那就马到半功吧。

Me and Cancer (23 - A Victory) It has been nearly three years since my relapse in March 2011. Over these three years, my internal organs have been like China's polluted mountains and water: though constantly being managed, the pollution still spreads from underfoot to a floating haze. Each bombardment of chemo destroys countless cancer cells, but some tenacious ones survive through drug resistance, and then they reproduce without limit. The PET-CT results from the end of 2013 showed that some original tumors had shrunk, but new tumors have appeared. In its efforts to coexist with me, it keeps changing form, going through all my trials and tribulations with me, and thus insists on killing me. But little does it know, where I go, my cancer will follow! I have been using Avastin as part of combination treatment for nearly 3 years. Since it is an antibody, unlike other chemotherapy drugs, it has many fewer side effects, but the most salient one is that it causes drug-induced hypertension. My training of the Fifty-Four Forms, combined with acupuncture and diet was able to ward off the hypertension for nearly a year, but when in March 2013 my blood pressure rose from 110/70 to 160/98, I had to start taking 2.5mg tablets of Amlodipine, which successfully lowered my blood pressure to around 120/90. From August 2013 until the end of the same year, my 5-cycle treatment of Abraxane, Gemcitbine, and Avastin gradually became less effective. I thought that after I stopped taking Avastin, my blood pressure would slowly begin to return to normal. But in reality, things were not as simple as in May when my blood pressure returned to normal after I stopped Avastin following my bowel obstruction. So I continued to take it, getting a head start on managing one of the side effects of the new drug Dr. K was about to prescribe me, which happened to also be high blood pressure. I finally drove to meet up with my colleagues, and I also watched the 2014 Spring Festival Gala. When my CA-125 levels rose to around 700, Dr. K decided to prescribe me the orally administered drugs Pazopanib and Cyclophosphamide, to be taken one hour before a meal or two hours after a meal. I first tried taking it before I went to bed, hoping that the side effects would not affect my daytime activities. The first night I didn’t take an antiemetic at the same time, and not only did my stomach rebel violently, three days later, my god, my blood pressure surged to 200/100, and I felt very dizzy and faint. I added drugs to lower blood pressure, and the result was that it didn’t lower my blood pressure much, but my legs started to swell and it even affected my face. I had lost all quality of life. This time when I went to see Dr. K, I started to uncharacteristically complain. Because I was following orders, I did not want to be killed by the side effects of these drugs. I know there are no standard thresholds, I had no experience with these drugs, and individual experiences vary greatly. I would just learn slowly, aiming for quality of life rather than quantity. I will always put in the most effort when I need to, and know when I should give up. Only through peaceful acceptance by the patient, their family should then willingly relate. This reminded me of all the encouragement and support I received from all my online friends, with whom I used to be strangers, since I started my blog. Especially W and Y, I have no words to express the extent of my thanks. After I’m gone, I only hope that you sympathize with me and not pity me, and then slowly forget me. It does not matter if I am in heaven or have returned to this world, I just want you to be happy after enduring sadness. Sorry, am I being a bit too melodramatic? Just happened to catch the tail end of Valentine’s Day, it shouldn’t be a problem, right? Some words, some matters, if explained clearly while one is still alive, can help avoid many frustrations and uncertainties later. I will now return to the subject. Dr. K decided to cut my chemo doses in half (IV doses are calculated based on weight, but tablets are not), and also change my hypertension medicine. After 3 days, I was able to function normally again. My CA-125 levels are still rising. In terms of FDA-approved drugs, my options are already limited. Clinical trials, however, were seemingly endless. I will try to participate when one is suitable, but I hope that I am able to get into one that is effective. I don’t dare to have extravagant  hopes for a victory, so I guess I’ll hope for a half victory.