Cancer · FOLFOX · SIRT

The Enthusiast

I’ve always been an enthusiast. My mother has an astrology book in which people born on my birthday are given the advice: “Remember that the object of your enthusiasm is at least as important as your level of enthusiasm”. This is sage advice for me.

Once I had settled into the shock of the cancer diagnosis, I started to in a strange way, get enthusiastic about it. Odd I know. Not about having cancer, but about what I could do in response. I changed my diet completely, cut out alcohol, tried to meditate etc. All very virtuous. And I am still doing those things. But with time, it is starting to wear on me somewhat.

I am tired. I have just finished round 8 of chemotherapy. The protocol I am on is called FOLFOX plus avastin and is administered fortnightly. This is a pretty short cycle – many protocols have longer breaks between infusions. FOLFOX is famously rough on the body and mind. I have been very lucky to have avoided the worst of the systemic side effects – no mouth ulcers or peeling hands and feet for me. But I do feel vile for at least five days of every fortnight. It’s a vile I can’t adequately describe, except to say that at points I have thought that this might be all too hard. I always come back to my senses though – the sickness passes and my quality of life returns, but those moments are scary and I have noticed that dread of each chemo cycle is building up in me even before the current one is completed.  My enthusiasm for FOLFOX is definitely eroding.

As part of my endless research into possible treatment options I came across the outcomes of a clinical trial run out of the Royal Melbourne Hospital which combined Selective Internal Radiation Treatment (SIRT) with the standard chemotherapy protocols (i.e. FOLFOX or FOLFIRI) in patients with liver metastases from bowel cancer. The outcomes of the trial were very positive and I was/am super keen to have the treatment.

In true Caitlin fashion I sent the findings off to my oncologist and he very promptly arranged a consultation for me with the professor who had lead the trial. I saw him yesterday and it was largely good news – pending a work up of my liver blood supply, it seems I am a good candidate for SIRT. All of this was something I had been hoping very much for.

However, I felt quite distressed for most of yesterday. And decidedly lacking in enthusiasm. The doctor was very kind, but was clearly taken aback by the extent of my liver mets. I’m so used to my diagnosis now that I almost forget the severity of it until someone else reacts anew.  It was also I think fatigue – the constant putting oneself out there asking for my treatments and  knowing they will be painful and sick inducing. Sort of like dating and I never enjoyed that. Sometimes the unfairness of it hits me suddenly. Instead of feeling grateful that SIRT may work for me I just felt resentful and tired and very very sad.


Thankfully, overnight the resentment seems to have lifted and I feel much more like my usual self. I’m excited again about the SIRT option, and looking forward to the next week or so of feeling well, seeing friends and family, eating Moreton Bay Bugs and just generally being on holidays.

Truly it is the fairytale and the abyss. This is what it is, and I just need to keep going.

“Success is the ability to go from failure to failure without losing your enthusiasm”
― Winston Churchill

5 thoughts on “The Enthusiast

  1. Caitlin you’re a beautiful writer. Thanks for sharing this I’ve read it over and over. I admire you more than ever friend xoxo


  2. Also- I have heard a good “feeling bloody crook” descriptor- “first I worried that I was going to die, then I worried that I wasn’t going to die.”
    Does that cover it?


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