We met my oncologist.... YEAH!

Dr Daniel Ibach

November 27th: We met with my Oncologist, Dr. Ibach, today. We had a close family member see him for treatment and he came with high expectations.  Our first impression was excellent. He seemed to live up to the billing, easy to talk to, understanding of our concerns, clearly experienced with discussing serious issues in a manner that sets the patients and family at ease. He was able to smoothly transition to a level of conversation that demonstrated a level of understanding of us and our situation. I have, naturally, looked up some readily available documentation on my situation (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3873742/ as an example for a little light reading if you are interested). He reaffirmed my prognosis is excellent based on the pathology report showing strong P-16 indicators. He noted that traditionally patients that presented with head and neck cancers were the hard-living men who haunt the VA and were tougher than nails but with poor outcomes. My case, however, is part of a significant rising trend in middle-aged caucasians whose cases were independent of life-style (no or little history of hard drinking and heavy smoking). Cases such as mine are highly treatable and can be addressed with Erbitux chemotherapy and an intensive radiation treatment to the oropharyngeal (head and neck) area.

The Erbitux chemotherapy is a greatly desired advance over the normal chemotherapy course. It specifically targets the receptors in the squamous cells. Traditional chemotherapy doses are much more general and inhibit cell reproduction throughout the body. This is the chemical equivalent of using a scalpel instead of a chainsaw to address my malady. The drawback (because there always is one) is that I may have an allergic reaction. Should that happen, I would have to revert to the traditional treatment and wave goodbye to my beautiful head of hair. The good news is that the cases of adverse reactions to Erbitux are statistically lower for people who were raised in this region of Tennessee (someone should study why that is the case).

My in processing exam showed that I have regained the weight that I lost over the initial 3 weeks since my diagnosis. I had lost 12 pounds over this brief period, but Dr. Myer told me to start gaining weight. I mentioned that this was a strange recommendation coming from a doctor since I was already 20-30 pounds overweight. Dr. Ibach quipped that they were in the cancer business and not cardiologists. Lucky me considering it is the holiday season, and I had doctor's orders to eat all I can! Carmen has been consistently reinforcing my intake of turkey and stuffing with protein shakes and Ensure. (I have made my way through several delicious pies as well!) My rigorous attempts to control my weight prior to this cancer have been cast away as I indulge in my pre-emptive calorie binge. I am quietly hoping that I will come out the other end of this treatment at a svelte 180 lbs.

To conclude our visit, we set up my appointment for my maiden voyage into chemotherapy. Dr. Myer had set up my inaugural radiation treatment for December 6th. This essentially forced Dr. Ibach to schedule my first chemotherapy treatment for a week prior so that I could have the requisite chemical loading in my body which meant that I have to have this chemo on Wednesday, November 29th. Dr. Ibach would have preferred that I had a port for the chemo placed prior to this, but the surgical assets are not available until Friday, December 1st. Therefore, my first treatment will be done the old-fashioned way, but I'm looking forward to graduating from the pin-cushion phase of my treatment to the piñata stage. My arms are starting to have the track marks of a seasoned heroin junkie since I am stuck with needles every time I have an appointment.