Appointment with Surgeons

Wendy took Kathy to see both of her surgeons last week. I will try to remember everything...I keep forgetting to update the blog. She saw Dr. Whiteford (Colon Surgeon) and Dr. White (I think that is his name, we have so many names to remember now! anyway, he is the liver surgeon). She really likes both of them and totally trusts their advice and opinions. The plan for now is for Kathy to have 6 rounds of chemotherapy (which will take 12 weeks) and then do surgery. They will be able to remove the spot on her liver and then do an ablasion. This method is 90% effective in removing all infected tissue. The colon surgery will still be the same as described before and they may even be able to operate at the same time. She was also told that she has more likely had cancer for 3-4 years. The liver surgeon said that it would take that long to travel from her colon. So if you are reading this and you don't get regular colonoscopies PLEASE DO! Kathy had a petscan this morning and is doing her 2nd round of chemo as I type. The petscan will show any more "hotspots" throughout her body. And obviously the hope is that there aren't any! She is feeling pretty good, didn't seem to have any major side effects from her first treatment. Her Rheumatiod Arthriitis is still really painful but the chemo will actually help with that. As soon as I know more I will post again but for now please continue to pray for her.

Results are in...treatment plan

Kathy saw Dr. O'Brien (Oncologist) this morning to review the CT scan and start chemotherapy. The liver biopsy is malignant. They also have to assume that the lungs are malignant as well. (a lung biopsy is too invasive, the nodule grew, and it is common for colon cancer to travel to the lungs) So...with all that said she will start chemotherapy today. She will go in for treatment every 2 weeks. After treatment she will go home with a pump for 2 days. In 2 months, or after 4 treatments they will do another scan to see how the liver and lungs are reacting to the medication. She will meet with the liver and colon surgeon next week. They will consult with Dr. O'Brien and decide when to do surgery. It is unknown right now if they will even do surgery on her liver. She is in good spirits and has a positive outlook, she is putting all of her trust in her doctors hands...and we feel like she is in the best hands possible.

Small update..Appointments scheduled

Kathy had her lower body CT scan on Friday to get a better look at her liver. The liver biopsy is scheduled on Monday the 12th in McMinnville. She is getting her port-a-cath placed today and will start chemotherapy on Wednesday the 12th. She also has an appointment scheduled with a surgeon that specializes in the liver on the 21st. We will know by then what is going on in the liver and if surgery needs to happen. As soon the results from the biopsy are in I will do another update.

Setback...Surgery Cancelled until further notice

Kathy saw Dr. O’Brien (Oncologist) yesterday to review the CT scan that she had on Monday. The first scan she had showed some small nodules on her lungs. They wanted to do a follow up CT scan to follow up on the nodules. Since Kathy has Rheumatoid Arthritis the nodules could have been side effects from that. There is no way to know exactly what the nodules are without doing a biopsy. A lung biopsy is very invasive and they will not do it unless it is absolutely necessary. One of the nodules in her lungs actually increased in size. Which means that they are assuming it is Cancer. This also means that the nodules did not respond to the Chemo treatment she has already had (or they would have shrunk). The CT scan also showed a spot on her liver that was not there previously. This is not the news we wanted to hear… So the path forward is to do another CT scan of her lower body (this is scheduled for Friday). This will give a more detailed picture of the liver so they can schedule a biopsy. They will also schedule to have her port-a-cath put in (which they use to draw blood and administer Chemo). They will start Chemotherapy right away (probably Monday). Dr. O’Brien consulted with Dr. Whiteford (Surgeon) and they decided to cancel her surgery. They want to take care of the lungs and liver first. As soon as we know more I will post the information. We are all in shock and saddened by this news. Thanks for all of the support and prayers.

Surgery Date and Details

Kathy’s surgery has been scheduled for August 20^th.  During the surgery she will have 12 inches of her colon removed.  She will also have a temporary colostomy bag put in place.  She will be in the hospital for 5-6 days following surgery.  Before she is released to go home, they will place her port-a-cath in her chest for her to receive chemotherapy.  She will start Chemotherapy 4-6 weeks after surgery.  They need to give her body time to heal and her immune system to build up.  This chemotherapy will be much more intensive (the typical chemo you hear about…hair loss, nausea, fatigue..all the fun stuff) .  Once she is finished with chemotherapy the surgeon will re-attach her colon and there will be no need for a permanent colostomy. 

Kathy is in good spirits and is feeling pretty well.  She has been off her chemo medication for over a month and so her Rheumatoid Arthritis is starting to flare up.  She is also scheduled for a CT scan on the 29^th to see the size of the tumor and to also check if the nodules in her lungs have shrunk.  

Also, while she has had a break from radiation and chemotherapy she was able to spend some time in Newport with Wendy and her family (Maggie and baby Garrett) and she and Grandma Willard also came to Utah for 10 days.  We loved having them!

Thanks again for all of your thoughts, prayers and support!

3 weeks down...3 weeks to go

Kathy is 1/2 way through her first round of treatment before she has surgery.  She is feeling pretty good.  Her pain is under control and the Radiologist is confident that the tumor is shrinking.  She has been tired and hasn't had much of an appetite.  She is doing really well though and is looking forward to being done...with this part.
Thanks again for all your prayers and support!

Chemotherapy, Radiation, and Surgeon Appointment

Kathy started Chemotherapy and Radiation on Monday.  It took a while since it was her first time but now that everything is set up things should go much faster.  Her PICC line was put in on Friday and she said it was painless.  She goes to the cancer center on Mondays and they will dose her “fanny pack” for the entire week and then she goes in on Saturday and they remove it until Monday.  This type of chemo will not have many side effects other than nausea and fatigue.  She will do radiation every day (Monday-Friday) but it takes less than 5 minutes.  This round of Chemo and Radiation will be done on 6/21.

She had an appointment with the surgeon on Tuesday, the appointment went well.  She has another appointment with him on 7/18 and they will schedule a surgery date then. It will most likely be the end of July or early August. They've found if they wait a few weeks after chemo and radiation the tumor will continue to shrink.  The surgery will be done in Portland and she will be in the hospital for 5-6 days after. 

They also talked about doing a permanent colostomy.  He is leaving this decision up to Kathy.  He said that he can do his best to re-attach the colon; however, there are side effects to this, including numerous bowel movements and increased chance of infections.   He gave her all of her options and said she can take all the way up until the morning of the surgery to decide what she wants to do.  He said that many people have colostomies and you don’t know it.  In fact he treats a 30 year old male patient with one that is very active in sports and it doesn’t affect him.

Kathy has been treated so well through all of this.  She can’t say enough about all of the Doctors and Nurses she has seen.  They have all been so kind to her.  She knows she is in great hands.

Thanks again for all of your support and prayers.

Oncologist Appointment Information & Path Forward

Kathy had her endoscopic ultrasound Thursday morning.  She had to "prep" for the test and she got really sick.  And on top of it she had a migraine and was up basically all night-throwing up, none the less.  So the drive and appointment was not that great.  Luckily, Wendy and Emily were able to take her and they took great care of her! As soon as she got home and was able to take some Imitrex, eat and rest she felt a lot better. 

Her Oncology appointment was today and this is what they found out: 

The appointment went really well and Dr. O Brien seems like a great Oncologist. Next Friday she will have a pic line placed for the chemo that she will receive along with radiation. This should start a week from Monday and last for 5 weeks. After her 5 weeks of treatment they'll let her recuperate then surgically remove the tumor. After surgery she will have a colostomy bag which may end up being permanent, we'll have to wait and see. Afterward she will have a more intense round of chemo lasting 4 to 5 months. 

During this time she will be off of her RA drugs and will need to protect herself from the sun.

The tumor is very low, 1 cm away from the anal sphincter so a permanent colostomy bag may be imminent. 

Her Endoscopy staged the cancer at 3 since its grown into the wall of the rectal muscle.

Her CT Scan showed some very small nodules in the lungs which is common with RA, however, if they end up shrinking after chemo her cancer will be stage 4. Hopefully there is no change and it's related to her RA!

Dr. Mark Whiteford at Providence in Portland is a colorectal surgeon and will be removing the tumor. If possible he will also implant the port for the chemo she will receive after surgery.

Wendy was able to go with her and send me this information to post.  I hope we can keep it all straight! 

Thanks again for all of the prayers and support.  We are going to really need all we can get!

Waiting Game

We finally got the appointment scheduled for the Endoscopic ultrasound on Thursday at 6:30 am.  Yeah, way early! But at least it is scheduled.  She will then see the Oncologist on Friday at 3:30.  So, with that said we should know a lot more information by Friday evening.  More to come....

How we got here....and what we know so far

What a pain in the butt...literally. 

Kathy was having some pain and rectal bleeding.  She had a colonoscopy on Thursday the 18^th.  After the procedure her Dr. explained that during the procedure she found a tumor on her rectum.  The tumor was biopsied and sent as a rush to the lab.  On Monday the 22^nd, Kathy received a call from the office saying that the results were in and the Dr. wanted to see her the following morning. 

Kathy and I went to her appointment on Tuesday with Dr. Nyugen (pronounced Wynn) and were told that the biopsy was malignant.  In order to determine treatment and surgery 3 things needed to happen. 

1-      CT Scan from her neck to her pelvis (This would show any other tumors or “hot spots”)

2-      Blood Work (This is for a CEA tumor marker test)

3-      Endoscopic Ultrasound (This will determine the depth of the cancer and the stage)

Since Kathy had not eaten breakfast they were able to schedule the CT scan and blood work on the same day.  The bad part was she couldn’t eat or drink anything until after the test, which wasn’t even scheduled until 2:30.  Both of these tests could be done in McMinnville.  The third test had to be done in Tualatin.  I called the Tualatin clinic and she was able to get in for a consultation on Wednesday. 

There was good and bad news at the appointment.  I will start with the bad.  After checking in, filling out all the paper work and meeting with the Dr. we found out that her insurance would not cover the hospital where the procedure needed to be performed.  The GOOD news about this appointment is that the Dr. was awesome.  He had requested all of her records and had the results from the CT scan and blood work.  The CT scan did not show any other tumors or activity.  The only thing it did show was a few lymph nodes around the rectum that were inflamed.  He explained that just because they show up doesn’t mean they are cancerous, and even if they are no other lymph nodes in her body showed as being active.  The CT scan also showed that the cancer was 14 mm thick into the rectum wall.  He said that this just tells the physician where to look when he is performing the endoscopy.  The CEA tumor marker came back at a 3.2, which he said is excellent.  If you do not have cancer they expect it to be under 3. 

So for now we are just waiting to have the endoscopic ultrasound done.  This will be done in Portland through the Oregon Clinic.  I will update more as soon as we know! Thanks for all of your love and support.

Kami