Everybody wants Miss Popularity. Literally a tug of war. Which of the two suitors gets to take Miss P. to the prom?
Well, maybe Debbi felt a little like that this evening. After the consult on Friday with Dr. Healey, Head of Orthopaedics, and passing her Pre-Admission Testing today, Debbi received a phone call around 3pm notifying her that all went well and that she was scheduled for surgery to remove the Caracoid process Tuesday (tomorrow)… arrival at 9:30 for surgery at 11AM.
At 5pm, Dr. Healey himself called Debbi and informed her that Dr. Bajorin decided that it was critical to stay on the chemo schedule and that the surgery would have to be scrubbed until the 6 chemo cycles were complete. Dr. Healey apologized for dragging Debbi to the East Side for Pre-Admission testing etc. but he said it was necessary to defer to Dr. Bajorin.
Thus, we are not going to Sloan Kettering tomorrow but we are planning to be there on Thursday for Cycle #2 Chemo #2. Imagining the phone call between Dr. Healey and Dr. Bajorin made me think of the Miss Popularity analogy. Hopefully, the BEST POSSIBLE CARE for Debbi is uppermost on the minds of all those involved in her healing. Therefore we appreciate everyone’s expertise and will progress as directed.
Imagining Debbi’s shoulder without any cancer was a very encouraging thought. Even though the chemo acts on all areas of the body, including the caracoid process, the rate at which the chemo attacks the cancer is certainly less than the speed of the surgeon’s prowess. We will readjust our mindsets and look forward to our next milestone… scans in approximately one month which will, Please G-d, show evidence that the chemo is working.
This just in… Baruch Hashem. We were just notified by our good friend, our dear engineer behind the scenes at Sloan Kettering, Dr. Michael Zelefsky, that Debbi’s bone scan is clean. Sure the cancer is still in Debbi’s kidney, but at least it has not spread to the bone. Now we have fighting chance to get through this. We are so thankful to all of our family and friends and readers of the blog for their prayers and good wishes as we know that these efforts culminated in this wonderful news.
In an hour, we are off to meet with our oncologist Dr. Dean Bajorin, where we expect to be formally told these findings and to receive instructions as to the program of chemotherapy with Cisplatin. We have now heard from several oncologists including Dr. Dov Gorshein who put it succintly… “go with the Cisplatin and kick it really hard from the outset… then get the kidney out of there.”
Chemo starts at 1pm.
So far, we have really only made one choice… to seek assistance and follow the advice of Doctors and Staff at Memorial Sloan Kettering Cancer Center. Now it is time to make a second choice. With the port going in tomorrow, we have one week to decide on the chemo regimen to follow of which we have been told that there is no wrong choice. However, one may prove to be more successful in Debbi’s particular instance and that is, of course, what we care about most.
Course #1, the standard, calls for 6 three week cycles of Gemcitabine & Cisplatin. Course #2 involves participation in a Phase II clinical research trial of Gemcitabine, Carboplatin, and Bevacizumab. [In case you were interested, Bevacizumab is more commonly referred to as Avastin]. Cisplatin is stronger and more invasive of the kidneys. Avastin is one of a new class of drugs that has been shown to be effective in other cancers and works by denying tumors blood, oxygen and other nutrients needed for their growth. The study is designed to find the effectiveness of Avastin in patients that can not tolerate the additional strength of Cisplatin. Since Debbi is very sensitive to drugs to begin with, we wanted to learn about this alternative.
We naturally listened carefully to the choices we were given and have been doing some research on line in order to learn more. Certainly, Dr. Bajorin did not pressure us either way. He only wanted to let us know the possibilities. Side effects vary widely. Tomorrow, while Debbi is having the port placed, I will try to contact some oncologists I have met over the years to try to gain some additional insights. Debbi’s comment while reading what I have written so far is… “OMG, this is really serious. Maybe I shouldn’t do anything” commenting on the deleterious nature of many of the side effects.
It is very scary looking forward so the best we can hope for is an immediate notification that the chemo process is working. That is what we have to pray for. That we choose a good chemo regimen and that it quickly works to measurably shrink the tumor in her kidney. I guess the tumor size will become the standard because we have not yet heard about any way to gauge effectiveness via blood tests or metrics away from the kidney.
With another invasive process tomorrow at 9:30, a bone scan and a CT scan on Monday, it still seems that there is much to accomplish, in addition to refining our decision on the chemo regimen, before chemo is to start on Thursday the 10th.
Good evening everyone! It’s been a very long day at Sloan Kettering but I am now in the system, have met my surgeon and oncologist and know that I am in the best of hands. I was surely hoping that I was going to the hospital today, surgery would be next week, and the doctors would then say have a fun life.
Unfortunately reality hit the fan and I was very dissapointed initially. Dr Paul Russo is a darling man with phenomonal bedside manner. His plan is as follows: 1) It will take ten days to schedule, but a biopsy is essential to determine what kind of cancer cells are present in order to use the correct treatment. 2) Ten days after the biopsy, we should have some idea what kind of cancer I really have. 3) A port will be placed in my chest for chemo since my veins are really tired from all the testing. 4) Even though there is a tumor in my kidney, the kidney is functioning and the lower part is healthy. Dr. Russo would like to use the kidney to help circulate the chemo, possibly shrink the tumor, and put less stress on the healthy kidney. 5) Hopefully my body will respond to the chemo and I may only lose 1/2 a kidney. Even though we have 2 kidneys, 1 1/2 is better than just one.
I am so fortunate that all other organs are working well and unaffected. We pray that I respond to whatever chemo is necessary and that we have a plan that is working for my specific disease. Needless to say, I need to go to sleep so I can go to work and enjoy my babies tomorrow at school. Thanks and love to all of you who are caring, praying, and giving me the emotion support to get through each hour.
After a week of discomfort in the area of the gallbladder, Debbi underwent a series of scans that ultimately found cancer in her right kidney. The cancer was confirmed by a PET scan performed at Park Avenue Radiologists in Manhattan on 3/12. A summary of their findings:
- A hypermetabolic right upper pole renal mass (SUV 6.5 peripherally, 4.3 x 5.8 x 5.2 cm in AP transverse and CC dimensions). No similar hypermetabolism in the right renal vein or IVC.
- A hypermetabolic solitary aortocaval lymph node (SUV average 4.2, 1.4 x 1.0 x 1.1 cm in AP and transverse dimensions). No hypermetabolic perirenal lymph nodes noted.
- A solitary hypermetabolic lytic lesion in the left scapula at the junction of the coracoid base and the glenoid (SUV average 4.0, 1.2 x 1.1 x 1.2 cm in AP, transverse and CC dimensions).
Thankfully, the left kidney, liver, gallbladder, pancreas, spleen, and adrenal glands are all normal.Today, Monday 3/17, at 4:30pm , Debbi is having an MRI on her left scapula to investigate the lesion there. In the meantime, an appointment with Dr. Paul Russo, FACS, a specialist in kidney tumor surgery has been scheduled for Tuesday 3/18 at 1:00pm at the Memorial Sloan Kettering Cancer Center. We are hoping that in short order, the right kidney and the involved lymph node will be removed and then we will focus on the left scapula and on the healing process.