A Cancer History

Too sad, but my wife was gone on July 18th, 2000, after she had fought against her cancer for almost five years. Since her bone metastases came up to the surface, she had pursued the following events and come to know the end. If you can find any tips about your survival in the following table, it's my and her pleasure.

M.	D.	Symptoms	Diagnosis/Treatments	Markers
7		Felt dull, faint ache on the back, but ignored it.
8		The ache remained. Went to a orthopedic clinic and was diagnosed as fatigue.	X-rayed. The 5th thoracic vertebra looked a little smaller than normal, but it could be convinced as an anomaly.
9		The ache still remained. Went back to the clinic.	X-rayed, again. The 5th thoracic vertebra was less than half the normal height.
	27	Went to a hospital.	The bone images were captured with Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and X-ray.
10	9	The ache became distinct.	Was informed of an orthopedist's opinion, "It must be cancer."	CEA:107 BMD: 0.829
	10	The ache extended around to the chest.
	11	Was admitted into the hospital.	Started searching for primary focus. She had known the stiffness in her breast. But she had experienced the disappearance of a similar stiffness in her twenties and had assumed it would be no problem. And started injecting Calcitonin to stop osteolytic changes of bones (every day).
	27	Struck by severe low back pain and became unable to stand.
	31		Diagnosed as breast cancer, stage IV. Vertebrae were in the conditions of crush fracture at 5th thoracic and 3rd lumbar vertebrae. A precipice of paraplegia. Chemohormonal therapy with Medroxyprogesterone Acetate (MPA) and 5'-DFUR.
11	13	A peak of her pain. It came intermittently even when she lay still.	Controlled the pain with anti-inflammatory drugs.
	15		Started radiation therapy for lumbar vertebae. (2 Gray/day, total: 40 Gray)
	16	The tumor block in her breast began to shrink.
	17	Pain seemed to become moderate.
	20			CEA: 206
	28	Abdominal pain (a side effect of radiation).
12	4			CEA: 215
	6	Diarrhea.
	7		Concerning the synergistic side effects of drugs and radiation suspended the use of 5'-DFUR for two weeks.
	9	Her friend recognized her "moon face" (a side effect of MPA).
	14		Started radiation therapy for thoracic vertebae. (3 Gray/day, total: 30 Gray)
	29	Esophagus stenosis (a side effect of radiation).

1	7			CEA: 5.2
2	4			CEA: 8.8
2	24		Was examined with Radionuclide Bone Imaging; A new focus was recognized on her flank bone.
3	4			CEA: 9.1
	8		Terminated the injections of Calcitonin.
	11		Tried intravenous injection of Pamidronate (30mg) to control the absorption of her bone.
	25		2nd IV injection of Pamidronate.
4	8		3rd IV injection of Pamidronate.	CEA: 9.2 CA15-3:8.8
	22		Because of no recognizable change of CEA, stopped the IV injections of Pamidronate to observe the effect.
5	6			CEA: 13.9 CA15-3:9.5
	27	The side effects, such as hair loss and vomiting, were more remarkable than those of the previous CE therapy. Felt pain at the base of her right leg when she rolled over on the bed to vomit.	Once again, tried the CE therapy with the increased dose of Epirubicin. Switched the hormonal anti-cancer drug from MPA to Toremifene. Was examined with CT about her lungs and liver; No tumor found.
	28		Was examined with X-ray; Broad shade region on her right flank bone was recognized.
	31		Decided to try the injections of Elcitonin (a similar drug to Calcitonin).
6	2		4th IV injection of Pamidronate.	CEA: 15.9 CA15-3:11.7
	4	The pain at the base of her right leg was felt to become lesser.
7	1			CEA: 18.6 CA15-3:12.8 ALP: 255
	21	Felt pain at her 7th right rib bone.	Was examined with X-ray; Could not recognize any focus at the 7th right rib bone.
	22			CEA: 21.4 CA15-3:14.3
	29	The pain at her 7th right rib bone subsided.	Determined the CE therapy had no effect and terminated it before completion.
8	5	Was admitted into the hospital to be watched about her response to Paclitaxel.	IV injection of Paclitaxel (100mg).	leukocyte: 4400
	9			leukocyte: 3100
	11			leukocyte: 3400
	12	Left the hospital.	2nd IV injection of Paclitaxel.
	16			leukocyte: 2200 CEA: 22.7 CA15-3: 22.8 ALP: 345
	19		Could not inject the 3rd dose of Paclitaxel because of the insufficiency of leukocyte.	leukocyte: 2400
	26		Could not inject the 3rd dose of Paclitaxel because of the insufficiency of leukocyte.	leukocyte: 2700
9	2		3rd IV injection of Paclitaxel.	leukocyte: 4900 CEA: 26.1 CA15-3: 25.7 ALP: 390
	6	A little loss of appetite.
	8	The pain at the base of her right leg subsided. Her hair was coming back.
	9		Could not inject the 4th dose of Paclitaxel because of the insufficiency of leukocyte.	leukocyte: 2500
	16		Could not inject the 4th dose of Paclitaxel because of the insufficiency of leukocyte. I thought her body was becoming fully exhausted and decided to keep her out of any chemotherapy for a while. Switched back the hormonal anti-cancer drug from Toremifene to MPA.	leukocyte: 2100
10	1			CEA: 31.3 CA15-3: 26.8 ALP: 252 leukocyte: 3200
	2	Felt pain on her right low back.
	15		Stopped the injections of Elcitonin.
	18		Decided to try the IV injections of Incadronate (a hundred-times stronger anti-osteolytic change drug than Pamidronate/10mg).
	27	The pain at her 7th right rib bone came back.
	28	Felt dong on her right low back.	2nd IV injection of Incadronate.
11	4		Started radiation therapy for her right flank bone. (2 Gray/day, total: 40 Gray)	CEA: 26.0 CA15-3: 27.0
	5	Was liberated from all pains.
	11		3rd IV injection of Incadronate.	leukocyte: 3600
	25		4th IV injection of Incadronate.	leukocyte: 3800
12	9		5th IV injection of Incadronate.	CEA: 27.1 CA15-3: 26.8
	24		6th IV injection of Incadronate.	leukocyte: 5640

1	6		7th IV injection of Incadronate.	CEA: 27.3 CA15-3: 24.4
	20		8th IV injection of Incadronate.
2	3		9th IV injection of Incadronate. Dose was doubled to 20mg.	CEA: 41.4 CA15-3: 24.4
	17		10th IV injection of Incadronate (20mg).
	21			CEA: 57.7
	24		Upon confirming the soaring tendency of CEA, decided to try Docetaxel which is reported to achieve some response rate even for Paclitaxel-resistant patients and to combine it with 5'-DFUR.
	25	Felt pains on her left thigh and right low back.
	26	Felt pains on her left low back, ribs and right upper arm and slight numbness on the tips of her left hand's fingers.
	28	Was admitted into the hospital to be watched about her response to Docetaxel.	Docetaxel IV injection (1st of the 1st kur/30mg).
	29		Was examined with CT; No change could be recognized on her lumbar vertebrae, but her cervical vertebrae were partially fractured.	leukocyte: 5600
3	1		Resumed Elcitonin injections (3/week).
	2		11th IV injection of Incadronate (10mg).
	3			leukocyte: 5500
	6		Docetaxel IV injection (2nd of the 1st kur).
	7		Started radiation therapy for her 5th to 7th cervical vertebrae. (2 Gray/day, total: 40 Gray)	leukocyte: 4700
	8	Left the hospital.		leukocyte: 6650
	10	The pain on her right upper arm faded away.		leukocyte: 6720
	13		Docetaxel IV injection (3rd of the 1st kur).	leukocyte: 6700
	18	Had inflammatory feeling inside her cervical esophagus (a side effect of radiation).
	27		Docetaxel IV injection (1st of the 2nd kur).	CEA: 153.0 CA15-3: 57.8 ALP: 429 Ca: 10.5 leukocyte: 5260
	30		Resumed IV injections of Incadronate (10mg). Terminated the use of 5'-DFUR, again.	Ca: 10.1
4	3		Docetaxel IV injection (2nd of the 2nd kur).	CEA: 136.1 CA15-3: 54.5 ALP: 403 Ca: 8.9
	4		Completed radiation for her 5th to 7th cervical vertebrae.
	5		Was examined with Radionuclide Bone Imaging; The focuses were increased and expanded to her skull, left thigh bone and so on.
	6		Started radiation for her left hip joint and upper thigh bone.(2 Gray/day, total: 38 Gray)
	9	Felt uneasy in the stomach and heavy in the head. Drowsiness was enormous.
	10		Docetaxel IV injection (3rd of the 2nd kur). Was examined with CT: New metastatic focuses were recognized in the lungs and liver.
	13		13th IV injection of Incadronate (10mg).	CEA: 145.0 CA15-3: 65.4 Ca: 10.2
	21		Terminated the use of MPA, again.
	24		Docetaxel IV injection (1st of the 3rd kur).	leukocyte: 3520
	27		14th IV injection of Incadronate (10mg). Injection of LH-RH agonist. Brain was examined with MRI; No focuses were recognized.
	28	Tingling pain from the right shoulder to the nape.
5	1		Docetaxel IV injection (2nd of the 3rd kur).	CEA: 165.5 CA15-3: 56.5 ALP: 406 LDH: 433 GOT: 85 GPT: 70 Ca: 7.8 leukocyte: 3600
	2	Felt uneasy in the stomach. Slight fever.
	4	Pain around the hip.
	5	Diarrhea.
	6	Dry in the mouth.
	7	Pain on the left vertex.
	8		Docetaxel IV injection (3rd of the 3rd kur).	leukocyte: 3570
	11		15th IV injection of Incadronate (10mg).	Ca: 10.5
	13	Dull pain in the stomach (possibly the transverse colon). Strong pain on the left shoulder.
	15	Felt choky in the car.	Was examined with CT: Osteoclasis of the left humerus and fluid in the thoracic cavity were recognized. Started radiation for her left humerus and blade bone.(2 Gray/day, total: 40 Gray) Adopted a Kampo medicine, Juzen-taiho-to.
	22			CEA: 266.6 CA15-3: 114.2 ALP: 551 GOT: 126 GPT: 73 WBC: 3900 PLT: 23.2 Ca: 11.3
	28	Choky feelings came stronger after she took a bath. Was admitted into the hospice (palliative care ward) of the hospital.	Injected steroid (Predonin). Oxygen tube was applied.

5	29	Choky feelings were removed. Felt intense pain at the base of her right leg.	Placed central venous catheter and injected routinely via it as follows;. · cisplatin+5-FU · steroid (Predonin) · expectorant (Bisolvon) Radiation for her left humerus and blade bone was continued.
6	1		IV injection of Incadronate (every Thursday). Took liquid morphine(10mg) four times to estimate her needs.	CEA: 361.8 CA15-3: 88.5 ALP: 461 LDH: 581 WBC: 6700 PLT: 26.6 Ca: 9.1
	2	Red palm. Cornification of skin. Hemorrhagic hemorrhoids.	Used diclofenac sodium. (She still expressed slight resistance against morphine.) Used ointment for skin. Used suppository for hemorrhoids.
	3		Accepted suppository of morphine.
	4		Used suppository of morphine (30mg/day).
	5	Nausea.	Add an antiemetic drug to the IV injection of 5FU + cisplatin. X ray exposed the fracture at the base of her right leg. Suppository of morphine (10mg/day).
	6		Switched radiation to her right leg from her left humerus and blade bone.
	7	Played ringtoss.
	8	Frequently coughed. Got a feeling that her chest was blocked by some panel and became weaker in her voice.
	9		Started the use of MS contin (20mg/day). And, assuming steroid could make gastric-ulcer, started the use of Gaster, too.
	10	The feelings in her chest became lesser.
	11	Had vomiting, stomachache and diarrhea.	To moderate the first side effect of MS contin, lessened the dose of it to 10mg/day only for a day.
	12	The corner of her mouth was cracked. (One of the side effects of steroid?) Oxygen saturation: 90% Wrapped her right leg with a plastic outfit.
	13	Her appetite declined. Felt dullness in her tongue and uneasiness in her stomach. Drowsiness was enlarged.
	14	Cheeks were reddened.
	15	Appetite remained poor. Uneasiness in her stomach was vanished but her tongue felt like being covered with some thin film.		CEA: 802.9 CA15-3: 141.7 ALP: 659 LDH: 408 GOT: 126 GPT: 263 WBC: 4930 PLT: 17.1 Ly: 1.0 Ca: 8.1
	16	Belch-like feelings arose from her chest intermittently.
	17	Oxygen saturation: 97%
	18	Pain at the base of her right leg was lessened. Appetite revived. Mouth was stimulated by acid food.	Used povidone iodine (Isodine Gurgle) and kenalog for her mouth.
	19	Spent all day without oxygen tube. Right leg was swollen. Small red spots appeared on her palms.
	20	Spent almost all day without oxygen tube.
	21	Vomiting. Coughing. Made a basket with chopsticks as a care by occupational therapist.
	22	Yawned frequently. Felt pain in her abdomen.
	23	Vomiting. Obstipation.
	24	Vomiting. Nausea remained. We -- I and our children -- handcrafted the box for supporting her right leg as suggested by a nurse.	An antiemetic drug, Primperan, was injected and, after the injection, she felt like being blocked in her chest by some panel. Started the use of magnesium oxide to soften her obstination. Started the use of Fungizone (amphotericin B) and Diflucan (fluconazole) to remove Candida from her mouth.
	25	Went out on the stretcher.	Antiemetic drug was switched to Nauzelin (domperidone).
	26	Her appetite was restored. It was supposed to be a result of the removal of Candida. One of our friends played trumpet in her room.	Reduced the dose of Predonin by half to keep Candida away from her mouth.
	27	Felt heart clamp. Maybe an result of reducing the dose of Predonin. Diarrhea.
	28	Withering of the muscles in her legs and arms were remarkable.	Started the daily injection of granulocyte colony-stimulating factor (G-CSF) to increase her leukocytes. Stopped the use of Fungizon and Diflucan.	CEA: 797.7 CA15-3: 126.6 WBC: 1500
	29	Felt heart clamp. Diarrhea.		WBC: 3490 RBC: 305 PLT: 3.5 Ly: 0.5 Ca: 7.6
	30	When the head of her bed was raised, the heart clamp came back. Redness was observed in the skin of her sacral area and suspected as a sign of decubitus.
7	1	Oxygen saturation: 98% Electrocardiogram: Nothing was observed. Spent four hours on the wheel chair.
	2	Vomiting. Obstination. Spent three hours on the wheel chair.	Used bisacodyl to ease her obstination.
	3			WBC: 3680 RBC: 279 PLT: 3.2 Ly: 1.5 Ca: 8.2
	4	Petechiae was observed in her left abdomen. Sang songs on the occasion of an afternoon tea.
	5	In her mouth candida was reproduced and the red dots like petechiae could be observed. Spent two hours on the wheel chair.
	6	Sang many songs aloud on the Tanabata party. Oxygen saturation; morning: 93% night: 92%	Restarted the use of Fungizone and Diflucan. Applied Bonalfa (tacalcitol) to her withered skin.
	7	Weakening of her arms and hands was more remarkable. Went out on the wheel chair.		CEA: 886.3 CA15-3: 121.7 WBC: 5310 PLT: 3.3 Ly: 4.0
	8	Played catch with rubber balls to preserve her grasping power. Went out on the wheel chair. Bled at her gingivae while brushing her teeth. Oxygen saturation: 89%
	9	Her right leg was swollen. Petechiae was observed on her breast. Spent three hours on the wheel chair. Felt dizzy when the back of it was raised.
	10	Spent three hours on the wheel chair.	Took a echocardiogram.	ALP: 1332 LDH: 488 GOT: 124 GPT: 323 ?-GT: 2007 WBC: 13680 PLT: 4.6 Ly: 0.5 Ca: 7.9
	11	Spent one hour on the wheel chair.
	12	At dawn, felt a hard heart clamp and so terrified. It occurred again early in the afternoon. Frandol tape-S relieved her from the feelings. Electrocardiogram: Myocardial ischemia was recognized. Went out on the stretcher with a oxygen cylinder for about two hours.	Frandol tape-S (isosorbide dinitrate) was applied to expand her coronary vessel. The dose of MS contin was increased to 40mg/day.
	13	At dawn, her fears of the terrific heart clamps were revived.
	14	Felt uneasiness all over her body. After lunch, began to say some absurd things, probably, as a result of increasing the dose of MS contin. Her temperature fell in the night. It could also be regarded as the antipyretic effects of morphine.
	15	Since 3 a.m. the heart clamps had come back to agonize her intermittently and the frequency was increased. Felt bitter in her mouth. At night, enjoyed seeing the exhibition of fireworks in a adjacent town beyond the water.
	16	Although no heart clamps had come, fears deprived of her sleep. Delirium, or the absurdity of her speaking, continued. Irritation was remarkable and the absurdity was increased. It seemed to be an affection of her rapidly deteriorating liver.
	17	Delirium continued. At breakfast, ate a piece of sandwich and a half of orange which were virtually the last foods she took.		CEA: 1533.7 CA15-3: 125.8 ALP: 1825 LDH: 2041 GOT: 848 GPT: 759 ?-GT: 2117 WBC: 13250 PLT: 7.6 Ly: 0.0 Ca: 9.8
	18	Early in the morning her consciousness became clouded and she became inarticulate and began panting. On arriving of our children the continuous subcutaneous transfusion of morphine was started. At 10 a.m. we began to talk a long series of past stories with our friends and the staff of the ward, surrounding her with our hands on her arms and legs. At 7: 36 p.m. she was liberated from all her agony and farewelled to us.

1	4			CEA: 92
	15	Felt faint numbness on her sural region, which was likely to be a sign of paraplegia.
	17		Decided to undergo a spinal fusion operation to replace her osteoclastic bones (5th thoracic and the adjacent vertebrae) with a ceramic bone and fix her spine.
	18		Started the use of Krestin (a biological response modifier) as a countermeasure for the possible decline in her immunocompetence after the operation.
	22		Started the CMF therapy as a countermeasure for the possible decline in her immunocompetence after the operation. C: Cyclophosphamide M: Methotrexate F: 5'-DFUR
	24		Tried her spinal fusion operation, but it was interrupted with an unaccountable sharp drop in the indication of oximeter.
2	1			CEA: 42
	14	Like stomatitis symptom occurred (a side effect of CMF?).
	19	Started to lift up the head of her bed incrementally.
	20		The stiffness in her breast had disappeared.
3	4		Was examined with CT and Radionuclide Bone Imaging; The effects of the therapies were distinctly recognized.
	8	Felt pick in the right side of her abdomen (possibly a side effect of MPA or Calcitonin).
4	3		Started her rehabilitation.
5	6		Completed the CMF therapy, but continued the use of 5'-DFUR.
	8	Pigmentation at the bases of her nails was recognized (possibly a side effect of 5'-DFUR).
	28	Started to use wheelchair.
	31		Terminated the use of Krestin.
6	3			CEA: 15.9
7	1	Could stand.
8	5		Started her sitting practices.
	8			BMD: 0.976
	16		Started her walking practices.
9	2			CEA: 8.5
	28	Left the hospital.	Continued the use of MPA and 5'-DFUR. Reduced the Calcitonin injections to 2/week.

1	9	Walked an hour every day.		CEA: 4.5
2	27	Resumed driving.
4	1	Travelled by train with family.	Reduced the Calcitonin injections to 1/week.
5	1		Was examined with CT; Rather positive (osteoplastic) change was recognized.
9	11	I published our book, "A Diary of A Man Who Retrieved His Wife from Her Cancer Bed."
12	1		Reduced the Calcitonin injections to 1/2 weeks.

1	14	Was featured in a TV program.
4	2		Was examined with CT; No change recognized.
6	11			CEA: 10.2
	13	A bus trip.
7	9		Was examined with X-ray; No new focus found.	CEA: 12.1
	23		Started the CE therapy to strike a rising tip of CEA. C: Cyclophosphamide E: Epirubicin Terminated the use of 5'-DFUR.
8	6	Her hair began falling down.
	13			CEA: 13.1
	14	Tended to lose her appetite.
9	10			CEA: 10.7
10	1			CEA: 8.1
11	5		Completed her CE therapy.	CEA: 6.1
12	1		Reduced the Calcitonin injections to 1/month.
	10			CEA: 4.6