Dendritic Cell Vaccine

It became apparent that if necessary, I could have the Dendritic Cell Vaccine as well as the Ipi simultaneously. This made the decision making easy. I consulted Dr Ramos, who, while unconvinced about the DCV, empathised with my situation and agreed to go ahead with harvesting the tumours for the vaccine. He is an old acquaintance through my friend Jenny and professor of surgery and master of keyhole surgery of the liver. I know that none of this is coincidental.

I also heard from the Research Genetic Cancer Centre that my cancer cells are responsive to Ipi. This is exceedingly good news.

So, we went ahead with the surgery on Monday. I'm back home now, with four holes and several stitches in my fat tummy and feeling as if I did a million sit ups yesterday. There will have to be a couple of days of teetering around. I am notorious at underestimating the effects of surgery and had planned to teach this morning!

The surgery was scary and successful. Dr Ramos, using his immeasurable skill, managed to extract 2 pea sized tumours from my liver. He had a look around and said the rest of the liver looked normal and definitely not 'riddled '.

They took 20 tubes of blood too and Tim and Nicola did the dash to get the material to Pretoria within the 4 hour margin, while it was viable for making the vaccine. What drama! They almost needed a poice escort. I was so relieved they could go together.

Unfortunately the blood was put into the wrong tubes, so yesterday, they had to take another 20 from 3 sites and Tim did the drive to Pretoria again.

The vaccine is all brewed up now and incubating and should be ready to be reinjected by the end of next week. I am so lucky to be able to participate in this cutting edge technology. It makes such sense to me. The tumour cells have been sectioned and frozen at -70C and fresh blood will be mixed with them to make a new vaccine every month.

There is much to celebrate as it is almost a year since I was given a 10% chance of surviving 6 months. So , a bit like Benjamin Button, I'm getting younger rather than older! A very old a dear friend of the family, who practised as a doctor for 60 years told me never to underestimate the power of prayer. There can't be another explanation.

Doing well

I know it is nearly two months since I last wrote, but on hearing bad news, I chickened out!The family holiday in Plett with the Martin Bashalls just seemed to be the best healer and a bit of escapism seemed to be in order.

It worked well. We had the perfect holiday, not marred by as much as a broken nail. Plett was utterly gorgeous, the children all on great form and the greatest delight was that Francesca and Matthew announced their engagement there with us. What a privilege for us and such a source of delight.

Home again and needing to face some of the less appealing aspects of reality.

The last CT scan showed that the tumours had grown by 9% and that there were some new ones too. I have been feeling fine and just didn't feel like acknowledging the progression. But, further to owning the situation, I've been doing some research and I have two main options now.

They are mutually exclusive so I need to be careful about my decision.

Dendritic Cell Vaccine; I'll need to have a tumour removed, then sectioned and frozen. They then take my blood and train the dendritic cells to recognise the tumour cells as baddies and to attack them. A vaccine is cultured and then injected back. One of Dr Golding's patients is doing well with this.

Ipiliminab: a newly FDA approved drug which has shown good results melanoma patients. It has bad long term side effects and I need to consider the risk reward ratio. Just today, I heard that my cancer cells can be tested for sensitivity to Ipi by the Research Genetic Cancer Centre in Greece and that result will make the decision making easier.

I have had the port put in under GA and it is making it much easier to take the vitamin c drip, as there is no prospecting for veins, so I'll be having that drip twice a week.

Nothing is straight forward.

In the interim, I'm leading a rich and full life. Nicola is back from her trip to Morocco, having had a wonderful time, James has exams in too short a time and after a gory, but glorious morning shadowing a surgeon, Ali has decided that he has to be a doctor. So my wings are clipped as I need to give him every opportunity to raise his marks significantly in 8 weeks. Testing reveals that he has the goods but now we need to create opportunity for the bottom to connect to the seat, frequently and for long periods at a time. For those who know me well, the idea of Al doing medicine does fill me with irrational delight!

The Link at Salvazione school is powering ahead and the children are making very good progress. The challenges of literacy in the language which is not a child's mother tongue are many. Every minute spent among the committed and willing volunteers and delightful children is a healer.

Thank you for bearing with me.