My Colon Cancer: The Awkward Question Everyone Asks

Clinician turned colon cancer patient, PPM contributor and pharmacist Jeffrey Fudin, PharmD, shares an update on his health in the hopes that his training and knowlege helps to educate and inspire fellow cancer patients and their loved ones. Part 2 is below. 

Pharmacist turned colon cancer patient Jeffrey Fudin, PharmD, with his favorite things.

Since my stage 4 colon cancer diagnosis in the spring of 2021, I have made some progress that I want to share with you. Despite the fact that I am back in the saddle (aka the chemo infusion lounge chair) on a regular basis, I also have found my time outside of chemo land to be fulfilling, optimistic, encouraging, and full of life and love.  Okay, you are probably thinking, what? This guy has one foot in the grave and one on a banana peel, so how can he be so optimistic and positive!? 

Dexterity and Determination 

Quite simply, there is a lot to be positive about. A round of chemo at the end of July left me feeling weak and with some eating-related challenges but I was looking forward to wonderful celebrations so I powered through the tough days. A family vacation week with my daughter and son-in-law at the beach in New Jersey would be followed by a Celebration of Life party for me in upstate New York.  

I had been feeling anxious about the beach week for a couple of reasons: my eating problems persisted, I was still anemic from the chemo, and I had trouble walking for more than a few blocks due to fatigue and labored breathing. So, I asked my doctor if I could be placed on dexamethasone, a steroid often used to help with symptoms like inflammatory pain, low energy, and general wellbeing.  

Dr. Onc (not his real name) agreed to a 4-day supply, as there can be both benefits and risks with dexamethasone. I decided to hold onto the medication for the Celebration of Life party. But in the meantime, either my IV iron supplements began to work, or the chemo was starting to show some benefit, or both.   

During that week at the shore, I was able to climb a kids’ mountain tower and kiss my four grandchildren good night. It was a wonderful vacation, and I didn’t miss a beat. I was very grateful for the energy and strength to keep up with the little kids and connect with the big ones.  

Family Ties  

The Celebration of Life party was quite an affair. Before the event, our friends put up a 20 by 20-foot tent for the party, cut our lawn and weed-whacked, too. Talk about feeling cherished! You guys rock! During the party my four kids handled it all—from soup to nuts. Arranging the seating, the food, and the libations as well as all the other party-related logistics and clean-up tasks.  

The party was partly for me, but we did recognize my 90-year-old father’s birthday that we celebrated earlier in the week at the New Jersey Beach House.  He is sharp as a tack and still gets around great. I have a contest going with my father—I refuse to die ahead of him, so the longer he lives, the longer I live.  

It incentivizes both of us to stick around without dwelling on the ultimate outcomes which everyone faces whether ill or not.  

At the Celebration of Life party, Robin, my wife of 40 years, and I learned we have more grandbabies on the way. Two to be exact and they will be born within five months of each other.

I don’t want to give away any secrets, but what this news means to me is that I have more reasons each week to stay alive. With each pregnancy announcement, I feel like I’m back working in a pharmacy rotating stock (sorting out the expired medication and keeping it all updated)—in this case, because I have to keep moving up my expiration date! 

Camp Chemo 

Before I knew it, it was mid-August and I was back in chemo: the start of cycle number five, to be precise. Robin playfully calls these days in the clinic “chemo camp” and, like a prepared camper, she sends me with my backpack and brown-bag lunch.

Lunch even included some surprise milk chocolate Dove candies and a clementine—already peeled and ready to eat, just the way my mom used to do it when I was in elementary school.  

Following Cycle Five, I felt well enough to take a planned trip to New York City with Robin to visit our daughter Sarah, son-in-law Andrew, and sweet little Emily. 

Baby Emily, grandchild number 5, made a surprise appearance—about two weeks early—so we were able to meet her during our visit. It’s hard to beat the distraction of cuddling a newborn! 

Pain and Persistence 

On September 1, 2021, I began chemotherapy Cycle Six—the last treatment before some scheduled imaging the day before. Hopefully, this imaging would bring good news of no disease progression and possibly some disease regression. 

After this cycle, together with my oncologist, we decided to abandon oxaliplatin, at least for now. Neuropathy is a common side effect of this chemotherapeutic agent drug. 

During my rounds of chemo, I have experienced mild neuropathies—mostly in my hands and fingers and a little in my feet. The unpleasant feeling lasts just a few hours following the chemo. Cold sensitivity is another weird but expected side effect that is also temporary. But, this toxicity is cumulative, and it started to become more severe and last longe—a sure reason to use a different option. 

But I’m happy to report that I haven't experienced any nausea or vomiting, and I still have my hair! I’m also getting more practiced at avoiding touching anything refrigerated or frozen as a result of the oxaliplatin.

If I do grab something in the freezer or wrap my hands around a bottle of cold orange juice, I have a few minutes of tingling and this has now continued to occur for 2-weeks after chemo (which is more than the couple of days after initially starting chemo)—evidence that my neuropathy is accumulating, which is why there will be no more oxaliplatin, a heavy-duty chemo drug that can have fairly serious side effects. 

Some Very Good News 

Prior to the start of chemo cycle seven, Dr. Onc received my CT scan results. I learned that there is no visible tumor mentioned at the sigmoid-rectal junction.  

For non-medical folks, the sigmoid colon is at the end of the large intestine on your left side where the large intestine meets the top of the rectum, the site where my primary tumor had been found.

This new scan reported only tissue thickness with no specific mention of a tumor. And the lymph nodes in the area were gone! No new metastasis was found anywhere. In particular, the lungs and liver, where we would expect to see them first, were clear. Overall, it was the best visit ever with Dr. Onc!  

Can You Survive Colon Cancer? That IS the Question

Many people have asked “How long can you survive with Stage IV colorectal cancer?” There are many factors; some we can control, and others we cannot.  

On some days, at fleeting moments I have wrangled with whether palliative chemo is all worth it. In my case, it is! I am all about accepting the cards dealt to me in exchange for the birth of two more healthy grandchildren due in February 2022 and the recent birth of Emily on August 28th.  

There have definitely been some lessons buried in my experiences of the past four months. One is that if you have estranged friends or family, you need to get past it, mend your differences, and agree to disagree. And figure out now how to do this when you’re healthy and of sound mind.  

What Else Have I Learned?  

Well, while terminal disease is a death sentence, no one knows when their time will come. Terminal illness should not define life, in particular when you are a husband, father, grandfather, friend, and mentor, and still breathing air with those who love you as much as you love them.  

Also, if you don’t have a medical background, it’s good to have a patient advocate to help you navigate the medical system, ask questions and discuss the treatments along the way. Patient advocates can help you understand all the medical and therapeutic options, assess the benefits and risks with attention to individualized therapy (rather than assembly line medicine), and stay on top of anemia. (Editor's note: For help finding an advocate visit the advoconnection directory.)

Rather than dwelling on death, I’m betting on life. It’s better to spend time living life, laughing every day, and experiencing the nirvana of nature and love all around than dwelling on death, as everyone is terminal from the day they are born.   

Adopted from "Pain, Lemons, and Lemonade". First published June 22, 2021 on PainDr.com, Dr. Fudin's website. You can follow Dr. Fudin's journey through his lemonade blog series and clinician lessons at https://paindr.com/category/pain-lemons-lemonade/.

 

 

Updated on: 09/23/21
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One of Our Own Faces Down Colon Cancer
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