Karen's doing great. We met with Dr Moriarty on Monday, and Dr Chamberlain today. They've spoken and are in agreement that based on Karen's most recent PET scan, she's cleared for surgery.
They are hard men to read but I get the impression they're both pretty amazed at how well Karen has done. Her tumors are still active but barely and perfect for resection. After ~18 months of uphill emotional and physical battle, Karen's gone from terminal cancer to having a possible curative surgery.
Surgery has been tentatively scheduled for the 3rd of March at St Barnabus [LINK] in Livingston. The good Doctor Chamberlain was named in the Top Docs 2008 list [LINK] so that's encouraging.
Surgery will not be easy, as we know. The idea is to open up K's existing scar and possibly elongate it. There will likely be scar tissue from the old surgery which will complicate the procedure. The plan is to remove Karen's right liver lobe and either cut out or ablate the tumors on the left lobe. Her gall bladder will come out and possible 10-12 inches of colon, along with lymph nodes and other sundry items. They'll do an intra-operative ultrasound to be sure every thing's removed and then sew her back up.
There's also a possibility that the procedure will need to be done in 2 surgeries instead of one. The doctor won't know until he gets in there. In the event of two surgeries, the first would actually tie off the right lobe but not remove it. This will trigger growth in the left lobe. Karen would come home and after 2-3 weeks the left lobe would be big enough. They'd go in and remove the right, leaving the larger left. Make sense?
Assuming one surgery, Karen'll be in hospital between 7-14 days.
Between now and the 3rd will be another colonoscopy, one more Erbitux, some pre-admissions tests, Chamberlain and Moriarty visits and likely some pre-operative prep.
The surgery is not without risk, both doctors have said they would not attempt this on a sixty year old woman, but we know what to expect and are ready for whatever comes.
"No Evidence of Disease" does not mean "no disease", it just means no visible tumors. There's also the chance of a recurrence after surgery but Karen's been off chemo since July 2008 with no new tumors appearing so this is a good indicator. If there were tumor cells ready to grow they have had time to do so.
The goal is to have Karen leave the operating room, visibly cancer free. As doctor Chamberlain put it, that would indeed be a true miracle. No one has worked harder for it than Karen.
Wednesday, January 14, 2009
Monday, December 22, 2008
Wowee Wow Wow!
Where do I begin. Today was an awesome day. I"ll try to stick to the facts.
We met with Dr. Chamberlain today to review the ct scan I had gotten done on Thursday. When he came in to meet with us he was visibly stunned. He said that he found it hard to find any viable tumor left. (the MRI does not show the calcification that would show up on a ct and the MRI is what he had to review last week.
He said now he is unsure as to whether to proceed with resection surgery or have SIRT (selective internal radiation therapy) done, while continuing to keep the option of resection open. This is the same question Moriarty and I have been mulling over for the past few months as I continue treatments.
The positive of doing SIRT as opposed to surgery is it will destroy any remaining unseen cancer. However it doesn't offer any possible chance at having a "you can be cured" prognosis. Resection surgery however does offer that possibility.
Surgery has its own negatives of course mainly increased morbidity and as with any surgery risk of not making it through etc.
So the bottom line is this. Dr. Chamberlain wants me to have another PET scan done. If there is any metabolic activity left we go to surgery. He would resect the right side of the liver and possibly a small area on the left. He said he feels very good about having a curative outcome.
If there is no metabolic activity then we will consider doing the SIRT spheres and continue along a path toward surgery. He ended by telling me with a big smile on his face, that being so young, and a mom of two young kids, having such a terrible cancer that I am the type of patient he lives to treat and give the possibility of a cure - at life.
He has impressed us very much so far in our two meetings and I don't think I could be any more blessed than having him and Dr. Moriarty on my team. He would be talking to Dr. Moriarty today and I will meet with Dr. M. myself on Friday before erbitux. Once I get pet scheduled I will meet up again with Dr. Chamberlain.
I am at a loss for words and have been all day. I feel like I have been giving the largest serving of hope poured into my soul since this all began. God has seen me through the horrible and now I am ready for Him to see me through the good. Joy, joy, joy that is all I feel.
God Bless all of you.
Love,
Karen.....yippppeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee
We met with Dr. Chamberlain today to review the ct scan I had gotten done on Thursday. When he came in to meet with us he was visibly stunned. He said that he found it hard to find any viable tumor left. (the MRI does not show the calcification that would show up on a ct and the MRI is what he had to review last week.
He said now he is unsure as to whether to proceed with resection surgery or have SIRT (selective internal radiation therapy) done, while continuing to keep the option of resection open. This is the same question Moriarty and I have been mulling over for the past few months as I continue treatments.
The positive of doing SIRT as opposed to surgery is it will destroy any remaining unseen cancer. However it doesn't offer any possible chance at having a "you can be cured" prognosis. Resection surgery however does offer that possibility.
Surgery has its own negatives of course mainly increased morbidity and as with any surgery risk of not making it through etc.
So the bottom line is this. Dr. Chamberlain wants me to have another PET scan done. If there is any metabolic activity left we go to surgery. He would resect the right side of the liver and possibly a small area on the left. He said he feels very good about having a curative outcome.
If there is no metabolic activity then we will consider doing the SIRT spheres and continue along a path toward surgery. He ended by telling me with a big smile on his face, that being so young, and a mom of two young kids, having such a terrible cancer that I am the type of patient he lives to treat and give the possibility of a cure - at life.
He has impressed us very much so far in our two meetings and I don't think I could be any more blessed than having him and Dr. Moriarty on my team. He would be talking to Dr. Moriarty today and I will meet with Dr. M. myself on Friday before erbitux. Once I get pet scheduled I will meet up again with Dr. Chamberlain.
I am at a loss for words and have been all day. I feel like I have been giving the largest serving of hope poured into my soul since this all began. God has seen me through the horrible and now I am ready for Him to see me through the good. Joy, joy, joy that is all I feel.
God Bless all of you.
Love,
Karen.....yippppeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee
Monday, December 15, 2008
Surgery Consultation
Karen's doing well. After a long lead-up and much anticipation (on my part), we finally met with Dr Chamberlain from St Barnabas Hospital today.
We had a very good first meeting with fairly positive results. Before coming in he first spent some time reviewing Karen's scans. There was some confusion here but we worked it out. After reviewing Karen's history etc. the doctor laid out the situation on the back of a piece of paper.
Essentially he drew liver, life sized, with veins going in, veins coming out and various different sections. Then he drew in the tumors, a big one here, big one there, a small one there, a tiny one over there etc.
In order for a successful surgery, you need to keep a certain amount of veins going in, a certain amount coming out and a certain number of zones that add up to roughly 20% of the overall volume. So the challenge is how to do a surgery that'll achieve all those objectives.
The next step is to get a couple more pieces of data together. A series of special blood tests which K' did today before we left and a 64-slice CT scan w/contrast. This'll be a high-definition scan that'll allow Dr Chamberlain to reconstruct the liver in 3D on his computer. This'll let him develop a clear plan.
One possibility is a two stage surgery. First they'll go in and clean up the right-lobe. At the same time they'll tie-off the arteries into the left lobe. This'll cause the tumors over there to die and trigger the right lobe to grow. Then in surgery #2 they'll go in and cut out the left lobe entirely. Another possibility is that Karen would get a pump, about the size of a blackberry, placed into her liver which'd deliver chemo drugs right into the liver. I don't know about this piece but let's see.
It all sounded good and was delivered in very clear, easy to understand language without dumbing it down for us. Overall this was a great meeting and went just about as well as we could've hoped. Next step is to check with Moriarty to make sure he's comfortable.
Dr Chamberlain is not wasting any time. The scans will be "squeezed" in this week with no doubt some calls from Chamberlain/Moriarty and we'll meet back again in 1 week.
At that time we'll confirm if surgery is a possibility. Despite all the good news, it's still not confirmed.
I think Karen and I both are still processing the events of the day but slowly the stress is leaving me at least.
Please spare a thought for Adam Beldycki [LINK] who was undergoing his 5th liver surgery today.
We had a very good first meeting with fairly positive results. Before coming in he first spent some time reviewing Karen's scans. There was some confusion here but we worked it out. After reviewing Karen's history etc. the doctor laid out the situation on the back of a piece of paper.
Essentially he drew liver, life sized, with veins going in, veins coming out and various different sections. Then he drew in the tumors, a big one here, big one there, a small one there, a tiny one over there etc.
In order for a successful surgery, you need to keep a certain amount of veins going in, a certain amount coming out and a certain number of zones that add up to roughly 20% of the overall volume. So the challenge is how to do a surgery that'll achieve all those objectives.
The next step is to get a couple more pieces of data together. A series of special blood tests which K' did today before we left and a 64-slice CT scan w/contrast. This'll be a high-definition scan that'll allow Dr Chamberlain to reconstruct the liver in 3D on his computer. This'll let him develop a clear plan.
One possibility is a two stage surgery. First they'll go in and clean up the right-lobe. At the same time they'll tie-off the arteries into the left lobe. This'll cause the tumors over there to die and trigger the right lobe to grow. Then in surgery #2 they'll go in and cut out the left lobe entirely. Another possibility is that Karen would get a pump, about the size of a blackberry, placed into her liver which'd deliver chemo drugs right into the liver. I don't know about this piece but let's see.
It all sounded good and was delivered in very clear, easy to understand language without dumbing it down for us. Overall this was a great meeting and went just about as well as we could've hoped. Next step is to check with Moriarty to make sure he's comfortable.
Dr Chamberlain is not wasting any time. The scans will be "squeezed" in this week with no doubt some calls from Chamberlain/Moriarty and we'll meet back again in 1 week.
At that time we'll confirm if surgery is a possibility. Despite all the good news, it's still not confirmed.
I think Karen and I both are still processing the events of the day but slowly the stress is leaving me at least.
Please spare a thought for Adam Beldycki [LINK] who was undergoing his 5th liver surgery today.
Monday, December 8, 2008
Just stuff
Hello all. I just wanted to let everyone know what's going on...which isn't too much but at the same time a lot. I've kind of been procrastinating in terms of updating the blog, I think because I am sick of talking about myself (ha ha).
The MRI went well last week. And following in the footsteps of my friend Adam, took home a copy of the films (on CD) to do my own armchair diagnosis. Things seemed unremarkable (for someone who has tumors in their liver) to me and Dr. Moriarty's assistant Kathy called me to let me know that Dr. M. was happy with the scans and the report and in fact things are even a bit smaller.
This wed. Dec. 10th I will have another colonoscopy performed by Dr. Lipsky and on Dec. 15th we have an appt. to meet with Dr. Chamberlain.
So though it doesn't seem like too much is happening it is exciting to see if their will be a continuous flow of cancer death and maybe even another shot at a liver resection in the future.
I am very interested in what Dr. Chamberlain has to say. I have zero expectations set however and I am taking things one day at a time. I have been feeling fine relatively speaking and I continue on Erbitux every two weeks. I know erbitux is an awesome drug but I have to admit I am very sick of the side effects, but its working.
I can't say enough thanks or ever appropriatley express my gratitude to every one who is praying for us and supporting us and loving us. I am always very humbled by all the prayers people are saying and the time they take out to show their support in their own ways. I really am so, so thankful and grateful. God has been very merciful to me and my family and I know it's because of everyone's prayers. God's light really does shine through us all in the everyday things we do for others. God created us to be good and beautiful in all kinds of ways and if I ever doubted that before I never will again.
I am praying for all of us everyday.
Love,
Karen
The MRI went well last week. And following in the footsteps of my friend Adam, took home a copy of the films (on CD) to do my own armchair diagnosis. Things seemed unremarkable (for someone who has tumors in their liver) to me and Dr. Moriarty's assistant Kathy called me to let me know that Dr. M. was happy with the scans and the report and in fact things are even a bit smaller.
This wed. Dec. 10th I will have another colonoscopy performed by Dr. Lipsky and on Dec. 15th we have an appt. to meet with Dr. Chamberlain.
So though it doesn't seem like too much is happening it is exciting to see if their will be a continuous flow of cancer death and maybe even another shot at a liver resection in the future.
I am very interested in what Dr. Chamberlain has to say. I have zero expectations set however and I am taking things one day at a time. I have been feeling fine relatively speaking and I continue on Erbitux every two weeks. I know erbitux is an awesome drug but I have to admit I am very sick of the side effects, but its working.
I can't say enough thanks or ever appropriatley express my gratitude to every one who is praying for us and supporting us and loving us. I am always very humbled by all the prayers people are saying and the time they take out to show their support in their own ways. I really am so, so thankful and grateful. God has been very merciful to me and my family and I know it's because of everyone's prayers. God's light really does shine through us all in the everyday things we do for others. God created us to be good and beautiful in all kinds of ways and if I ever doubted that before I never will again.
I am praying for all of us everyday.
Love,
Karen
Sunday, November 23, 2008
Some Updates
Hi everyone. There isn't too much to report which is good and why the blog has been slow. Dr. Moriarty spoke with his surgeon of choice who is Dr. Chamberlain out of st barnabas in nj. He as worked on many cases with him and feels very confident about his ablities as a surgeon.
Dr. Chamberlain requested a mri of my beautiful liver to look at it in greater detail. I have that scheduled for Dec. 2nd I will aslo be scheduling an appointment to meet with him hopefully in december also. But as Dr. Moriarty cautioned me "this is only a meeting."
What he means is we don't know if anything will come of it or if resection surgery is back on the table. But it is definatly time to meet with a surgeon especially considering how well things look on scan in conjunction with my low cea levels. It will be good to get some fresh eyes to look at everything review the case and give us his opinion. So I am looking forward to this.
Thank you everyone for you prayers and support.
Please take time to think of and pray for my friend Lee Dolan who past away two weeks ago from cancer. She was a very kind lady and a very kind friend to me. So if you could just say a quick prayer for her it would mean a lot to me.
And lets keep praying for each other eh???
Love,
Karen
Dr. Chamberlain requested a mri of my beautiful liver to look at it in greater detail. I have that scheduled for Dec. 2nd I will aslo be scheduling an appointment to meet with him hopefully in december also. But as Dr. Moriarty cautioned me "this is only a meeting."
What he means is we don't know if anything will come of it or if resection surgery is back on the table. But it is definatly time to meet with a surgeon especially considering how well things look on scan in conjunction with my low cea levels. It will be good to get some fresh eyes to look at everything review the case and give us his opinion. So I am looking forward to this.
Thank you everyone for you prayers and support.
Please take time to think of and pray for my friend Lee Dolan who past away two weeks ago from cancer. She was a very kind lady and a very kind friend to me. So if you could just say a quick prayer for her it would mean a lot to me.
And lets keep praying for each other eh???
Love,
Karen
Thursday, November 6, 2008
Moriarty back at his post
Karen's doing well. She met with Dr Moriarty today. Essentially Moriarty read the radiologist's report from Karen's latest PET/CT scan and her overall status is "stable". An amazing result considering where she started from.
It's definitely time to consult a surgeon again to see if surgery is an option and this time we're letting Dr. Dan drive that process for us. We will likely meet with him again in another few weeks. Until then Karen continues the regime of Erbitux as this seems to be keeping things in check.
It's always a stressful and overwhelming exercise whenever these scans come up and this time has been no different. We may not always be conscious of the stresses we're under but they are there nonetheless and no doubt will lift over the next few days.
It's definitely time to consult a surgeon again to see if surgery is an option and this time we're letting Dr. Dan drive that process for us. We will likely meet with him again in another few weeks. Until then Karen continues the regime of Erbitux as this seems to be keeping things in check.
It's always a stressful and overwhelming exercise whenever these scans come up and this time has been no different. We may not always be conscious of the stresses we're under but they are there nonetheless and no doubt will lift over the next few days.
Tuesday, November 4, 2008
Waiting
Just a quick note to let ya'll know that I haven't yet met with Dr. Moriarty. He is still out. Hopefully he will be back in by the end of the week. I just want him to get well. I am told I am at the top of the scheduling list when his dr.'s give him the okay to come back to work.
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