Thursday, May 29, 2008

A Key Weekend for Cancer Patients

Karen's doing well. She'll undergo another round of chemo tomorrow so we're mentally preparing for the week ahead.

We've spent the last few weeks battling our insurance company. There are numerous issues but I have been protesting one particular charge (> $1000) since October 2007. Countless phone calls, numerous emails and two written letters later, there may be some movement on it. Until we get the money back I'm not holding my breath.

We actually have pretty good medical insurance (Lord knows we pay for it) but even with that, we consistently get charged for in-network services at the out of network rate. If you don't constantly monitor and run your own analysis it's easy to get over-charged.

Incidentally Karen's current total is up to $367,000 roughly. I only mention it in wonderment as I cannot imagine how hard cancer is on families without adequate coverage.

This weekend the American Society of Clinical Oncology (ASCO) will host their annual meeting (May 30th-June 3rd) in Chicago, Illinois. This is a key meeting as many drug companies, researchers and scientists will discuss their current research as well as unveil the results of the trials they've been executing.

I'll be watching the AP for potential news.

Friday, May 23, 2008

Conference Debrief: CyberKnife

Karen's doing well. We met with Dr. Moriarty this morning and he debriefed us on the conference that took place this week (Tuesday) at Overlook. He was rather serious but understandably so.

From what we could discern this is a coming-together of various experts and leaders in various disciplines, radiology, oncology, surgery etc.. The agenda is to review key patients' cases both in terms of knowledge sharing (how the patient is doing) as well as idea generation (where to go next).
Not that Dr Dan doesn't know what to do next but rather he wants to solicit input and guidance from a wide audience to get the best possible outcome for Karen.

Dr Dan told us the group was VERY impressed with her. The group reviewed ALL her scans, all the way back to April 2007, not just the last set. Without treatment this time last year, she'd no longer be with us. Thanks to the treatment plan and her determination we are in a much better situation. Her tumors have shrunken, some have died. Microscopic disease is likely still around and we'll continue on chemo for that. The next step is to decide what ELSE we can do.

There are a couple of options;
  • Surgery - to remove what she has left in the liver.
  • Radio Frequency Ablation - To burn what's left.
  • Embolization - to remove the tumors' blood supply and kill it.
  • SirSpheres - to Irradiate what's left with tiny tiny bits of stuff that carry radiation into the tumors.
  • CyberKnife treatment - This one we talked quite a bit on and I think it's where Dr Dan is leaning.
The CyberKnife system uses a particle accelerator combined with a real-time imaging system as well as "seeds" placed in the liver to directly target the hyper-metabolic activity (tumor) and kill it.

The procedure is painless and done on an out-patient basis. It's also extremely accurate with radiation being targeted to the sub-millimeter. As if that wasn't enough the entire procedure is done by robots!

There are a number of videos on YouTube that describe how it works. This is truly next-generation technology and YES our hospital (Overlook in Summit) has one.

Dr Dan is away to Africa for the next two weeks and we'll talk more about this when he gets back. Until then, chemo is the order of the day.

Saturday, May 17, 2008

Radiologist's Report

This'll be a quick post as I'm typing with one hand.

Karen's doing well. Had Erbitux yesterday and gets next week off. Her scans were read and revealed she's doing well. Some things did show up such as a suspected cyst on an ovary but this is nothing to worry about.

Doctor Dan heads to Mozambique soon to participate in "doctors without borders".

In other news I cut my thumb yesterday and so this week K's taking care of me! The doctor who stitched me up as it turns out has a niece with colon-cancer, diagnosed in '98 with liver and lung mets. After resection and ablation, she's been 6 years without a recurrence. This alone was worth the trip to the ER.

Friday, May 9, 2008

Happy Birthday Karen

Today's Karen's birthday! Happy day. Karen gets a double-whammy this year with Mother's Day falling on Sunday.

Let me start off: Sweetheart, I want to wish you the happiest of birthdays. You're an amazing person whom I'm so proud of.

I love you and Happy Birthday!

Unfortunately Karen's still not feeling 100% after last week's chemo. She visited the hospital on Wednesday and seems to have contracted a virus. Karen'll receive Erbitux this morning and hopefully some fluids to pep her up.

We should get the radiologist's report today also.

Friday, May 2, 2008

Consultation Update

Karen's on chemo again and all that that brings. Nausea, sickness, etc. Otherwise doing well.

A quick update is warranted; We met with Dr Moriarty today at Overlook. The idea was to review the scans that Karen had taken this Tuesday.

Unfortunately the radiologist has not read the scans as yet and hence no written report was available. However, Dr Dan did walk us through them in somewhat layman's terms. He showed us the scans taken back in February 2008, before this session of chemo was initiated. Those were not pretty and it was very hard to discern what was going on in Karen's liver. The right lobe was consumed with white fluffy stuff. The desired pattern is clear, uniform grey. Her left lobe also had a few small-ish spots on it, signifying tumors.

These last scans are markedly different. Her left lobe is fairly clear with the exception of two necrotic things where the tumors were. The right lobe is much clearer, with the exception
of what looks like a large crescent moon shape. This might be tumor cells or it might also be inflammation. It's surrounding a dark area the size of an orange, which is almost certainly a dead tumor.

Overall this is a great result, we'll still wait for radiologist confirmation of this early next week.

A week from Tuesday, members of Overlook from all disciplines will meet for a conference, during which Karen's case will be reviewed. Dan wants as many eyes on it as possible. There are still many options available to us and he wants to make sure we pick the right one. For now we're sticking to chemo.

We are bolstered by today's news and continue to believe Karen is getting the best treatment possible.