Ruth/Mom/Grammy had surgery on the 28th to insert her chemotherapy port and PEG tube. She did remarkably well during surgery considering she is 85. I am sure all the prayers played a part in making the surgery uneventful and successful. Thank you. She had to stay overnight in the hospital to make sure she didn't run a temperature and that the PEG tube stayed in place. With that accomplished, she is now home and recovering nicely. She is still able to chew and swallow so she is not using the PEG tube at the moment. We hope she never has to use it, but it is there if she needs it.
Next appointment: with chemotherapy oncologist to check the healing process after insertion of her port and hopefully to schedule the beginning of chemotherapy treatment.
THANK YOU for all your prayers and thank you to those of you who have been sending cards to Mom.
Tuesday, March 29, 2011
Wednesday, March 23, 2011
March 22, 2011
We met with Mom's radiation oncologist (I love him!) on Tuesday morning. The PET scan confirmed she has T1N1 Stage III cancer of the hypopharynx with 1 involved lymph node. He again went through the options with us, giving us a few new ones to consider.
1) Surgery to remove the tumor and lymph node - NOT recommended because of the damage to the throat/larynx/voicebox
2) Organ Preservation without surgery to get rid of the cancer - 3 options -
(CT/RT = Chemotherapy/Radiation)
1. concurrent CT/RT - chemotherapy and radiation at the same time - most frequently recommended - 65-70% cure rate - most toxic
2. sequential CT/RT - weeks of chemotherapy followed by weeks of radiation - less recommended - 60-65% cure rate- less toxic that 1.
3. RT alone - 55-60% cure rate - least recommended, but the least toxic because of no chemotherapy
3) Hospice - Allow the cancer to spread while treating the symptoms but not the disease.
4) Chemotherapy Alone - Attempt to hold the cancer "at bay" to keep it from growing larger.
This doctor, along with the surgeon who did her biopsy, still recommends trying 2) 2. - sequential CT/RT - in mom's case. He said women are usually tougher than men and that although she is "old" and "feeble", he thought we should give it a try. If the chemotherapy is too hard on her, we can always switch to Radiaion alone. It will still cause damage to her neck and throat, but the drug toxicity is not there from the chemotherapy.
So, I asked Mom what SHE wanted to do, and she wants to try 2) 2. - sequential CT/RT - as this wonderful doctor who I LOVE recommends (I already said that, didn't I!). First, she will have surgery to receive a chemotherapy port in her chest to receive the drugs and not have to become a "pin cushion" and a Percutaneous Endoscopic Gastrostomy/PEG (feeding) tube to help her get enough nutrients when her throat becomes too sore to swallow food or when the chemotherapy makes her too sick to eat. After the port heals for about a week, Mom will begin chemotherapy treatments. We still don't know how many days a week or for how many weeks she will receive chemotherapy, but we should find out soon.
CONTINUED PRAYERS PLEASE!!!
1) Surgery to remove the tumor and lymph node - NOT recommended because of the damage to the throat/larynx/voicebox
2) Organ Preservation without surgery to get rid of the cancer - 3 options -
(CT/RT = Chemotherapy/Radiation)
1. concurrent CT/RT - chemotherapy and radiation at the same time - most frequently recommended - 65-70% cure rate - most toxic
2. sequential CT/RT - weeks of chemotherapy followed by weeks of radiation - less recommended - 60-65% cure rate- less toxic that 1.
3. RT alone - 55-60% cure rate - least recommended, but the least toxic because of no chemotherapy
3) Hospice - Allow the cancer to spread while treating the symptoms but not the disease.
4) Chemotherapy Alone - Attempt to hold the cancer "at bay" to keep it from growing larger.
This doctor, along with the surgeon who did her biopsy, still recommends trying 2) 2. - sequential CT/RT - in mom's case. He said women are usually tougher than men and that although she is "old" and "feeble", he thought we should give it a try. If the chemotherapy is too hard on her, we can always switch to Radiaion alone. It will still cause damage to her neck and throat, but the drug toxicity is not there from the chemotherapy.
So, I asked Mom what SHE wanted to do, and she wants to try 2) 2. - sequential CT/RT - as this wonderful doctor who I LOVE recommends (I already said that, didn't I!). First, she will have surgery to receive a chemotherapy port in her chest to receive the drugs and not have to become a "pin cushion" and a Percutaneous Endoscopic Gastrostomy/PEG (feeding) tube to help her get enough nutrients when her throat becomes too sore to swallow food or when the chemotherapy makes her too sick to eat. After the port heals for about a week, Mom will begin chemotherapy treatments. We still don't know how many days a week or for how many weeks she will receive chemotherapy, but we should find out soon.
CONTINUED PRAYERS PLEASE!!!
March 14, 2011
The visit with the chemotherapy oncologist did not go well. (Please know as you are reading this, that the next blog will let you know that were have already been back to the radiation oncologist whom we LOVE already after only 2 appointments and that we don't care what this doctor says, we are going ahead with chemotherapy and radiation treatment, but more on that later.) Although her cancer (which is squamous cell cancer of the hypopharynx) is a fairly typical kind of cancer, he informed us it is an agressive cancer, not slow growing. Therefore, one lymph node is already involved which makes it Stage III cancer. He also does not recommend surgery to remove the cancer. He then said, " if only you were 40 years younger..." for the first time and repeated it many times during the visit. The throat is also a hard area to treat because of the nutrition issues. He said she needs to spend time with the family discussing how hard the treatments would be on her because many of the patients are unable to eat because of the treatment as well as the cancer. He said Mom is not a good candidate for treatments because of her COPD and atrial fibrillation. She would have to have a feeding tube inserted directly into her stomach to provide nutrients and fluid as she has already lost 5% of her body mass. He said it was not reasonable to put her through too much at her age. He again said that the chemo drugs would be hard on her even if she was 40 years younger and that we have a complicated problem on our hands. He wants to talk to her radiation oncologist again and that he has a "to do" list of things that need to be done and reports he needs to see before he will consider treatment. He said there would be no formal follow-up with him yet and basically I felt he sent Mom home to die. As Kip said, "you're damned if you do and damned if you don't" have treatment. I called the radiation oncologist the same day I heard the audio version of this appointment as I was out of town during spring break and did not attend this appointment in person. We scheduled an appointment with her radiation oncologist and I will tell you more about that in the next blog.
Friday, March 11, 2011
March 11, 2011
Ruth/Mom/Grammy had both a PET scan and a CT scan today for planning her radiation therapy. She tolerated both well, but was glad when the procedures were over. Dr. Truelson, her surgeon, called this morning and said that her pathology results were back from her biopsy and that yes, it is squamous cell cancer as he suspected. I guess if you have to have cancer, it's a good cancer to have because it is slow growing and slow spreading which is part of the reason the PET scan already came back clear for all other organs except the larynx and I believe one lymph node on the same side of the neck as the tumor. (We'll double check that next week.)
Thank you for all your prayers as they lift us all up, especially my mom, and we continue to be positive about the final results of the chemotherapy and radiation.
Thank you for all your prayers as they lift us all up, especially my mom, and we continue to be positive about the final results of the chemotherapy and radiation.
Thursday, March 10, 2011
March 10, 2011
Ruth/Mom/Grammy met with her radiation oncologist today. Dr. Barker told her the growth is cancer of the larynx and hypopharynx. They used to treat this type of cancer with surgery and radiation, but in the 1970's studies began to evaluate the use of radiation and chemotherapy instead. This helps preserve the larynx and thus the voice. There are 2 kinds of radiation/chemotherapy regiments - concurrent and sequential. In concurrent, radiation and chemotherapy are given at the same time. This regiment, although it can get better results, can be very toxic and hard on the elderly. In sequential, chemotherapy is given first, followed by radiation at a later time. It is less toxic and the complete regiment lasts longer. Although its results are not quite as positive as concurrent, it still has positive results in shrinking and eradicating the cancer. It is better for someone of mom's age and health so she has decided to go with sequential treatment. We will meet with mom's chemotherapy oncologist next week for confirmation, but Dr. Barker has talked to him and believes sequential will be the regiment of choice.
Future Appointments:
CT scan for planning radiaton treatments
PET scan to make sure the cancer has not spread
Initial visit with chemotherapy oncologist
Future Appointments:
CT scan for planning radiaton treatments
PET scan to make sure the cancer has not spread
Initial visit with chemotherapy oncologist
March 9, 2011
Ruth/Mom/Grammy had surgery to biopsy the growth on her larynx. She tolerated the surgery well. Dr. Truelson confirmed it looks like a cancerous tumor. He sent a sample of the tissue to pathology. It will take approximately 72 hours for us to get a written pathology report.
Saturday, March 5, 2011
March 5, 2011
I begin this blog with some difficulty as many of you know of my previous blog keeping you updated about Jake and his cancer. I am again beginning a blog to keep family and friends updated on the progress of Ruth/Mom/Grammy as now she battles cancer. Here is the sequence of the events so far.
Dec. 9
Initial visit with gastroenterologist due to swallowing problems and feeling of "something" in her throat
Dec. 20
Esophogram (Barium x-ray) to evaluate swallowing
Jan. 3
EGD/Endoscopy (Esophagogastroduodenoscopy)
Jan. 17
Follow-up with gastroenterologist - gastric tract looks okay except doctor sees "something" on the larynx - barium x-ray shows aging of esophagus normal for an 85-year-old - recommends and makes appointment with ENT (ear, nose, and throat) specialist
Jan. 24
Initial visit with ENT - has hearing test (significant age related loss of hearing) and schedules scope of nose and throat
Feb. 7
Scope by ENT - he doesn't see anything (how, I don't know) but I say "she still feels 'something'" and he recommends CT/CAT scan and appointment at Voice, Speech, and Swallowing Clinic to help with age-related swallowing issues
Feb. 21
CT/CAT scan
Feb. 23
Receive call from ENT's office saying "something" did show up on the CT scan on the larynx and it appears to be cancerous as it also involves the lymph nodes. Recommends and makes appointment with surgeon in Dallas who specializes in cancer of the head and neck
March 3
Initial visit with surgeon - reviews CT scan and does additional scope to view growth on larynx as well as does extensive physical exam of head, neck, throat area. Recommends and schedules biopsy to confirm suspicion that growth is a squamous cell carcinoma. Recommends chemotherapy/radiation treatment route instead of surgery/radiation treatment route as chemotherapy/radiation has the potential for the least amount of trouble with swallowing in the future.
Future Appointments:
Biopsy in Dallas
Initial visit with Radiation Oncologist in Fort Worth
Initial visit with Chemotherapy Oncologist in Fort Worth
We are hopeful that we have caught the cancer fairly early and that it has only spread to the lymph nodes and no other organs. (I imagine a PET scan will eventually be scheduled to check other organs as well.) We were also told that squamous cell cancer is one of the easier cancer types to eradicate as compared with the small cell cancer that Jake had. Please keep Ruth/Mom/Grammy in your prayers. She is in good spirits and ready to tackle the cancer. I will update the blog as often as I have new information to pass along.
Dec. 9
Initial visit with gastroenterologist due to swallowing problems and feeling of "something" in her throat
Dec. 20
Esophogram (Barium x-ray) to evaluate swallowing
Jan. 3
EGD/Endoscopy (Esophagogastroduodenoscopy)
Jan. 17
Follow-up with gastroenterologist - gastric tract looks okay except doctor sees "something" on the larynx - barium x-ray shows aging of esophagus normal for an 85-year-old - recommends and makes appointment with ENT (ear, nose, and throat) specialist
Jan. 24
Initial visit with ENT - has hearing test (significant age related loss of hearing) and schedules scope of nose and throat
Feb. 7
Scope by ENT - he doesn't see anything (how, I don't know) but I say "she still feels 'something'" and he recommends CT/CAT scan and appointment at Voice, Speech, and Swallowing Clinic to help with age-related swallowing issues
Feb. 21
CT/CAT scan
Feb. 23
Receive call from ENT's office saying "something" did show up on the CT scan on the larynx and it appears to be cancerous as it also involves the lymph nodes. Recommends and makes appointment with surgeon in Dallas who specializes in cancer of the head and neck
March 3
Initial visit with surgeon - reviews CT scan and does additional scope to view growth on larynx as well as does extensive physical exam of head, neck, throat area. Recommends and schedules biopsy to confirm suspicion that growth is a squamous cell carcinoma. Recommends chemotherapy/radiation treatment route instead of surgery/radiation treatment route as chemotherapy/radiation has the potential for the least amount of trouble with swallowing in the future.
Future Appointments:
Biopsy in Dallas
Initial visit with Radiation Oncologist in Fort Worth
Initial visit with Chemotherapy Oncologist in Fort Worth
We are hopeful that we have caught the cancer fairly early and that it has only spread to the lymph nodes and no other organs. (I imagine a PET scan will eventually be scheduled to check other organs as well.) We were also told that squamous cell cancer is one of the easier cancer types to eradicate as compared with the small cell cancer that Jake had. Please keep Ruth/Mom/Grammy in your prayers. She is in good spirits and ready to tackle the cancer. I will update the blog as often as I have new information to pass along.
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