Sandy plans to return to work nearly full time on Monday. She's been working half days for the past couple of weeks and is feeling better since . . .
She had 850cc's of fluid extracted from her right lung on Thursday. She had had a pain in her right side, a persistent cough and shortness of breath. We went to our family practice doctor on Monday, who referred her to a lung doctor (for lack of a more accurate term), who scheduled her for the extraction. Over 3 1/2 cups or more than a bottle of wine. Once done, she could literally breathe easier.
But, we wondered, were there any cancer cells in the fluid? She got a call yesterday telling her that there were no cancer cells in the fluid. Good news. We cracked open a bottle of non-alcoholic wine to celebrate, no irony intended.
This was a side trip on the way to recovery from the cancer. She still has a pain in her side, which might be residual or might be due to something yet undetected. If the pain subsides in the days to come, we'll have our answer.
We had a first appointment with the oncological gynecologist at the University of Chicago on March 13th. We hoped for a definitive answer from her, Dr. Yamada. She gave us a number of options, which was disappointing. How are we to know which option is best? Here they are:
1) Join a clinical trial. The trial is to test a drug called Avastin (containing the unpronounceable bevacizumab). The trial has three "arms." Each arm entails the use of standard chemotherapy (2 chemicals) plus the addition of either Avastin or placebo (the control group). This is 6 cycles at 3 weeks apiece, followed by 15 months of treatment without the 2 chemicals but with the use of either the Avastin or placebo. The purpose is to determine whether Avastin is more effective than no Avastin. Avastin has been approved for colorectal cancer, and this trial is to determine whether it's advisable for use in ovarian cancer. It's a double-blind study and it would pay for chemicals used.
2) Because Sandy had a 4cm diameter cancer attached to her colon following the laparotomy on Feb 18, the possibility exists to undergo a "second look" surgery to remove it and do repairs as necessary before beginning chemotherapy. I should add that, if the doctor were to do this and remove all cancer or leave a cancer of less than 1cm in diameter, then chemotherapy would differ from "normal." I mean that "normal" chemotherapy would involve inserting a port catheter into Sandy's chest. The catheter feeds into a major vein or artery (whichever is the correct term) and it is into this port that the chemicals would be administered. This saves on "blowing out" smaller veins because of the caustic side effects of these chemicals. If this is "normal," then the "not normal" procedure would be to insert a port near Sandy's abdomen, to feed chemicals directly into the affected area and thus bypass areas that do not need them. This is called intraperitoneal injection, or IP chemotherapy. This is the most effective chemotherapy for ovarian cancer, but is tolerated by less than half of those women who receive it. It's brutal but it's the most effective method, by all accounts. After hearing about the side effects of IP chemo, Sandy is leaning heavily away from it.
3) Begin chemotherapy as soon as possible in hopes that this will kill all remaining cancer cells, making a second look surgery moot.
After researching Avastin on the Internet, we decided not to participate in the clinical trial. At least with regard to colorectal cancer, Avastin has been shown to prolong life only another 5 months and it costs about $100,000 a year. Since Avastin has not been approved for use with ovarian cancer, it's doubtful that insurance would cover the cost. If we had the money of, say, Bill and Melinda Gates we might pursue this, but we do not.
Sandy thinks Dr. Yamada might lean toward going in for a second look surgery prior to beginning chemotherapy. Of course, this means healing from surgery all over again, possibly with more difficulty if the doctor performs a colon resection. We don't know. The doctor has been out all this week.
Sandy will call Dr. Yamada on Monday to see what she thinks, or worse yet, set up an appointment to get the same information face-to-face, wasting precious time. In any event, we'll go with what she deems most appropriate.
For most of the time, our days are as normal as those of anyone else. Right now she's making one of her favorite all-time foods, pasta e fagioli as made by Olive Garden. She plans to spend some of this afternoon reading some steamy novel while sitting in the sun on the front porch. She visits her mother in a nursing home. She talks to her sisters on a daily basis. She watches HGTV on a daily basis. She's sewing occasionally. Doing things, living her life. Shopping. Meanwhile, I have a lot of yard work to do after having installed a French drain on two sides of the house. The yard's a mess. I have a couple guys from the local University of Illinois County Extension Office working with me to determine how best to patch up or repair a large area of brown grass in the back yard. Rototilling is planned, along with twice-annual core aeration to try to get grass roots to grow in this thick, gumbo clay soil our house is built on.
We don't now what the doctor will say on Monday. After we talk, we'll know more and proceed as she advises.
She had 850cc's of fluid extracted from her right lung on Thursday. She had had a pain in her right side, a persistent cough and shortness of breath. We went to our family practice doctor on Monday, who referred her to a lung doctor (for lack of a more accurate term), who scheduled her for the extraction. Over 3 1/2 cups or more than a bottle of wine. Once done, she could literally breathe easier.
But, we wondered, were there any cancer cells in the fluid? She got a call yesterday telling her that there were no cancer cells in the fluid. Good news. We cracked open a bottle of non-alcoholic wine to celebrate, no irony intended.
This was a side trip on the way to recovery from the cancer. She still has a pain in her side, which might be residual or might be due to something yet undetected. If the pain subsides in the days to come, we'll have our answer.
We had a first appointment with the oncological gynecologist at the University of Chicago on March 13th. We hoped for a definitive answer from her, Dr. Yamada. She gave us a number of options, which was disappointing. How are we to know which option is best? Here they are:
1) Join a clinical trial. The trial is to test a drug called Avastin (containing the unpronounceable bevacizumab). The trial has three "arms." Each arm entails the use of standard chemotherapy (2 chemicals) plus the addition of either Avastin or placebo (the control group). This is 6 cycles at 3 weeks apiece, followed by 15 months of treatment without the 2 chemicals but with the use of either the Avastin or placebo. The purpose is to determine whether Avastin is more effective than no Avastin. Avastin has been approved for colorectal cancer, and this trial is to determine whether it's advisable for use in ovarian cancer. It's a double-blind study and it would pay for chemicals used.
2) Because Sandy had a 4cm diameter cancer attached to her colon following the laparotomy on Feb 18, the possibility exists to undergo a "second look" surgery to remove it and do repairs as necessary before beginning chemotherapy. I should add that, if the doctor were to do this and remove all cancer or leave a cancer of less than 1cm in diameter, then chemotherapy would differ from "normal." I mean that "normal" chemotherapy would involve inserting a port catheter into Sandy's chest. The catheter feeds into a major vein or artery (whichever is the correct term) and it is into this port that the chemicals would be administered. This saves on "blowing out" smaller veins because of the caustic side effects of these chemicals. If this is "normal," then the "not normal" procedure would be to insert a port near Sandy's abdomen, to feed chemicals directly into the affected area and thus bypass areas that do not need them. This is called intraperitoneal injection, or IP chemotherapy. This is the most effective chemotherapy for ovarian cancer, but is tolerated by less than half of those women who receive it. It's brutal but it's the most effective method, by all accounts. After hearing about the side effects of IP chemo, Sandy is leaning heavily away from it.
3) Begin chemotherapy as soon as possible in hopes that this will kill all remaining cancer cells, making a second look surgery moot.
After researching Avastin on the Internet, we decided not to participate in the clinical trial. At least with regard to colorectal cancer, Avastin has been shown to prolong life only another 5 months and it costs about $100,000 a year. Since Avastin has not been approved for use with ovarian cancer, it's doubtful that insurance would cover the cost. If we had the money of, say, Bill and Melinda Gates we might pursue this, but we do not.
Sandy thinks Dr. Yamada might lean toward going in for a second look surgery prior to beginning chemotherapy. Of course, this means healing from surgery all over again, possibly with more difficulty if the doctor performs a colon resection. We don't know. The doctor has been out all this week.
Sandy will call Dr. Yamada on Monday to see what she thinks, or worse yet, set up an appointment to get the same information face-to-face, wasting precious time. In any event, we'll go with what she deems most appropriate.
For most of the time, our days are as normal as those of anyone else. Right now she's making one of her favorite all-time foods, pasta e fagioli as made by Olive Garden. She plans to spend some of this afternoon reading some steamy novel while sitting in the sun on the front porch. She visits her mother in a nursing home. She talks to her sisters on a daily basis. She watches HGTV on a daily basis. She's sewing occasionally. Doing things, living her life. Shopping. Meanwhile, I have a lot of yard work to do after having installed a French drain on two sides of the house. The yard's a mess. I have a couple guys from the local University of Illinois County Extension Office working with me to determine how best to patch up or repair a large area of brown grass in the back yard. Rototilling is planned, along with twice-annual core aeration to try to get grass roots to grow in this thick, gumbo clay soil our house is built on.
We don't now what the doctor will say on Monday. After we talk, we'll know more and proceed as she advises.
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