Staying Pragmatic

A few people have been asking me how I am feeling about next Monday's meeting and it has also been put to me that my views sound a little negative.

Throughout the process I have done my best to do what I feel are the right things and keep moving forward in a focused manner.  Like everyone else in my situation there is every reason to desire recovery and my desire has not waned.

What I don't want to do is to have unrealistic expectations.

The good thing is that we are not looking for cure from the latest round of treatment.  Rather we are simply looking to get me into theatre.  That will mean that

1. The infection that has burst outside the oesophagus (e.g. between the lungs) must have diminished.  The nodal infection was too big and too plentiful
2. The length of the tumour must have shrunk
3. The depth of the tumour in the oesophageal wall must have shrunk

These are all things that the first round of treatment failed to achieve in large enough measure and this round of treatment is designed as second shot at it.  I was only given this round of treatment (rather than palliative treatment) after all the departments had met to discuss my case.

Of course, age and general levels of fitness are both on my side and, to be honest, I feel that I deserve a break!

There is a big difference between the first phase of chemotherapy treatment that I had and the combined chemo/radiotherapy.  With the chemotherapy there are obvious yardsticks to judge progress e.g. tumour counts, ability to eat, how one feels.  With the radiotherapy there is no statistical and scientific feedback instead the body is propelled into a mess for a few months and you just have to hope for the best.

That is a much more difficult framework to be consistently optimistic in because when all symptoms are negative and everyday is difficult and you are not given any information to support optimism then where do  you pull it from?

I will enter next Monday's meeting with my feet firmly on the ground but hoping for the best possible results.

The scan has been brought forward by four weeks, so there isn't a guarantee that I will get a cast iron response.  It may be for example that the consensus is that things seem to be progressing but that the radiotherapy needs longer to work and later reassessment.

We will see.