Columbus and the Valley

Sweet Home Alabama

What I do know:
• I don’t have tumors in my brain.
• I don’t have tumors in my lungs.
• I don’t have tumors in my chest, abdomen or pelvis.
• I love my wife.

What I don’t know:

• I don’t know the outcome of my adrenal tumor biopsy.
• I don’t know whether I’ll be having surgery or going on Tyrosine Kinase Inhibitor (TKI) therapy.

We have spent 11 days and untold thousands of dollars and we really don’t know much more than we knew when we left Seale, Ala. In a fews days(4 or 5) we will have a confirmation on whether or not the adrenal tumor is the third renal cell cancer metastasis. There is better than a 90% chance that it is. Once we have that confirmation, I’ll be having another consultation with new medical oncologist Dr. Lance Pagliaro at M. D. Anderson (probably via email or phone). I’ll also talk to Dr. Andy Pippas at the John B. Amos Cancer Center, Dr. Janice Dutcher at Roosevelt/St. Luke’s in New York City, Dr. Dan George at Duke University Hospital and the members of the kidney cancer forum of acor.org. The question is whether to go the surgery route or the TKI route. That is not a decision we’ll make on our own.

We miss our home. We miss our sons, our family, our friends, our co-workers our church mates and our pets. Tomorrow morning we’ll be heading back that way and we’ll be back home Tuesday or Wednesday. Sweet Home Alabama, here we come!

 

Humble Pie is On My Menu

We’ve got a down weekend out here in Houston. I miss home. We feel like we’ve been gone for a month. I know I have gained five pounds since we got here. It is always so much fun to explore new places to eat. Restaurants that are different from the places we always go at home. Houston is a huge city. Six and a half million people of all kinds. With such a large medical community (I heard M. D. Anderson employs 14,000) there are people from every corner of the world in this city and authentic restaurants are here to serve them the food they eat at home. We have enjoyed exploring the tastes and ambiance of these mostly tiny places. It has been particularly nice to be able to hook up with Susan and Fred Morgan from Columbus who are both fighting the fight and making the best of what M. D. Anderson Cancer Center has to offer them, just like me.

Jill and I were in an elevator this morning at M.D.A. heading for a consultation with the anesthesia department in advance of my needle biopsy, which now is scheduled for Monday at 1 p.m. If everything goes according to plan, we’ll be leaving here on Tuesday headed back to God’s country.

I have really screwed this trip up, though. With the exception of Dr. Ken Ogan, who is the Emory Urologist who performed my robotic, laparoscopic nephrectomy in June of 2009, every doctor who has touched me has been a friend of mine. Some closer than others, but I have known them, played golf with them, ridden bikes with them, drunk beer with them. That makes for pretty casual meetings when we’re in their offices before or after a procedure. That luxury has yielded incredible results for us personally and medically. I have been well cared for.

I’ll just say, that “stuff” doesn’t play out here. For the most part, these doctors are the best of the best in the world. I went into our meeting with the surgeon, who is really the only person I absolutely wanted to see out here, with a bit too much of the same casual demeanor that I have come to expect in my doctors’ visits over the past three years. It didn’t go well. At all. I asked too many questions. Leading questions. He didn’t want to be led. At all.

I am going to do whatever I have to do to repair the damage I might have caused. This guy is a great surgeon. I’m sure there are others, but I don’t know them. I want Dr. Chris Wood to be my surgeon. I’m about to take a big gulp of humble pie, or whatever else I have to do to get things back on track. God, I miss Andy Pippas. Brilliant, kind, devoid-of-ego, mad scientist Dr. Andrew William Pippas. We’ve got some stuff to talk about the next time I see him.

So the biopsy will be done on Monday. It is almost certainly going to indicate a cancerous tumor on my left adrenal gland. Dr. Wood wants a six-month regimen of Sunitinib (Sutent). I haven’t discussed this with Dr. Pagliaro, my M. D. Anderson “team leader.” I think he’s going to be surprised that Dr. Wood doesn’t think an immediate surgery is what I need. I left my appointment with Dr. Pagliaro this past Monday thinking surgery was probably a slam dunk.

I do not want to take that drug, unless there is a clear, logical reason for me to do so. I’m not convinced that time is now. But what do I know? We’re only talking about my life.

New News and We’re Houston Bound

We just returned to the office after our scan follow up with Dr. Pippas. As soon as he walked in and gave us that look, I knew it was on. I have another “lesion” to deal with, this time on the left adrenal gland, near the site of my total left nephrectomy in June of 2009. It is likely a metastasis from the original renal cell carcinoma and it has doubled in size over the last year and is a 3.9 cm mass.

Dr. Pippas has reiterated on a number of occasions, including today, that this (not in general, but the one I have) cancer is a fairly indolent disease. Jill and I decided today that we’re going to schedule a trip to Houston to M. D. Anderson for a consult to determine what is the next best option. Based on our discussions today with Dr. Pippas, we could have surgery to remove the left adrenal gland or maybe radiation to kill the tumor.

We have scheduled an appointment with Dr. Mac Molnar (he’s already been body spelunking inside of me twice) if a surgery is what we choose. Thankfully, we have some great local general surgeons here in the Columbus area.

Honestly, I am caught off guard with the adrenal gland issue. I have spent a great deal of time researching bone mets and the possibility of a recurrence in my lungs, so I’ve “read up” on those. Looks like I’ve got some work to do to understand the issues with a metastasis in the adrenal gland. I’m up for it.

This post is short because I’m gathering documents and making the calls I need to make to family to let them know what is going on. I will be at the drum circle on Friday night beating my drum like there’s no tomorrow. If you want to stop by, there will be plenty of stuff to beat, shake or otherwise get you into the groove. Please continue thinking of us in your prayers, as well as all the others who are dealing with this damn disease.

Good Report Today

I am so sorry that this post is coming so late. I only slept for about 3 hours last night and when we hit our hotel room after our appointment, I took a much needed 2.5 hour nap. I got up just in time to meet two of our sons and Michael’s girlfriend for dinner. We just got back to the hotel room and so I’ve settled in to write.

Dr. Stapleford came into the treatment room today after viewing the MRI scan results and said,  “Nothing has changed.” I looked at her and while I was staring I was thinking, “I came into this place with cancer in my spine and you’re telling me nothing has changed!” I wasn’t liking the way this was going. And my dad sent us up to Atlanta with some of his semi-world-famous peanut brittle for the doctor, too. Unless something changes pretty quickly, this peanut brittle is going back home with us.

So the questions started flying. What do you mean nothing has changed. Is that good? “Oh yeah, that’s good,” she said. Turns out what the good doctor was saying is that the hole that was left in my spine at L-2 is still there and it is still the same size. Although they can’t reach in there and look for individual cancer cells, if the radiation did its job, there should be nothing but dead tissue inside the hole in my spine. “Nothing’s changed” is good. Chances are good that the high dose of radiation killed the tumor, because if it wasn’t dead, it would likely have grown over the past few weeks since the treatment.

She poked and prodded. She asked more questions and determined that we should follow up with Dr. Pippas, Dr. Gorum and do another MRI without contrast in 3 months, which we’ll have done at The Medical Center. She is quite thorough and at the end of our appointment, I whipped out the peanut brittle and handed it over. She is quite thin, so this should be good for her.

So, the news is good and we’ll be meeting with Dr. Pippas this coming Monday, January 10 to discuss next courses of action. We’ll probably start an infusion of a drug called Zometa, which should help strengthen my bones against another metastasis. That is one of the things on our list to talk to Dr. Pippas about.

We’re both pretty tired and we’ll head back to Columbus tomorrow afternoon after a seminar we’ll attend in the morning up here. Once again, thank you all for your good birthday wishes and your concerns about my health and the welfare of our family. Also, please say a prayer for our friend Fred Morgan, who is having renal cell carcinoma surgery tomorrow morning at M.D. Anderson in Houston. He is really on my mind right now.

Please forgive me for the late post and thanks for following my blog.