Some medical updates arrive like warnings. Others land like confirmations. Today’s December 8 review from Princess Margaret, paired with the echocardiogram I completed last Friday, is something different: a reminder that even in recurrence, my body continues to show resilience exactly where I need it most.
This is the kind of update that shapes Chapter Four, not with drama, but with clarity.
The Bloodwork That Sets the Stage
Every line of my December 8 bloodwork points to one thing: stability. My hemoglobin is strong, my white cells and platelets are normal, and my electrolytes sit exactly where they should. Even liver enzymes — numbers that often drift when cancer returns to the liver — remain firmly in the normal range. My kidneys, too, continue to do their work without complaint.
The significance of this is simple but enormous. Nothing in my blood suggests systemic stress, inflammation, or organ dysfunction. In oncology, the absence of bad news is often its own form of good news.
Even the outlier from earlier in the month — a wildly abnormal coagulation panel — has now been confirmed as nothing more than a heparin-contaminated line draw. The repeat tests are completely normal.
The Heart of the Matter
On December 5, I had a transthoracic echocardiogram, the full ultrasound evaluation of my heart. What it showed was not just reassuring — it was definitive.
My heart is structurally strong. My left ventricular ejection fraction sits at 60%, comfortably in the healthy range. My global longitudinal strain, a more sensitive measure of cardiac performance, is –21.5%, which is the territory occupied by athletes, not patients.
There is a small note about mild hypokinesis of one basal segment of the septum, but it changes nothing. The overall picture is clear: my heart is functioning beautifully, with no signs of disease, no strain, and no impairment. The valves open and close exactly as they should. The right side of the heart shows normal pressures. There is no fluid, no thickening, no warning.
For someone preparing to re-enter systemic therapy or a clinical trial, this matters. A strong heart expands options. It increases tolerance. It gives doctors room to treat aggressively when needed. It confirms that everything I do — the walking, the fasting, the routine — is building a foundation that medicine can work with, not against.
Imaging, Markers, and the Shape of the Fight
The December 8 summary at Princess Margaret also pulled together my recent scans. The MRI and PET tell a consistent story: recurrence in the liver, but nowhere else. A few lesions have changed slightly, one labelled as “suspicious,” several others shifting in both directions. It is not a static disease, but it is contained.
CEA trends remain upward, which matches what the imaging shows. Nothing dramatic. Nothing explosive. Just the slow, persistent rhythm of recurrence that Chapter Four is built upon.
And yet, the summary’s tone is clear: I show no symptoms of progression. I walk every day, I train twice a week, and my body has not folded under the weight of it all.
In oncology, strength is not measured by optimism. It is measured by capacity. Right now, I have capacity.
Positioned for What Comes Next
Princess Margaret has clearly laid out the following steps. I remain under consideration for the GSK B7-H3 antibody-drug conjugate trial, and the team will update me this Wednesday with the final decision on my participation. FOLFIRI plus Panitumumab (the standard care) — is already prepared, should the trial not go forward.
And all of this rests on the stability shown in today’s results. A strong heart. Balanced bloodwork. Quiet organs. No systemic distress. The disease is active, but it has not outrun the boundaries that still make treatment effective.
The Meaning Inside the Numbers
What I take from today is not hope, not fear, but alignment. My body is doing its part. The scans outline the battlefield. The labs confirm that the system is holding steady. The heart shows it is prepared for whatever comes next. There is a path — not guaranteed, not simple, but navigable.
Chapter Four is not being written from a place of weakness.
It is being written from a place of readiness.