Both Feet And A Boat

The nastiest side effect so far showed up about four days after the last treatment (#4 - end of the 2nd full cycle). At first it was just an interesting foot rash - both feet almost identical, with a red band of skin wrapping around the ankle. It was like this for a day or two, and then it got really painful. So painful that I couldn't walk or stand. When I called the oncology nurses, after a lot of questions and research, they determined that "you have to find a doctor to get eyes on this - ER, family doctor, acute care clinic, whatever - somebody needs to see this." Fortunately I was able to get in and see our family doctor's practice - he wasn't there but one of his colleagues would see me. She had a close look, eliminated all causes for real concern, and basically ended the visit with "you need to tell the oncology people to update the side effect list - I have no idea what this could be." Fortunately, the pain and rash subsided and today it only looks like my feet are a strange colour. And one of my toes fell off. It was a middle one so not important. 

At the same time, while sitting in a ferry lineup, I got a call from Dr. Narinesingh (radiation oncologist) about treating my tumour. He said at this point they would not approve radiation, but if there were any changes (tumour not shrinking, tumour growth, etc) they would absolutely revisit. Without current imaging, it was probably the only logical choice to make at this point. 

For a nice break from it all (and fortunately my feet were functioning again) we travelled to Campbell River and then to Quadra Island to meet up with Dave and Sherri on their boat. We spent three days with them anchored out in Quadra and Cortes Islands, and it was a very nice escape. We even met up with one of Laura's (and Sherri's) old high school friends and her husband - they were anchored about 100m from us at Manson Landing (Cortes). We did a little clamming the next morning, and everybody limited out in about 5 minutes. Dave spent a full day smoking and candying some salmon for us, all while trying to prevent the boat from catching on fire (what could go wrong?).

Finally, today we met with Dr. Suo (oncologist) - he wanted to put eyeballs on me before the start of Round #3. My lab work all checked out - liver function OK, kidney function OK, side effects under control (or gone). So tomorrow we'll start again at 100% dose of both Keytruda (pembrolizumab) and Padcev (enfortumab vedotin or EV). Bring it on cancer boy.