Treatment Phase 2 begins on 2009.06.01

i'm going to call the radiation+chemo treatment i received in 2008.12 and 2009.01 Phase 1. At the time, i thought it was the only treatment i was going to get for my cancer, but i had totally underestimated my adversary's power over me. Phase 1 was completed in Toronto. Now i've moved to Taipei and will begin Phase 2 on 2009.06.01.

Phase 2 includes radiation and chemotherapy, similar to Phase 1.

The chemo will be the same, except that in Taiwan, i will check in at noon and stay overnight at the hospital to receive the weekly chemo. The medicine used is called Cisplatin. It is the same as what i had received in Phase 1. This medicine needs a lot of fluids to wash out in order to preserve my kidneys. Therefore, i'll be given several bags of saline solution during my chemo stays at the hospital. (In Canada, i was simply told to drink 2 litres of water a day. My chemo sessions there only consisted of 1 bag of saline and 1 bag of Cisplatin.) As such, i'm not so hopeful that i would be unaffected by the side effects. But the good thing is that i won't need any catheter (人工血管) installed on my chest or arm for the i.v. Cisplatin is covered by insurance (健保) but hospital stays are only partially covered. Double room is NT$2,200 per day and single room is NT$4250 per day. Hospital food is about NT$390 per day. i will receive 6 chemo sessions in Phase 2. (In Phase 1 i only received 5 sessions of chemo.)

Radiation will be targeted at my abdomen area, as opposed to pelvic area in Phase 1. i was told that the upcoming radiation will go easier on me compared with Phase 1 because i'm paying a little extra money (about NT$28,000 for the course of Phase 2) to receive a better targeted radiation treatment. My Phase 1 radiation was basically a boxed-area treatment - hence the damages to my intestines. Hopefully Phase 2 radiation will only aim at the cancer cells and avoid my good cells, so as to minimize damages and side effects.

The radiation oncologist believes i will be able to work during treatment. However, i'm not so optimistic after speaking to the chemo oncologist.. In any case, whatever they say i may or may not experience is really irrelevant to me, because everybody reacts differently to these treatments. i will know how i feel when the time comes.. which is soon enough!!

Phase 2 is expected to be 6 weeks but the exact time frame isn't determined yet. i will go to the hospital 5 days a week to receive radiation, and stay overnight one day per week to receive chemo.

i was told that there's some unidentified water in my abdomen (腹水) that needs to be monitored. The dr said it could be cancerous, or it could be my body's reaction to the existing tumor. In any case the water is too little to be analyzed right now so we'll have to wait and see.

Phase 3, adjuvant chemotherapy, will begin a few weeks after Phase 2 ends. The date is not determined yet because it depends on how i react to Phase 2. Phase 3 will be chemo only. There are two options for me: 1) Cisplatin + Taxol and 2) Cisplatin + Topotecan. i will be given chemo once every 3 weeks, and i will need 6 cycles = 18 weeks in total. Cisplatin is covered by insurance but Taxol and Topotecan are self-paid. Option 1 will cost about NT$30,000 per session with 1 day of hospital stay, and option 2 will cost about NT$20,000 per session with 2 days of hospital stay. The dr said both provide about the same results but the side effects are different. i'm still trying to understand more about the two before i decide which to go with.