Taking The Scenic Route — Nick McFadden

Hey Team! It’s Nick.

Today, Ashley and I made the journey to the University of Iowa Hospital and Clinics Holden Comprehensive Cancer Center (Do you think they call it the UIHCHCC for short?) to get a second opinion on the treatment plan and diagnosis. As a part of the appointment they drew some blood so they could check my tumor markers and other ‘blood stuff’. These tumor markers are going to serve as our measure of success as we start moving through treatment. They are essentially proteins in the blood that will tell the doctors what kind of impact we are having and how far the cancer has progressed.

The scale works like this:

0 - 1,000 is considered low risk
1,000 - 5,000 is considered intermediate risk
5,000+ is considered high risk.

My first blood test that was used to measure tumor markers was taken right after the doctors found the mass in my abdomen. This test came back with a tumor marker score of 908 and put me at the high end of the ‘low’ bracket. After having surgery about 10 days later we tested again and the score was 496 which was a good surprise! So, with that score in mind, our treatment plan was set for three rounds of chemo.

Today, the tumor marker came back at 1,012. The team of doctors we were working with at the University of Iowa seemed almost as surprised by this as Ashley and I were. They asked if we wanted to retake the test and we said yes (I love retaking tests). The second take came back with essentially the same score. Because of the new tumor marker score, I have been bumped out of the ‘low’ category and into the ‘intermediate’ category. This doesn’t change much other than adding one more cycle of chemotherapy to our treatment plan. Now I will have a total of four cycles instead of three (twelve weeks instead of nine).

As the doctor explained, the treatment of testicular cancer is driven by protocol. They are treating to cure the patient of the disease, and they are very successful with the protocols in that are in place. He also said that even if we were at 1,001, he would recommend going with four cycles because it is better to over treat than it is to under treat. If we were to under treat and the cancer comes back in a couple of years, it turns into a much more aggressive treatment plan that uses different drugs and is more harsh.

So, we are going forward with the extra cycle. This will also give us a better chance of shrinking the tumor even further. If the tumor is smaller than one centemeter in size, I will not need surgery after chemo. This gives us a little more time to avoid surgery.

Well, that is the recap of yesterday’s trip to Iowa City. Today, I am having my chemo port installed in my chest. Maybe I can get the surgeons to live stream it for you!

Oh hey - do you want to see the tumor? I took a picture of the scan when the doctor had it on the computer monitor this morning. I enjoy giving things names. If you have any suggestions as to how we should refer to the tumor from today forward, put them in the comments (the funnier, the better). Here is the scan...

The square thing that the arrow is pointing to is the tumor. For context, the bottom of the image is my back and the top is my belly. The bright white thing that the tumor is leaning against is my spine (I think). Also, if anyone knows what that weird, dirty looking thing is on the left side of the screen, let me know. Maybe they can clean it up the next time they are in there.