Latest Scan Good

As some of you may be aware, Kerry has been having some discomfort in his side (near where his previous liver problems were) -- so he got to have another scan.  They found nothing amiss and assume that it must be delayed effects of the radiation he had last fall.  Not sure if this will be temporary or not -- hopefully it is.

Final Pathology - All Good!

I had a postop follow-up with my surgeon, Dr. Hansen, today and the news was good - No Cancer!  It occurred  to me that it's the first time I've been certified cancer-free in a year.  Feels good - a weight off.  I was back at work last week, off this week for a conference.  I will have scans about every 3 months for a while.    Thanks again for all of your support!

Kerry (+)===i=::

Good News

The doctors did laperoscopic surgery and used ultrasound to guide them while they took several biopsies.  They looked at the biopsies in the operating room and did not see any evidence of cancer.  They assume that the activity they saw on the CAT scan was inflammation from the radiation he got last fall.  They will send the biopsies to be further analyzed by the pathologists.  I was told there is still a 5-10 % chance that they will find cancer in those cells.  The other good news is that they took a tour of his abdomen while they were in there and saw no other evidence of cancer cells.

He will spend tonight in the hospital and tomorrow will come home.  He will take at least a couple of days to recuperate at home.

Thank you everyone for your support -- it makes such a difference knowing you are all out there cheering and praying for him.

January 29

Just an update that Kerry's surgery was delayed several hours and did not start until around 5 pm Portland time.  Will post more info as I have it.

January 27

FYI -- on Tuesday, Kerry's surgery is at 11 am (he has to be there at 9 am).  Sorry if my previous posting led anyone to think the surgery was at 9 am.

January 21

The laparoscopic biopsy is now scheduled for Tuesday, January 29 at 9 am.  If it turns out to be melanoma and there are no other tumors seen outside the liver they may proceed with a liver resection and remove the part of the liver with the tumor.

January 18

After talking to the liver surgeon today, Kerry and the doctor decided to do a different kind of biopsy.  Rather than an ultrasound guided needle biopsy through the skin, they will do an internal laparoscopic biopsy which uses an ultrasound probe which can be placed directly against the liver and will provide the best visualization of the liver for an accurate biopsy.  The date for the biopsy is postponed since the liver surgeon who would do this is out of town next week.  We won't know the date of the biopsy until next week.

January 17

The liver board decided to do a liver biopsy next week.  Did not get to talk to the doctor, but presume that this is to make sure that the serpiginous thing (sorry I can't throw any medical terms at you that sound any better...) that lights up on the CAT scan is really a tumor and not inflammation due to the radiation.  Kerry is out of town at a training to learn to use EPIC -- the new torturous computer system. He may have a chance to talk to the doctor more tomorrow and get some details.

The procedure is Tuesday at 8:30 am and he is expected to be there for 6 hours while they do the ultrasound guided biopsy.  He will be under IV sedation -- not a general anesthetic.

That's all I know for now.

Maggie

January 14

Today we visited Dr. Hansen, the liver surgeon, who spent over an hour talking to us about the possibility of Kerry's liver surgery. He explained that the surgery would likely involved removal of the right lobe of his liver as well as part of Kerry's diaphragm which the radiation to his liver tumor "spot welded" to his liver.  It might also involve removal of part of the lung if there is adhesion there.  So all in all, a larger surgery than we were thinking about going in.  It could take between 4 and 12 hours depending on the degree of involvement of the diaphragm and lung. The good news is that he says that liver surgery is much less risky than it used to be because of their improved understanding of the liver anatomy.  Very little blood loss usually occurs.  The other good news is that the detailed CAT scan they did last Friday did not find any tumors in the liver -- other than those shown by the previous scan.

The next step is that the tumor board will review his case again on Wednesday in light of the detailed liver CAT scan.  If they approve, then Kerry has to decide if that's the route he wants to pursue. The surgery could take place as soon as a couple of weeks. Healing could take a couple of months with about a week anticipated in the hospital.

January 11, 2013

The tumor board said the tumor might be a good candidate for surgery.  Kerry gets a more detailed catscan of his liver today and goes in to talk to the surgeon on Monday.  Will have more information then.

January8, 2013

The results of Kerry's most recent scan were that there is a tumor in his liver that is growing at a rather rapid rate.  He started having some discomfort 2 days before the scan so was not surprised by the results.  The good news is that there are no tumors anywhere else. At this point there seem to be 3 potential courses of action:

• Yervoy -- a drug which can be effective in putting melanoma tumors at bay.  It doesn't work in all patients, but is the only FDA approved treatment there is that he hasn't tried to treat his stage of disease.
• A drug trial with an MEK protein inhibitor.  The OHSU doctor gave an explanation heavily laden with biochemistry terms that I never studied in college -- so I really don't understand its mechanism of operation.   It is a phase 2 trial that has been effective with patients with the NRAS melanoma mutation that he has.  The side effects vary, but do not appear to be deadly or irreversible. As with Yervoy, it doesn't work for everyone and we wouldn't know until it is tried if it would work for Kerry.  Also because it is a trial, the long term effectiveness or side effects are not know.
• Since the tumor is only in one lobe of his liver, some consideration is being given to removing that lobe.  Apparently the liver regenerates quite quickly.  A group of doctors (called the tumor board) meet tomorrow to discuss whether this is a viable option. Two of the doctors Kerry talked to yesterday seemed to think that this might be his best option.

Making decisions like this are very difficult.  Please send us your good thoughts.

Post-IL-2 Update

Hiho -

It's been  6 weeks since I finished the 6th and final IL-2 treatment.  The major side effects have resolved and  I'm feeling well.  I am starting back to work part-time next week.  Yesterday I had a PET/CT scan, which showed continued improvement, but not complete resolution of the active liver nodules.  There was nothing new or worsening.  While its possible the nodules would continue to improve on their own, my oncologist recommended  I talk to my radiation oncologist about treating the residual nodules with radiation.  I will see him next week and discuss the proposed zapping.  In other news, I have finished building a new front door.  Feel free to knock on it if you're in the neighborhood!  Thanks for your ongoing concern and support.

Kerry

All done!

It was a big day for us -- with meaningful endings and beginnings.  Kerry had his last Interleukin 2 treatment and Seth began college.

Kerry ended up having a total of 5 doses this week which they say is a typical amount for Round 6.  He is elated to have the treatments behind him.  I will miss the amazing sunset views from his room -- as well as some of the nurses -- but that's about all.

Hopefully Kerry will be home tomorrow.

Meanwhile Seth is moved into his dorm room and has started classes.  His only complaint so far is that his room is next to the laundry room for his floor and the squeal of the washer's spin cycle is rather alarming especially at midnight. (Surprisingly, he isn't bothered at all by the trains that run all night long on the track just a few feet from his dorm. Go figure.) Though the newness of everything must be overwhelming for him, he seems to be doing OK.

For the dedicated readers of the blog, I will do sporadic updates for awhile to let you know the results of the treatment. Please keep us in your thoughts and prayers.

Round 6 -- Day 2 August 21

So far Kerry has had 2 doses and will likely have another one tonight.  His doctor said that he expects Kerry to get no more than 4-5 doses this week since by the 6th week of treatment that's about the most that patients can tolerate.  Kerry was comfortable but sleepy most of the day.

For those of you wondering about progress getting Seth off to college, so far he has packed nothing and he leaves in 36 hours. He did manage to say farewell to a few more friends today, so I guess that is progress.

Round 6 -- Day 1 August 20

The good news is that Kerry has a room with a great view.  The sunset tonight was amazing.  And its probably the most expensive room in town.  Too bad its in the hospital.

The first dose went pretty well and he got a second dose at 11 pm.

Sean, Tracy and Keenan -- Kerry's brother and family -- have been in town helping out and stayed with Kerry at the hospital today while I worked.  Sean took his guitar and Kerry's banjo to the hospital and they played until Kerry got his 3 pm dose. Apparently there are no hospital rules against bluegrass music -- yet.  Kerry said the only complaint was from a nurse who said they weren't loud enough. (My theory is that the patients were all too weak too complain.)

It should be a crazy around here since Seth starts college on Thursday.  We have done most of the pre-college shopping, but I'm not sure he realizes that he needs to figure out what he is taking and pack.  He is spending every waking moment with his friends saying goodbye and trying (with some sadness) to move on.  I think it will prove to be an emotional week for us all -- Seth saying farewell to his current life, our oldest son leaving home, the realization that Kerry and I will have to figure out how to operate the computer, and writing the enormous check to pay for Seth's education (while he is mostly focused on how much FUN he is going to have.)  All this while Kerry is in the hospital -- wish us luck.

Round 5 -- Finished

Kerry is done for now. His last dose went pretty well with no drastic drops in blood pressure. He had a total of 6 doses this round and will be back in 2 weeks for more fun.   Kerry is sick of hospital food and ready to get home where he can get out of bed whenever he wants without loud alarms going off and where he can go to the bathroom without an audience.

It will be good to have him home -- flaking, snoring and just laying around.  The dog will be happy to have him back too -- Kerry's lap is bigger than mine.

For those of you who need something to look forward to after the Olympics are over, I will start putting up more blog posts when he goes back into the hospital for his next round of treatments on August 20.

Round 5 Day 3

Kerry got one more dose today with a resounding response of shakes and drop in blood pressure.  But thanks to modern medicine and the constant vigilance of the nurses, they got things under control pretty quickly (in 2-3 hours) and he is now stable, doing a crossword puzzle and watching the Olympics.

Probably won't have another dose before tomorrow afternoon as it will take them at least that long to wean him off the neosynephrine they use to keep his blood pressure up.

Today's highlight was seeing Kerry do some exercises in bed with the elastic bands the physical therapist provided as a way to keep his muscles from atrophying too much while confined to bed for the week.  Seeing him do exercises when he is healthy is a very rare site -- so seeing him do them in a hospital bed was definitely a site to remember.

Round 5 Day 2

Going pretty well.  Kerry has had 4 out of 5 possible doses. Side effects didn't really kick in until after the 4th dose with some shakes and low blood pressure.  But he's bouncing back pretty well. Should have a restful night since he didn't get a dose tonight.

We've been watching lots of Olympics -- but it seems like Kerry's a major contender in his own event right now.

July 30 Back in the Saddle Again

Kerry is back in the hospital for treatment 5 of Interleukin 2. He started today and will be in for the rest of the week.  The first dose went well and he will get a second dose later tonight. Kerry has had a few extra weeks off between treatments. and this is expected to allow his body to better tolerate more doses. So far so good.

Our friend Kasia, from Brooklyn, is visiting now and helping with cooking, the kids, and moral support.  Kasia, Seth, :Peter, Kerry and I had a picnic lunch in Kerry's room today before he got his first dose (needless to say we didn't eat hospital food).  Peter spent the afternoon with Kerry watching the movie Gladiator(a hospital room is a perfect setting for the blood and guts in that movie), while Seth went off to his job as a swim instructor. Day 1 has been good.

Feel free to enter the pool on how many doses Kerry will get this week.A dose consists of a 15 minute infusion of 45 ML of Interleukin 2. Kerry's nurse guessed 6, Kerry guessed 5 and I guessed 10 (wanna get our money's worth out of this place). The maximum number of doses possible is 14 -- and the most Kerry has ever gotten is 11.

Thanks for your prayers and good thoughts.

Maggie

Difficulty following hospital instructions

Honest to goodness this is the sign on the wall of Kerry's recovery room.  He's had a hard time following the last goal -- but got to go home anyway.

The hernia surgery was not quite the walk in the park he had hoped for.  The doctor said the 2 hour laparoscopic surgery went well and now that he has some pain meds on board he seems to be doing pretty well.

So now 6 weeks of no heavy lifting -- he may have to get a light weight banjo.