Today we met with the radiation oncologist, Dr. Cheung. He talked to us for quite a long time and answered all of our questions. He seems to think that it is worth trying 4 weeks of radiation therapy. He let us know that it is not a cure, but it may produce some helpful effects. If it works, the potential good outcomes would be: the tumor shrinks, maybe as much as 30%; Bob might be able to breathe easier; and it might help with the cough. Also, if the tumor shrinks the doctor said he wouldn't expect it to begin growing again for possibly 6 months. Right now the tumor has doubled in size in a little over two months. Unfortunately, he also said that the radiation might produce no results at all.
The doctor thought the side effects of the treatment would be minimal. He said that for the first two weeks, Bob wouldn't notice anything. Starting at the third week he would begin to feel some burning, and his esophagus would be puffy and tender. He seemed to think that this would be manageable though. He said that there was medicine they could give him to numb his esophagus. These side effects should recede a week after the treatment ends.
The fear of a hole developing in his esophagus is still a real possibility and would be very dangerous as I discussed before back in my beginning posts. If this happens he might develop a serious and very hard to treat infection, or pneumonia. This possibility would last for at least three months after the treatment ended, as the tumor continues to respond to the radiation.
Bob and I considered all of this and decided to go ahead and try the radiation treatment. The doctor thought it was a good idea, and we would really like to have relief from some of the symptoms and a good six months. So we decided to try it.
We start Tuesday at 10:45am. We'll go for this treatment 5 days a week, Monday through Friday in Temple for 4 weeks. You can only have six weeks of radiation total on most body parts or the tissue starts to break down. The doctor seemed to think that at 4 weeks the side effects would be less. If Bob was responding very well, he could have the additional two weeks either at that time, or later if needed. The treatment itself is very quick, they said only 5 minutes, which is a huge good change from the chemo. I worry that all the travelling is going to be very tiring for Bob. He's feeling extremely tired these days. But we're just going to have to try and see how we do.
That's the latest. Also, as of last check, Walter has bounced back again; I don't even believe it. He started walking around and looking for food soon after my last post. What a dog.
Carol
Friday, October 19, 2007
Thursday, October 18, 2007
The Cat Scan Results
Well, I won't beat around the bush, we did not get good news yesterday. The scan showed that the tumor has grown, and it has grown through and around the stint they put in several months ago. The doctor showed us the cat scan pictures and you could see that at one point in Bob's esophagus there is only a very narrow opening left. I would estimate that there is only about 10-20 percent of his esophagus remaining clear. The doctor was amazed that Bob has not had any trouble swallowing recently, but he hasn't. The doctor explained that the esophagus can expand, so that is probably the reason he has been able to swallow without any problems.
Because the tumor has grown so much and is growing so fast, the doctor doesn't think any more chemo will help. He said that we could try some other chemo drugs, but that there was only a 5-10% chance they would help, and it was much more likely they would make him sick, because he is so weakened now. So Bob decided against additional chemotherapy. The doctor suggested that we speak with the radiation oncologist about the possibility of radiation. He didn't give us much hope, however, of this producing any significant help either. He said it could make it easier for Bob to eat for a while, but that it would also make him very uncomfortable and while he was getting it, sore and unable to take in anything other than liquids. We have an appointment with the radiation doctor tomorrow to get his opinion. After that we'll make a decision about how to proceed.
I also have a bad Walter update. Just about an hour ago, he seemed to have what might be another stroke. He dropped to the floor and didn't move, and hasn't moved since. I have him resting comfortably in his bed. He's still breathing, but my gut instinct says he won't recover from this.
Thank you so much for all the kind wishes everyone, I wish I had better news to report.
Carol
Because the tumor has grown so much and is growing so fast, the doctor doesn't think any more chemo will help. He said that we could try some other chemo drugs, but that there was only a 5-10% chance they would help, and it was much more likely they would make him sick, because he is so weakened now. So Bob decided against additional chemotherapy. The doctor suggested that we speak with the radiation oncologist about the possibility of radiation. He didn't give us much hope, however, of this producing any significant help either. He said it could make it easier for Bob to eat for a while, but that it would also make him very uncomfortable and while he was getting it, sore and unable to take in anything other than liquids. We have an appointment with the radiation doctor tomorrow to get his opinion. After that we'll make a decision about how to proceed.
I also have a bad Walter update. Just about an hour ago, he seemed to have what might be another stroke. He dropped to the floor and didn't move, and hasn't moved since. I have him resting comfortably in his bed. He's still breathing, but my gut instinct says he won't recover from this.
Thank you so much for all the kind wishes everyone, I wish I had better news to report.
Carol
Monday, October 15, 2007
The Cat Scan, not results
Hi,
Just wanted to update on how the cat scan process went. You might remember that I said I wanted to stay with Bob when he had it done. Well, when the technician came to take us back for the procedure, I looked at him and said "I'd like to come with him." He looked like he started to say something else, then had a look at my face, and said, "OK." I think I must have a had an "I'm asking, but I'm not taking No for an answer" look. He even gave me a lead vest so that I could stay while the scan was occurring. So, I thought that was pretty nice. I was glad I was able to stay too. I don't know about Bob, but it made me feel a lot better to be able to stay right with him.
Walter is hanging in there. He wants to eat all the time, which must be a good sign.
I'll update again when we get the results on Wednesday.
Carol
Just wanted to update on how the cat scan process went. You might remember that I said I wanted to stay with Bob when he had it done. Well, when the technician came to take us back for the procedure, I looked at him and said "I'd like to come with him." He looked like he started to say something else, then had a look at my face, and said, "OK." I think I must have a had an "I'm asking, but I'm not taking No for an answer" look. He even gave me a lead vest so that I could stay while the scan was occurring. So, I thought that was pretty nice. I was glad I was able to stay too. I don't know about Bob, but it made me feel a lot better to be able to stay right with him.
Walter is hanging in there. He wants to eat all the time, which must be a good sign.
I'll update again when we get the results on Wednesday.
Carol
Thursday, October 11, 2007
The latest oncologist update
Yesterday Bob had an appointment with Dr. Posada, the oncologist, for his monthly check up. First Bob has lost more weight. He lost 10 pounds in the past month. That's a total of almost 50 pounds since this started. He weighs 156 right now. It's hard to maintain your weight when you're fighting cancer, but the doctors stress how important it is.
When we talked to the doctor we told him that Bob has been more tired this past month than the one before. Before he heard that and considered the additional weight loss, he was going to schedule another round of chemo. He feels that now we should go ahead and get a cat scan to see what's going on. He is afraid that because of the fatigue and weight loss that the chemo drugs may have stopped working.
So, we have an appointment to get a cat scan tomorrow at 11am, and then we will go see Dr. Posada for the results of that next Wednesday at 4pm. If the tumor hasn't decreased or has grown, the doctor will change the chemo drugs he has been using. He warned us that sometimes when you have to change them, the effectiveness gets progressivly less each time. So, naturally, feel free to send us good cat scan thoughts.
I'm going to try to get them to let me stay with him during the cat scan tomorrow. The small spaces freak him out. Plus, the last time I sent him back for a test alone, somebody almost jammed a needle straight through his vein. They might not let me, but they'll hear about it if so.
I'm also going to try extra hard to make sure Bob has a good meal for every meal. He's been trying too, but there have been times when he's just had yogurt for lunch. So, I'm going to see if I can make sure he has something decent to eat all the time.
For those of you following my Walter saga, he's not doing too well I'm afraid. He's not tinkling on the bed right now, and the tinkling situation is down to a managable level, but he's not doing well otherwise. He's weak; sometimes he has trouble standing or walking. His back legs seem stiff and weak. He follows us around the house and just stares at us. It's like he doesn't know what else to do. We had a scare with him last week. He was lying on his bed in the floor and was not moving and didn't move when I touched him. He felt stiff even. I was afraid that was it that night. But a little while later he followed me into the kitchen to eat. Now I'm wondering if it's possible if he had a little stroke or something. Well anyway, in spite of all that he is still eating good and enjoying being petted, so we're taking it one day at a time. We're doing a lot of that around our house right now.
Carol
When we talked to the doctor we told him that Bob has been more tired this past month than the one before. Before he heard that and considered the additional weight loss, he was going to schedule another round of chemo. He feels that now we should go ahead and get a cat scan to see what's going on. He is afraid that because of the fatigue and weight loss that the chemo drugs may have stopped working.
So, we have an appointment to get a cat scan tomorrow at 11am, and then we will go see Dr. Posada for the results of that next Wednesday at 4pm. If the tumor hasn't decreased or has grown, the doctor will change the chemo drugs he has been using. He warned us that sometimes when you have to change them, the effectiveness gets progressivly less each time. So, naturally, feel free to send us good cat scan thoughts.
I'm going to try to get them to let me stay with him during the cat scan tomorrow. The small spaces freak him out. Plus, the last time I sent him back for a test alone, somebody almost jammed a needle straight through his vein. They might not let me, but they'll hear about it if so.
I'm also going to try extra hard to make sure Bob has a good meal for every meal. He's been trying too, but there have been times when he's just had yogurt for lunch. So, I'm going to see if I can make sure he has something decent to eat all the time.
For those of you following my Walter saga, he's not doing too well I'm afraid. He's not tinkling on the bed right now, and the tinkling situation is down to a managable level, but he's not doing well otherwise. He's weak; sometimes he has trouble standing or walking. His back legs seem stiff and weak. He follows us around the house and just stares at us. It's like he doesn't know what else to do. We had a scare with him last week. He was lying on his bed in the floor and was not moving and didn't move when I touched him. He felt stiff even. I was afraid that was it that night. But a little while later he followed me into the kitchen to eat. Now I'm wondering if it's possible if he had a little stroke or something. Well anyway, in spite of all that he is still eating good and enjoying being petted, so we're taking it one day at a time. We're doing a lot of that around our house right now.
Carol
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