The Next Phase

"Mister, you have dropped 3 kg over the past 2 and half weeks, that is a lot!" the nurse exclaimed after taking my weight Wed Oct 17. That was due to the side effects after the 9th cycle of chemotherapy. I was feeling really lethargic, the diarrhea further reducing the appetite. Took a lot of rest, and slept much more too. Then the pimples which showed up during the past few cycles on the face were all over my head. They  bring much discomfort especially when I lay down.

A PET scan was done earlier on Oct 16. Reviewed with the oncologist on Oct 17. He examined the blood and urine test reports, and said they were excellent. The PET scan results showed some anomalies over the liver area, after further check with the radiology doctor who performed the RFA, he thought it could be due to that procedure. Another scan will be done in 2 months' time. Meantime, there is no cause for concerns.  One of the chemo drug would however, still be administered for as long as possible, this had proven to be helpful in the radiation therapy. This is dispensed through a pump, which is connected to the catheter line 24/7.  I could also move away from the high protein diet taken during the chemo treatment period. The oncologist said the toughest period was over, I should feel very happy. Thanks to God for seeing me through this trying period, and grateful to many who send prayer heavenwards.

Thur Oct 18, I was at the hospital again for the preparation of radiation therapy. A CT scan was done, with all the necessary markers done on the body. A newer form of radiation therapy called tomotherapy would be used for the next 5-6 weeks, for 27 sessions. The first session was done on Oct 23. The procedure lasted about 15 minutes. Basically I laid down on the radiation machine, a scan was done, then the nurses would make some necessary adjustment, then proceed with radiation. There was no sensation whatsoever. Before I realized it, the whole process was completed.

So the appetite has return to normal, I could eat well again. Pray that there is minimal or no side effects from the radiation therapy.......Trusting in God the Almighty for He is good all the time, His loving kindness and mercies cease not!



1Pe 2:24  He himself bore our sins in his body on the tree, that we might die to sin and live to righteousness. By his wounds you have been healed. 
彼得前书 2:24  他被挂在木头上，亲身担当了我们的罪，使我们既然在罪上死，就得以在义上活。因他受的鞭伤，你们便得了医治。 

Coping with side effects

Some friend asked me about the side effects arising from chemotherapy, mainly as reference to help someone they know.

Below is a record of what I experienced, and some ways I cope. Depending on the drugs used, there could be various side effects, and individuals would react differently too.

- Chemotherapy drugs originated from chemical warfare, which someone also found some therapeutic effects and adapted the toxins for cancer treatment. So drink lot of fluid to help the key organs (kidney and liver) to get rid of the toxin. Water, barley drink, chrysanthemum tea, green tea, green bean soup etc are some recommended fluid. Typically 2-3 liters per day. If the urine passed is yellowish, that means insufficient fluid is taken.

- Low white & red blood cell: reducing immunity level: avoid those who sneeze or having flu. Avoid crowd.  Get blood booster from the oncologist during those days the blood counts dive.

White blood cell booster syringe

- Fever: Take medication, if body temperature exceeds 38deg C, take prescribed antibiotics, or see the doctor.

- Taste buds change, causing lose in appetite:  a fellow patient told me to put some hard candy in the mouth during chemo infusion, this proves to be useful in minimizing the taste change

- Low in protein: Take lots of meat and other proteins during chemo treatment period

- Diarrhea: Drink lots of water to re hydrate  Some food could help in easing the diarrhea, like boiled rice,  tapioca, banana, peanut butter......isotonic drink like H2O, 100Plus and porridge water would help. Avoid milk, coffee, high fiber food till conditions improve

- Fatigue: Take lot of rest. Sleep

- Dry skin:  Moisturize.

- Skin peels, on fingers, legs, and feet: Get prescribed medicine from oncologist.

- Fungus growth on tongue:  Get prescribed medicine from oncologist.

- Nose bleeding: Squeeze the nose to prevent flow to help in blood clot.

- Skin pigmentation especially on fingers, toes, and bottom of the soles. This should fade away after chemo.

- Hair drop: Shave.

- Dryness in throat and mouth: Drink water regularly. For mouth wash, use salt water to gargle, avoid using alcohol-based mouth wash

- Mouth ulcers, sores: use pain relief gel like "bonjela"....

- Numbness on fingers, lips : -

There are other side effect like change in voice especially the first few days the chemo infusion was done, difficulty in sleeping the first day of the chemo infusion etc.....
.So my strategy is not to look out for side effects, but inform the oncologist if any arises. He would make necessary remedies.

Also, on the other front, to help get over the side effects:

+ Keep faith in God, have a strong 'dose' of prayer and praise.

+ Keep positive attitude. 1Peter5:7 Casting  all the cares upon the Lord, for He cares for me. Philippians 4: ⁶ Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. ⁷ And the peace of God, which surpasses all comprehension, will guard your hearts and your minds in Christ Jesus.

+ Support from family, friends and colleagues

+ Exercise if the body allows.

+ See a good TCM physician. TCM is able to moderate some of the side effects. Inform the oncologist about taking TCM too.

以 賽 亞 書 40:28-31 Chinese Union Version (Simplified) (CUVS) 28 你 岂 不 曾 知 道 麽 ？ 你 岂 不 曾 听 见 麽 ？ 永 在 的 神 耶 和 华 ， 创 造 地 极 的 主 ， 并 不 疲 乏 ， 也 不 困 倦 ； 他 的 智 慧 无 法 测 度 。 29 疲 乏 的 ， 他 赐 能 力 ； 软 弱 的 ， 他 加 力 量 。 30 就 是 少 年 人 也 要 疲 乏 困 倦 ； 强 壮 的 也 必 全 然 跌 倒 。 31 但 那 等 候 耶 和 华 的 必 从 新 得 力 。 他 们 必 如 鹰 展 翅 上 腾 ； 他 们 奔 跑 却 不 困 倦 ， 行 走 却 不 疲 乏 。 Isaiah 40:28-31 New American Standard Bible (NASB) 28 Do you not know? Have you not heard? The Everlasting God, the Lord, the Creator of the ends of the earth Does not become weary or tired. His understanding is inscrutable. 29 He gives strength to the weary, And to him who lacks might He increases power. 30 Though youths grow weary and tired, And vigorous young men stumble badly, 31 Yet those who wait for the Lord Will gain new strength; They will mount up with wings like eagles, They will run and not get tired, They will walk and not become weary.

Emm.....finally

The 8th cycle of chemo had brought some more severe side effects, I was feeling real lethargic during the 2nd week of the cycle. It was normally 2 days each for 1st and 2nd weeks to get over the fatigue. This time it dragged on for up to 5 days during the 2nd week. I was spending a lot of time resting and sleeping. Also developed a fever during the 3rd week. It was the first time ever I had this issue. Thankfully with medication and prayers, the fever quickly subsided overnight, even though associated headache lasted few days more. Very grateful, however, that other side effects like diarrhea had greatly reduced. God was good.

Reviewed with the doctor on Monday Oct 1. All indicators from blood and urine tests were well, except for the liver functions. These could be due to the fever and associated medication.

The doctor said finally this is the 9th and final cycle of chemo. Started the chemo this Monday, ending in 3 weeks' time. PET scan will be done towards the end of this cycle. Depending on the results, he would probably activate the next course of treatment, the radiotherapy.

Have some preliminary discussion with the doctor in charge of radiology oncology. He would need to read the previous and latest PET scan reports to recommend a treatment course. Typical treatment would be 33 times, 5 times a week. Looking forwards the completion of all treatment. It has been a long journey. Thanks to all who supports me one way or another. May God Bless you and your family!

Psa 91:14  "Because he holds fast to me in love, I will deliver him; I will protect him, because he knows my name. 
Psa 91:15  When he calls to me, I will answer him; I will be with him in trouble; I will rescue him and honor him. 
Psa 91:16  With long life I will satisfy him and show him my salvation." 


诗篇 91:14-16
  神说：因为他专心爱我，我就要搭救他；因为他知道我的名，我要把他安置在高处。 
  他若求告我，我就应允他；他在急难中，我要与他同在；我要搭救他，使他尊贵。 
  我要使他足享长寿，将我的救恩显明给他

Soldiering On

Reflecting on the day I first arrived in this new land to pursue higher study many years ago....... Little did I know I would stay here longer than I stayed in home country. It is here that I feel comfortable and at home. It is here that I made friends and set up family. It is here that God found me.....

It was during those undergrad days that a good friend and classmate who persistently encouraged me through Bible verses. He stood out as a helpful guy, compassionate and cheerful, very much exemplifying the characters of God. On quite a few occasions he invited me to church. After rejecting him a few times, I relented and followed him one Sunday. After attending couple of services, I felt my heart stirred quite a bit.  Later I stepped forwards to accept Jesus Christ as my Lord and Savior.

There was a fellowship in the campus which we attended regularly. We learnt and grew together in the knowledge of God. We became good friends who remain faithful after so many years. So I was glad to met up one last week over a simple lunch, a special friend whom I clicked very well since those we first time we met in that fellowship. We had a good time and shared about family, travel, church, missions, health and so on.....Throughout so many years, we can see the hand of God over our lives. Despite many failings on my part, God remains faithful, His loving-kindness never ceases, His mercies never comes to an end.

Last week a team of colleagues also visited. Some sent books to nourish my soul. It was good to catch up. They are all blessings in my life. I thank God for all the colleagues, friends, relatives and families. Indeed they have given me much strength with their support.

As a routine after each chemo cycle of 3 weeks, we met with the doctor on Monday for a review. After usual examination, the doctor said according to the blood and urine test reports, the kidney and liver functions continue to be good, blood counts were alright, tumor marker CEA was good at <0.5. He also confirmed that I would need to go for 9 cycles of chemo.
" I know this is a tough program", he reiterated, "hopefully the reward is well worth it."
"Surely, have faith." I said. It was after I said this that I saw exactly the 2 words - Have Faith - printed on his cup.

Thereafter the 8th chemo cycles started. The past few weeks my appetite continued to improve, over latest 3 weeks, I found myself putting on 2.5kg. I am grateful that the side effects seem to be much reduced now. Praise God for his wonderful answers to our prayers. So soldiering on.......

Psa 37:3  Have faith in the Lord, and do good; be at rest in the land, and go after righteousness. 
Psa 37:4  So will your delight be in the Lord, and he will give you your heart's desires. 
Psa 37:5  Put your life in the hands of the Lord; have faith in him and he will do it. 


诗篇37:3-5  你当倚靠耶和华而行善，住在地上，以他的信实为粮； 
又要以耶和华为乐，他就将你心里所求的赐给你。 
当将你的事交托耶和华，并倚靠他，他就必成全。 

RFA

I went for early admission on Aug 21, a day after the Hari Raya holiday. The hospital was efficient, I was in the ward shortly after submitting the registration papers.

I was pushed around 11.30am to the CT scan room where the procedure was to be performed. Light anesthesia was applied around 12noon, the doctor assured me I would be awoke within 1 hr. The radiologist came and explained the procedure, and I signed the paper. He mentioned that from the PET scan there is no tumor, but the procedure would be preventive.

By 12.50pm I was awoke, feeling nausea the few hours after, which  I slept  through most of the time. I felt no pain, though painkiller was given for the next 18 hrs. The procedure involved inserting a needle through the stomach wall into the liver, guided by CT scan. High Frequency electricity was applied to generate heat to burn off any cells/tumors that were undesirable. The night sleep was interrupted with constant monitoring of blood pressure........

The oncologist did his round early the next morning, arriving at the ward at 7.30am. He mentioned all was well. The nurse had earlier removed the gauze measuring around 6" by 6", and replaced with a small plaster. When the oncologist checked the size of the wound, he immediately said get discharged. He mentioned all was well, and encouraged me with the experience of another patient. So I was discharged early. Only after reaching home did I felt some slight pain around the area, which did not bother me too much.

The billing was efficient too, the biz associate came to ask me to sign off the bill before the discharge. It came up to a significant 4-digit sum, to my surprise. I was grateful that this was paid by the insurance policy which I purchased (Integrated Medishield Plan, the premium is paid using CPF fund). Also the chemo sessions did not come cheap, each at a 5-digit sum. Since there have been multiple sessions, the sum quickly added up. I saw how a friend struggled financially when his cancer-stricken wife had to foregone some treatment..... So it is imperative to have sufficient insurance coverage, hopefully there is no need to be used at all .....

Glad to report that the side effects from the recent round of chemo are much reduced. Try to do more exercise to stay fitter. Thank God and praise Him for answering our prayers.......

Psalm 121

⁵

The Lord watches over you—
    the Lord is your shade at your right hand;
⁶ the sun will not harm you by day,
    nor the moon by night.

⁷ The Lord will keep you from all harm—
    he will watch over your life;
⁸ the Lord will watch over your coming and going
    both now and forevermore.

诗篇121:5-8  保护你的是耶和华；耶和华在你右边荫庇你。 

 白日，太阳必不伤你；夜间，月亮必不害你。 

 耶和华要保护你，免受一切的灾害；他要保护你的性命。 

 你出你入，耶和华要保护你，从今时直到永远。 

It is not to be yet

Done blood test and PET scan on Thur Aug 16.

Reviewed the results with the doctor Fri Aug 17. The doctor said the results were excellent. The treatment so far has shown results with improvement beyond his expectations (And we know why). Liver, kidney functions were good. Blood test results were well, with tumor marker of <0.5 (detection level).

To be on the very safe side, the doctor recommended some more chemotherapy to be done. I felt he was keeping the card too close to his chest, perhaps he was concerned with information overload???.....
"How many more cycles, Doc?" I asked.
"Maximum 3 cycles." He replied.

On top of this, he recommended a procedure called Radiofrequency Ablation(RFA); a high frequency electricity using electrode is used to generate heat to kill the tumor on the liver. Though the scan has shown no tumor, the doctor believed that this procedure will help to prevent any possible recurrence. I will be admitted to hospital Tue Aug 21 for the procedure, and be discharged the next day.

So the 7th cycle of chemo started on Fri Aug 17. So my earlier wish on final chemotherapy session was not to be, as yet. Nonetheless, it is on count-down mode. Very thankful that the previous round, the side effects were much reduced. Indeed God has been merciful and faithful! We could praise Him always.

³ 

Psalm 71:3
Be to me a rock of refuge,
    to which I may continually come;
you have given the command to save me,
    for you are my rock and my fortress.

詩 篇 71

³ 求 你 作 我 常 住 的 磐 石 ； 你 已 经 命 定 要 救 我 ， 因 为 你 是 我 的 岩 石 ， 我 的 山 寨 。

Onto next step

Finally done the last chemo infusion yesterday.

Reviewed with the doctor last Monday. Again all the blood and urine test results were positive. Kidney, liver functions were well, tumor marker CEA at all time round low of 0.6. Indeed God has been faithful! Praise Him! I was complaining and felt discouraged with the side effects from the 5th cycle. But the results probably was worth that amount of physical suffering.......One good news is that the appetite has improved quite a lot over these few weeks.

The schedule for this round of chemo is as follows:

Mon 30 July 6th cycle of Chemo session I

Wed Hydration, white blood cell(WBC) booster injection
Sat Blood test
Mon 6 Aug Chemo session II
Wed Hydration, WBC booster injection
Fri WBC booster injection
Sun WBC booster injection
Mon 13 Aug Hydration, Red blood cell booster injection

Doctor has asked for another round of full blood test and PET scan on Aug 16. 

On Aug 17 there will be another review with him. Based on the results, he would decide on the next phase of treatment. We pray that God would grant him wisdom in determining the best course of action. Trusting in God based on His promises.

Rom8

³⁷ In everything we have won more than a victory because of Christ who loves us.

罗马书 8 

³⁷ 然 而 ， 靠 着 爱 我 们 的 主 ， 在 这 一 切 的 事 上 已 经 得 胜 有 馀 了 。