Chicken or the Egg?

Recently I have had separate appointments with my gastroenterologist and with my oncologist. My gastroenterologist clarified one detail that I had either missed or misunderstood. The consultations with Mayo clinic experts resulted in a recommendation to avoid Remicade and Azathioprine for as long as possible. The detail I missed was the reason why. The recommendation is not based on a theory of the drugs causing cancer cells to begin growing; rather they are worried that if any lingering cancer cells exist or if recurrent cancer cells begin to grow the immunosuppressant drugs may retard the immune system’s natural ability to fight them off. They are not sure if either drug actually caused my initial bout with cancer. No one is sure of that. My appointment with my oncologist further confirmed that mystery. Even the hematological oncologist experts are not sure what caused my cancer. My oncologist also discussed my case with experts and none of them had a definitive answer. Everyone is in agreement that the longer I can avoid going back on the immunosuppressant drugs the better. The question is: if I find no other alternative and must go back on either one, will that possibly cause cancer cells to begin growing or will that simply allow cancer cells that may or may not already exist to spread? I may never know.

On the bright side, I am doing very well. Physically, my strength is back, although my muscles frequently are sore for several days after physical activity. I don’t have difficulty during the activity, such as climbing a 14er or biking, but afterward I realize my body does not bounce back like it used to. Also, the neuropathy in my feet still has not gone away, and after 9 months it is likely that it never will.