Husband doing ECX chemo following sub-total gastrectomy

Hi guys

My husband was diagnosed with a tumor of the pylorus at the end of May & underwent a subtotal gastrectomy in Mid June, discharged from hospital on Jun 30th and started chemo treatment ECX last Tues.

He was an incredibly fit 73 year old Triathlete (current World Champion Triathlete for his age.) I noticed in Feb that he was losing weight, but thought that he had been training too hard, as he was assisting a buddy's training (who was competing in Ironman here in March), going on the long bike rides etc with her. He had also booked in to compete in the Australian Ironman here in Western Australia in Dec, (but we have cancelled that for obvious reasons!) He started asking for smaller meals & then softer meals. I suggested that he stop training so much as the calories in were less than calories out! He had been taking Reflux medication for a month or so and we thought he had an ulcer. In April, he was really ill at 2am, & I called the ambulance & he was taken to hospital. Discharged in mid morning, we went to our local doctor who gave him the breath test for Pylori. It came back as positive & was given the antibiotic mix required to cure that.

Meantime, our Doc also suggested he have an endoscopy, to check the stomach internally. He was having incredbly smelly burps/reflux that almost made ME ill! The endoscopy was done & the tumor (just called 'nodes' at that point) was discovered. Pathology confirmed a signet ring tumor almost blocking food from entering the Duodenum. So the smelly burps were the result of the undigested liquid food that couldn't exit the stomach!

We went to Sydney to see the GI Specialist Surgeon, who initially intended putting him onto 9 weeks of chemo before operating, but the next day, when doing an endoscopy and laparoscopy to check inside & outside of the stomach for breaches, he discovered that the tumor was worse than before & operated 2 days later, removing most of my husband's stomach. THe surgeon DID, however, 'increase the size' of the remaining stomach, using a piece of the small intestine & reattached the duodenum not far below this. They also removed a huge 50 lymph nodes & found cancer in only one of them, so were pretty sure that chemo would follow surgery.

The epidural pain relief for the first 5 days following surgery was brilliant. He felt no pain whatsoever. He was in Intensive care from Sat-Mon & then up to the Gastro ward. Within a couple of days, he was pulling himself up into a sitting position & out of bed walking (albeit slowly) using the drip pole and the physiotherapist as support. On the 5th day, the epidural was removed and a PCA attached to his drip (patient controlled morphine pain relief.)

He recovered very well from the surgery, tho he lost a lot of weight, as he had 11 days pre & post op without food, so withered to 50kg. He has always been thin, but this was too thin. Back home, he over ate on the first evening & was horribly ill. He resolved not to do that again! In the first week, I put a timer on to ring every hour. He ate one hour, then drank the next - having about 6-8 small meals for that first week. He put on 2kg & I was ecstatic. The next 2 weeks he only gained 1kg, but that was still good.

On his 4 week checkup since surgery, the surgeon was very happy with his recovery & we spoke with chemo & radiation guys about followup treatment. It was decided to give him ECX chemo & that radiation was not necessary. The ECX would be to 'mop up' any rogue cells that may have entered the system from that one positive lymph node, on 3 weekly sessions for 9 or 12 weeks.

He started ECX this Tuesday & is already feeling very fatigued - having a couple of rests - morning and afternoon. He has gone off his food for now, too, dropping back to 51kg. Right now, my focus is on him at least maintaining his current weight & hopefully, increasing it a bit, to withstand the rigours of chemo. Even if this mean having fries on a regular basis, or KFC Chicken Wraps with fries (something he would not normally eat, but has enjoyed in the past few weeks ....) then I am happy to go & get it for him.

He has been eating surprisingly well up til now - most 'main meals' being a good sized bowl of porridge, vege soup with pasta and evening meal, along with snacks of cheese & biscuits, pistachio & cashew nuts, pasta & sauce during the day. I was expecting him to only be able to eat food by the tablespoon! Not so - we just gradually increased some of the meals & he has even been out to Chinese Restaurant meals with triathlon friends twice! I may get some takeaway for him, as I don't want to expose him to anyone with colds or flu until he is totally over the whole regime of medication & well on the way to recovery.

So far, he hasn't had any real nausea to speak of, but i realise that it is still very early into his chemo treatment & is already taking anti nausea tabs to prevent it. We go back for the second chemo session (as long as his blood count is OK) on Aug 23. We live in a small coastal town 4hrs north of Sydney and now drive 1.5hrs north to Port Macquarie for the treatment. They have a lodge that cancer patients can stay in at a nominal cost, so that is a terrific help to us, as it is only a 200m walk to the cancer clinic. All the medical staff that we have encountered so far have been absolutely terrific. We really do believe we had the best surgeon for the operation and the staff at the cancer clinic are brilliant too. Very funny almost, tho efficient in their jobs.

I just hope & pray that he doesn't get any of the nastier side effects that ECX can give - (so far, so good) & that the 9 or 12 week courses of chemo goes quickly & successfully, so that we can then concentrate on him putting on more weight & just getting better!

He has been going for walks along the beach every morning & up til this morning, was even having a little jog ..... but today, he just felt too plain tired to jog, so only walked. With the weight loss, we'll cut out the walking for now, & just have him doing stretches & maybe some pilate exercises, to keep him toned (mentally as well, as sport has been his life for the last 50+ years.)

So far, he has been a model patient & we hope his recovery follows the same path & DOES mop up any rogue cells.

I hope that anyone else going thru this treatment has good support from family & friends and a successful outcome.

Cheers

illAussie