How many more treatments?
December 26, 2018
Sometimes I wonder if people are tired of our reports on my husband Lynn’s cancer. But we keep getting comments from those who say they really appreciate the updates. It’s been enlightening to learn how many of our friends and neighbors have experienced or are going through cancer treatments.
I recently read a book that said while we’re eliminating or lowering the incidence of most diseases, the number of cancer cases is still increasing. It’s now second following heart disease in the number of people affected in the U.S. The book also points out that only eight percent of cancer cases can be traced to genetic causes, but genetics and DNA are the focus of a majority of the current cancer research.
If you’re interested in learning how cancer treatments were developed, check out the book “The Emperor of All Maladies: A Biography of Cancer” by Siddhartha Makherjee. It provides a history of our understanding of this complicated disease. You might read some reviews before you buy. The book is somewhat complicated and may not appeal to you.
There are three ways medical doctors currently treat cancer: surgery, radiation and chemotherapy. The first two were not options for Lynn so he’s undergoing chemotherapy (chemo for short).
In some cases, a surgeon can remove the cancerous portion of the esophagus, pull the stomach up and attach it to the remaining esophagus. In Lynn’s case, the surgeon explained this was not an option because the cancer covered too large an area and included the lymph nodes just behind it.
For a similar reason, he was not a candidate for radiation. The tumor area is too large and too close to the heart, lungs and other vital organs.
It was decided the best course was to use chemotherapy to try to shrink the tumor so radiation and eventually surgery could be used. There were also a couple of outlying spots where the cancer had metastasized. The chemo took care of one spot and shrank the main tumor somewhat, but the liver developed a couple of new spots.
Because the liver was not responding to chemo, a liver biopsy was taken. It was a different but related form of cancer. This required a different chemo formula.
People frequently ask me how many rounds of chemo Lynn has left. I can’t answer because we don’t know. Lynn himself has been asking the doctors similar questions. Dr. Phil Self’s answer pretty well says it, “Do you have a crystal ball?”
Lynn had chemo last week and is scheduled for more Jan. 2. Around mid-January, he’ll be able to have another PET scan, which uses a radioactive agent injected into his blood. This solution uses glucose, and cancer cells just gobble up glucose (sugar). The spots lighting up from radiation indicate cancer cells. It should give us a picture of whether the current chemo formula is doing its job.
Unless something miraculous has occurred, I’m expecting Lynn will be undergoing more chemo treatments in following months. The drug formula may be changed depending on the PET scan results, but it’s unlikely the tumor has decreased enough for other types of treatment yet.
Throughout this experience, I’ve learned a lot about the problems doctors face in helping patients. The new opioid laws are intended to cut down on deaths related to the use of illegal opioids. But the laws put doctors under so many restrictions that it’s hard for them to provide some legitimate pain relief. At least a cancer diagnosis cuts through some of the red tape and documentation required.
I’ve learned that some chemo protocols are not approved by Medicare or other insurance carriers for treating certain kinds of cancer, even though doctors have evidence they are the best option. Doctors have to research this so patients don’t get stuck with a huge bill their insurance won’t cover.
While electronic health records provide some helpful information to patients and make it easier for the various doctors in your life to share information, they place a burden on doctors and medical practices. A great deal of time is spent entering information into the computer and adding the correct codes for insurance. It seems to be a cumbersome system that steals time away from doctors interacting with patients. And not everything fits into those convenient check boxes. Surely some doctors and some IT people could sit down together and figure out how to streamline the system.
Meanwhile, Lynn and I continue on this cancer journey. We appreciate all your well wishes, prayers and cards. Please add special prayers for the doctors and researchers who continue to look for ways to defeat this emperor of all maladies.
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