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Radiation in the mix

I was going to expound on how today’s oncology appointment was one of the most important of my journey so far, but I realized that they’re all important, aren’t they?

My last update shared some of my fears and concerns about having metastatic cancer in both my liver and spine.

Today’s appointment was positive and helped shed a bit of light on how we’re going to proceed forward.

…and there is a path forward.

I should have years, not months.

Picking off the cancer

The area that’s a primary concern for my oncologist is my liver.

One piece of good news: my liver is stable on my current treatment, which means that we’ll continue the bi-weekly poisoning until it shows itself to be ineffective.

Since I’m not prepping for surgery anymore, we’re going to add another treatment—bevacizumab—back into the cocktail to ensure that the systemic treatment is as effective as possible.

The aim here is to prevent the cancer from spreading anywhere else—the next likely place being my lungs—and to shrink whatever we can. We’re still working toward a liver surgery (even though transplant and the HAI pump clinical trial are off the table for now).

The liver is the most important focus because it’s responsible for processing so much of the medication that’s keeping me alive.

This seems important.

Secondary to my liver are my spinal lesions.

My spinal MRI confirmed that I have two cancerous growths which are going to be the focus of radiation therapy. The precise when of it all is approximately the week of September 11th, but the specific details are forthcoming as I’ve yet to meet with my radiation oncologist.

The growths are putting pressure on my vertebrae and have caused a couple of them to fracture. It fucking hurts.

Here’s my shittiest possible rendition.

It’s not to scale and isn’t even really representative of the where for my fractures, but you get the gist.

I full on went camping with compression fractures and thought I was just getting old.

Adapted from Mayo Clinic’s diagram on compression fractures.

The idea is to blast the growths with radiation, which should kill them and ease some of the spinal pain as the fractures heal.

Every few months I’ll have scans and every few months we’ll treat whatever we find.

An aside: my medical oncologist did NOT like that I asked if we’d be playing “whack-a-mole” with my cancer but eventually conceded that it’s a good analogy.

Focusing on quality of life

I also sought a referral to palliative care today.

Palliative care is different from hospice care, though they are sometimes conflated.

Palliation focuses on my quality of life and, I suppose, hospice would focus on my quality of death.

There’s no need for hospice because I have some L-I-V-I-N to do.

My primary reason for connecting with palliative care is because pain management will become an important part of my day-to-day. I’m already managing seven different medications, so a single source that’s in control of the pharmaceuticals will be helpful.

They can also help with many other things that I’ll need as I move through upcoming treatments.

Sleep medicine. It’s sleep medicine.

What’s next?

Next week I’m heading to New York for the annual Man Up to Cancer retreat: the Gathering of Wolves.

It’s convenient timing that I’m on a break from chemotherapy for the duration.

This year there’s a sense of urgency for me to go. Several of our brothers who attended last year have died since, which is a sobering reminder of the unpredictability of this disease.

I want to go while my health permits.

Of course, this means that I’ll be away for Shannon’s birthday, so we’ll have some kind of celebration once I get back.


If you’ve made it this far, congratulations!

I appreciate you following along with this whole ordeal.




My name is Jason Manuge. I'm an early onset Stage IV colorectal cancer survivor. You can find me on social as CancerCanuck!

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