Another Curve Ball

We returned home from Indy late last night, and did not see that we had a message on our home phone. This turned out to be a good thing. When we listened to it this morning we received news from IU that my HCG has gone back up. Despite all of the optimism yesterday, my HCG is back up to 40. This is a much smaller number than what we have been dealing with in the past, but more critical that the number is the trend. Unfortunately the trend appears to be a rising tumor marker.

So what do we do now? Well, we made a trip to Ann Arbor today for more tests, and there are four things that we are looking at as possible explanations. The most likely scenario is that the cancer is not yet dead. This will be determined by following my HCG and testing the other scenarios. If we rule out the other three, then we will locate the remaining live cancer tissue and determine a plan of action. The three other scenarios are as follows:

1. There is always a possibility, and in this case a hope, that the lab in Indy made a mistake. This is fairly unlikely, but by testing my blood today in Ann Arbor we can confirm or contradict the results from yesterday.

2. There is a very small chance that this is the result of lowered testosterone due to the high dose chemo. When the testosterone is lowered, the brain senses this and triggers the release of LH (leutenizing hormone) that would stimulate more testosterone production. LH is molecularly very similar to HCG, and therefore elevated levels of LH could be interpreted as elevated levels of HCG. Tomorrow they will give me a shot of testosterone, then check my HCG in one week. If this is the scenario playing out in my body, HCG should be back down to normal next week.

3. I will be getting another MRI of my brain if scenarios 1 and 2 prove false. The brain is a "safe haven" for testicular cancer because the chemo, no matter how high the dose, cannot cross the blood-brain barrier. So chemo will have no effect on a brain tumor. I have had 2 MRI's in the past and both were normal (despite what you may all think). It is unlikely that the cancer had a chance to spread to the brain since my last MRI, but it is something we need to investigate as a possibility.

So we hope for an error or a small miracle. I am not sure if scenario 3 is better or worse than having cancer that survived high dose chemo. Most likely, the explanation for the rising HCG is living cancer in one or more of the metastatic sites.

We had planned to spend this day packing for a trip to Traverse City, but that has been cancelled and we feel like we are back to square one a bit. Nonetheless, I have killed off most of this cancer. What remains may be just a few cells or just a small percentage of the original cancer. I will stay the course and finish this thing off! If I have beaten 99% of this cancer, you can bet that I will kill the last 1%. I feel as healthy as I have felt since June of last year. I continue to walk daily. On Wednesday I worked out at the YMCA and spent 22 minutes on the elliptical machine. Thursday I took two walks, a mile each, and Friday I walked 2 miles consecutively. Before my appointment in Indy yesterday I spent 28 minutes on the elliptical at our hotel. I may be walking instead of running, and my resistance setting on the elliptical is still on the lower half of the scale, but I am getting stronger each day. I feel great!! My doctors are amazed at how good I look; my hair is slowly beginning to grow again. I am determined to continue this trend of health, and reverse the HCG trend.

I said it early in my treatment; bring it on cancer, you don't know who you are messing with! The fight goes on.

Thank you all for your support and prayers, it looks like I will continue to need them a little longer. Thank you from the deepest part of my heart!