Archive for May, 2006
CT Scan #1
Sarah & I just returned from the doctor’s office where we got the results of some blood work, had a CT scan, and heard the preliminary report on that CT scan.
First, blood work was all great, further indicating the tumor was a typical carcinoid as suspected. Also indicated Sarah is healing from the surgery wonderfully.
CT scan showed NO signs of any tumors we didn’t already know about, so that too is very positive. Lungs, stomach, lymph nodes were all seemingly clear, so that is good news.
On the liver, her oncologist indicated he saw about 12 spots, which he said is similar to what he suspected. The largest tumor is about 3.3 centimeters across. The remainder all appeared to be in the 1-2 cm range, to my uneducated eye. The doctor has prescribed thrice-daily injections of Sandostatin (or Octreotide), which began this afternoon. If you’ve ever wanted to inflict minor pain on Sarah, the shot schedule will be approximately 7 a.m, 3 p.m, and 10 p.m., with her insisting she’ll be unable to do the deed herself.
We have another appointment tomorrow morning with a surgical oncologist at Ellis Fischel, where we’ll further discuss treatment options. At this point, the most likely immediate option is hepatic artery embolization. That would be a series of outpatientish surgeries where they restrict the blood flow to Sarah’s liver, a procedure which makes life very difficult for the tumors, but doesn’t harm the liver too much. This procedure is good for two different reasons — first, it harms the tumors; secondly, it treats the issue without eliminating other treatments from possibility down the road. We are very anxious to have the opinion of the surgical oncologist tomorrow too, though.
Sarah, Adelaide, Jack, and I are all doing well. Sarah’s report to the nurse was that she was ‘almost normal’, which is about as good as any of us can hope for really.
Once again, thanks to all family, friends, co-workers, and even fairly random acquaintances who have offered kindnesses, kind words, prayers, and positive vibes. Thanks also to the NCAA, who gave a bid to the MU baseball team, so their last game of the season didn’t have to be a sickening loss to the prairie chickens of beakerville. Down with the shoebirds, and All Hail the Scarfman (read Sports Illustrated’s letters to the editor, if you haven’t already. And if you haven’t already, you should probably consider reevaluating your priorities).
Jason
Oncology Appointment #1
Sarah met with her oncologist on Friday and received relatively good news. He agrees with the Poplar Bluff pathologist that the issue is/was a gastrointestinal carcinoid tumor, metastasized to the liver. If you’ve searched for “gastric cancer” or “stomach cancer” online, you probably read articles that didn’t necessarily apply.
Carcinoid is very slow growing, with the MU and Poplar Bluff pathologists believing this to be a very typical example. He said it was possible the tumor had been in Sarah’s stomach for 10 years, the spots in her liver for 5. She has CT scan scheduled for the Tuesday after Memorial Day, with blood work and other testing being done in the meantime.
After seeing what the CT scan shows, it’s possible treatment will be shots of octreotide, which can slow the growth of the spots in the liver, and then careful monitoring of those spots. It’s also possible that we’d consider more invasive treatment, including attacking those spots with alcohol, chemotherapy, forms of radiation, or other. Much like before, though, until we see the CT scan results, we’re still unsure what we’re dealing with.
Thanks for continued thoughts, assistance, and prayers. We’re doing well.
Jason
(and down with the mythical shoe-wearing birds)
Sarah is Home
Sarah was released from Poplar Bluff Memorial Hospital a day earlier than first predicted. We thank them for their efforts.
We drove home Sunday afternoon then, with the trip going smoothly. Sarah is sore from the surgery, but relatively comfortable. I think if you saw her walking down the street, you’d never know she’d had such a shocking week. Everyone, kids included, made it through the first night at home with no major incidents (thanks to a grandmother, as usual).
We can’t say thank you enough to everyone for their support and offers of help. However, special thanks to those friends and family that combined to finish the flower gardens Sarah had started out front and beside our back patio. Absolutely wonderful. Also, special thanks to those who helped Adelaide get ready for her dance recital on Friday night and then again to those that documented the event for Sarah to see.
Sarah has an appointment with her oncologist (at Ellis Fischel) later this week, at which point we’ll begin learning more and more and more about how she is going to beat the illness.
Many have asked about bringing meals to the house, with Amy LaHue being the first of many to offer to coordinate such a thing. So, if you are interested in such a thing, e-mail Jason and he’ll forward to Amy so she can coordinate. Many have offered already, but I’m going to make you offer again (to give you a chance to back out!).
Sarah Update
This will be old information for some, brand new for others. For those hearing for the first time, I apologize that it’s online…. I can’t emphasize enough how thankful we are to have such a strong and wide group of family and friends that are offering help from every angle imaginable.
Last weekend, Sarah, Adelaide, Jack, and I drove to Malden to visit my family, both just for normal weekend fun and because my sister Jan was visiting from Switzerland.
Early Sunday morning, Sarah woke me stating she needed to go somewhere, because of severe pain on the left side of her stomach. We drove from my mom & Bill’s house to the ambulance shed in Malden, where we then rode to the hospital in Poplar Bluff, Mo.
After x-rays and CT scan, they discovered Sarah had a ‘leak’ in either her stomach or intestine and began exploratory surgery to find and repair that leak. In successfully completing that surgery however, they found the leak was in her stomach and was caused by a cancerous tumor. Literally then feeling around, the surgeon also found the cancer had spread to her liver. The official diagnosis is carcinoid tumor, gastric (stomach) ulcer, which has metastatized to the liver. By definition, it is a Stage IV tumor (advanced).
She is still in Poplar Bluff right now (I’m in Columbia for today) recovering from the stomach surgery, with all signs seeming to indicate release from there on Monday. Right now, the focus is almost purely on healing from the stomach surgery. On return to Columbia, we will then begin investigating her diagnosis further, naturally including treatment options.
Through family and friends, we have had oncologists at MU, KU (bastards), and Johns Hopkins review the pathology report, which we received yesterday morning. All three places noticed something unusual in the growth rate of the tumor. It appears to be growing faster than typical for this type of tumor, which could be good/bad/incorrect or just unusual. The samples are being sent to Columbia now for a second opinion there, and we’ll possibly send to either Johns Hopkins or Wash U (or other) after that.
Beyond that, Sarah needs to have testing done extensively to discover more about her situation. Once we get that process going, we’ll then really begin investigating treatment options for the cancer.
I’ve been tight on information, simply because we don’t know much and I wasn’t interested in correcting any false information. Everything I’ve said here, though, is as much as we know right now and can be passed on to anyone who asks.
Sarah is doing remarkably well. She is able to get up and walk around well and had her first ‘meal’ of jello and iced tea yesterday afternoon. Both kids are handling everything very well, including no longer nursing for 28 lb “baby” Jack. Grandparents and family have been an invaluable part of that, and we’ll start accepting some of those offers from friends very soon.
With the offers we have received, it is quite conceivable that I could do nothing but help Sarah for a period of months/weeks, for which I’m unbelievably grateful. Sarah fully intends to best this current hurdle, with the lovely kids and love of friends and family providing additional motivation. I fully intend to do everything possible to help her however she needs it.
Thanks again to all for your thoughts, prayers, and various actions/offers of unbelievable kindness.
Jason Becking
(and on a side note, screw ku.)