Wednesday, March 2, 2016

Genetic Testing and a Little Bit of CrossFit

After three primary cancers between us in the past 2.5 years, my wife and I met with a genetic counselor a few weeks ago.  I was the main target of the conversation, with 2 primary cancers of my own, but my wife has some significant family history of cancer, so we both went.  There were 2 reasons for doing this.

First, we wanted to know if either of us carried any genetic mutations that would predispose our children to increased cancer risk.  The fact that I had prostate cancer well before age 65, and that my uncle had the same cancer close to age 65 means my son is clearly at an increased future risk for this disease.

My wife and her father have both had melanoma, but they were different types and her father's melanoma occurred in his mid 80s - an age where it's no longer considered a genetic risk.

Secondly, we wanted to know if I had any mutations that would affect future treatment for my liposarcoma.  For example, a problem with the well known p53 oncogene could mean that the use of radiation to treat me now could greatly increase my risk of future cancers.  There are other genes that I won't list here that would allow doctors to target therapies for me in the future.

By the end of the visit, the genetic counselor thought I should have some genetic sequencing done, but that we shouldn't bother with my wife.  We followed her advice.  Yesterday, I got my results, and not a single genetic marker was out of order.  So, it sounds like I've simply been unlucky.  This is good news for me and for our children though, so I was happy to hear the results.

Now, there is still an area where sequencing might have some value for me.  When I have surgery next week, the surgeon could order genetic testing on the tumors he removes.  It's possible that the mutations in the tumors themselves could give us more information on how to treat any future recurrences.  But, I have no obvious flaws in some of the better known genes related to cancer, which is the best possible outcome, at least to the best of my knowledge.

I must admit that with another surgery looming, I've been a bit of a mess.  When I had surgery last September, I was sick, I was in pain, and I just wanted that damned tumor out of me.  Right now, I am most recovered from chemo, my workouts are improving, and I feel fine.  Yet, I am scheduled for major surgery in 8 days.  It just feels wrong to have such a significant surgery when I feel OK.  I've done it before with prostate cancer, and I still can't decide if that was the better treatment option or not.

On Monday, we fly to NYC.  I have medical appointments on Tuesday.  Wednesday, I have to do a bowel prep, and my surgery is on Thursday.  I'll probably be in the hospital for 4-7 days, depending on how fast my bowel functions return.  I know I need the surgery, but I can't seem to feel anything but anxiety and dread as the day gets closer.  There are also some "dignity" aspects to this whole process - a catheter, a CT scan with rectal contrast - that I'm dreading somewhat.  Yet, I know that skipping this surgery would likely be a death sentence, so I don't really have much choice.

In the interim, I'm doing as much as possible to take my mind off the surgery itself (except maybe writing this post).

Last night, we did a really tough workout at the gym, named for skier Ryan Hawks, who died after an accident in competition 5 years ago.  Our coach noted last night that I was the only person doing the workout (at that particular time of day) who had been a gym member when Ryan was also a member.  Ryan was an elite athlete who amazed me when he trained with us, and the workout is tough:

For time:

Row 1000 meters
50 deadlifts
50 thrusters
50 box jumps
50 burpees
50 per side lunges with a plate overhead
100 double unders

The last time I did this workout, I'd done only a few CF sessions in months, due to being sick and having surgery.  I scaled the weights and also scaled the reps to 30 each for the middle 5 movements.  Last night, still not being 100%, I scaled to 40 reps, and my time was nearly identical to last time.  My previous time doing this was right before I started chemo, so I was happy with a better outcome after months of chemo.

Monday night, we'd done a squat workout, but it was a deloading week, so things weren't too bad.  Then our main workout had been short after the squats.  Today, I'm pretty sore and my daughter's high school basketball team is playing in the state semi-finals, so I get a rest day.  They're playing the #2 seed, but they've already beaten #6 and #3, so maybe they have a chance tonight.  In the other bracket, #4 took out #1 on Monday, so there is a path for them to win it all.  If they can beat #2, #3, #4 and #6 as an eleventh seed, I think they will have earned the title.

After today, my goal will be to do as much CrossFit and skiing as I can before I leave for NYC.  And, looking at the weather for next week in NYC, I hope to get in some running or walking in Central Park and maybe a CF workout before my surgery.  Doing some training will at least take my mind off the impending surgery.


janinsanfran said...

I've asked to have your name (first and no particulars) added to our church prayer list of people who are sick. I have no idea whether prayer does anything for anyone, but it is a very human way of remembering to have the backs of people who may need support. Will get you removed if offends.

Damon said...

Jan, I'm not offended. If anything, even though I'm not really a praying man myself, I've been very touched just to know that people are thinking about me, worrying about me, and praying for me. It's more than a small consolation. I've met some fellow sarcoma patients online and I'm amazed at how many have described how friends and even family (a spouse in 2 cases) deserted them when they most needed help. I've had the opposite reaction - an outpouring of support that I never would have imagined. I always think of my wife as the "good" person in our marriage, while I'm more of an opinionated jerk at times (at least that's how I view myself). My wife has reminded me constantly that the support we are getting isn't about her, but rather for me. And, that's very humbling. Thank you.

Harriet said...

Thanks for the update Damon. Of course I am pulling for you.