The Oncologist Appointment

We saw the oncologist today; well first we saw a cancer treatment advocate, then the doctors’ physicians assistant, then the doctor. These are some things we learned.

The cancer numbers indicator from the CEA (carcinoembryonic antigen) blood test shows normal levels for Bonnie. More information here.. http://www.webmd.com/cancer/carcinoembryonic-antigen-cea

She was checked twice, once at the colonoscopy on January 16 2008, and once before the surgery on the 22^nd. The first one gave a result of 1.0 and the second one a 0.9, below 3 is normal. So the type of cancer that Bonnie has does not have a measurable indicator. Which means, as I understand it, that we never know if it is all gone or comes back unless it shows up on a scan (CT/PET) or some sort of x-ray or ultra sound or going in to check. The first place it should show up is in the liver since that filters everything in the body and should pick it up first. But the one scan she had showed no problems in the liver. I like that news. I would want them to do another scan or two to verify the liver is still good. But, they don’t think that needs to happen at this time.

The Dr. said the colon resection went well and it had ‘clean margins’ as he called it meaning the surgeon felt along the colon on both sides of the tumor/growth and that he felt the cancer was contained to that section that was removed and the ‘clean margins’ meant that the resection was done without any cancer still being present. They did say that she is basically now considered disease free/cancer free because the cancer was taken out with the surgery. And what may be left is not detectable, so they say she is cancer free. But, since there was malignancy in 18 of 25 nodes that they removed, they want/recommend to do chemotherapy treatments to make sure it gets knocked out. He said the surgeon would have felt along the rest of the colon to see if there were any other growths and there must not have been any.

He made a drawing for us (see picture) that showed how the growth had started and grown into and outside of the colon until it blocked the colon 90%. When it starts going outside the colon it can get into the lymph nodes and/or the blood vessels. Hers did affect the nodes of course. Then it would spread to the liver, then lungs, then bone. So far so good along those lines I guess.

They are recommending a course of treatment called FolFox, check the WebMD link (Colorectal Cancer Health Center link at the left) to find out more about these terms. It would be administered through a tube inserted into her upper chest into a blood vessel where the chemo (oxalapletic?) would be inserted over a 3-3 ½ hour period and then a pump would be connected that would administer more treatment (5FU) over the next 48 hours. So she would have to go back 2 days later to get the pump removed. The treatment would be repeated every 2 weeks for 12 treatments which would take about 6 months to complete. It will be a long and tough process ahead still.

The side affects of this would be that she would be very fatigued starting the night of treatment and lasting a few days and slowly getting better until the next treatment 2 weeks later. Her immune system would be highly affected (wiped out) so we would have to be very careful not to expose her to germs/bugs/viruses/etc. He said to have hand sanitizer in the house for all to use. He said hands spread the most germs. If anything causes a temperature of 100.5 then they would administer antibiotics. Lastly, she would have neuropathy, meaning anything cold ingested or touched would feel like she was getting electrically shocked. So wear socks and drink room temperature drinks and she will learn other things to avoid. Then there can be tingling in her fingers and toes that should last a little while and if it continues they may need to reduce some of the meds in the ‘recipe’ as he called it that make up the chemo treatment. So you do not see a side affect of hair loss, that does not occur with this treatment apparently and she is happy about that. And there shouldn’t be a lot of nausea either.

Since there are no test indicators of her type of cancer the prognosis of it returning/recurring is not known (as I understand it, even though we did not ask that question). So if one were to have a NON-recurrence percent of 50% the treatments could improve that an additional 15% to 30% (65%-80%). If the NON-recurrence rate were 65%, it would help it to improve to 80%-95%. I guess annual or bi-annual colonoscopies and scans would have to be taken to try to see anything.

We setup to get the line inserted on February 15 and to have the first treatment on the 19^th. We have to work around our trip to Los Cruces NM on the 12^th of March for the WAC Basketball tournament (go USU AGGIES!). And then our trip to Yellowstone in May also has to be worked around. We are looking into getting a second opinion and also checking into having treatments at the Huntsman Cancer Institute instead of the Utah Cancer Specialists. So the dates may change if we change courses/groups of treatment. Stay tuned.

We feel like maybe we have experienced a minor miracle here and credit you for your fasting and prayers and prayers and prayers. This has been a roller coaster of a ride but hopefully things smooth out from here and we can knock this out.

Thanks again all for your many kindnesses and thoughts/comments.

Love the Rawlings