Major Richard Dennis West
February 6,1949-July 5,2009
Tuesday, July 7, 2009
Tuesday, June 2, 2009
Down but NOT out!
After nearly a week of agonizing waiting we travelled to Miami to meet with Dr. Gulec and learn of his final decision. He remains hesitant to give the second round of spheres to Dennis's left lobe due to Dennis's liver function. Although we are disappointed we hope the picture will change and it will be an option in the near future. Dr. Gulec and Dr. Ardalan have spoken at length and we will return to Miami's Sylvester Cancer Center on Monday June 7th and resume therapy with Dr. Ardalan. We're not sure what our new attack will be but we are happy to know there is something more we can do.
Dennis also had a second paracentesis done today outpatient at Jackson North to remove 1 liter of the ascites fluid from his abdomen and he feels much better!
Looking forward!
-"Pain is temporary. It may last a minute,or an hour,or a day,or a year,
but eventually it will subside and something else will take it's place.
If I quit,however,it lasts forever."
Lance Armstrong
Dennis also had a second paracentesis done today outpatient at Jackson North to remove 1 liter of the ascites fluid from his abdomen and he feels much better!
Looking forward!
-"Pain is temporary. It may last a minute,or an hour,or a day,or a year,
but eventually it will subside and something else will take it's place.
If I quit,however,it lasts forever."
Lance Armstrong
Thursday, May 21, 2009
Preliminary Observations from Treatment
It has been 4 weeks since Dennis's treatment to his right lobe of the liver. It has been a tough recovery road. Dennis experienced considerable fatigue,ascites and weight loss of about 10 lbs due to poor liver function and effects of the radiation.
Today he had his post procedure PET/CT scans at 0800 and we met with Dr. Gulec and Dr.Berkman at 1:00pm so they could take a look at the new scans. They were as anxious as we were to see what benefits we achieved through Selective Internal Radiation Therapy.
Based on their intial observations it appears Dennis has achieved between 75-85% reduction in tumor activity in his right lobe-good news! Bad news is that his left liver lobe without treatment for this period of 8 weeks has progressed rapidly with cancer. Fortunately the cancer has not advanced beyond his liver!
Dennis's liver function is "marginal" and his liver is struggling.
Dr. Gulec will be looking at the scans during the next few days and waiting for the final report from Chicago. Since the response from this treatment has been extremely good he hopes to treat the left lobe quickly if possible. The only hesitation is Dennis's liver's ability to withstand another procedure. As I have been advised throughout this last year, the goal is always to kill the cancer and not the patient.
We will meet with Dr. Gulec next Wednesday morning to see what our next step will be.
-"When you get into a tight place and eveything goes against you,till it seems as though you could not hold on a minute longer,never give up,for that is just the place and time that the tide will turn."- Harriet Beecher Stowe
Today he had his post procedure PET/CT scans at 0800 and we met with Dr. Gulec and Dr.Berkman at 1:00pm so they could take a look at the new scans. They were as anxious as we were to see what benefits we achieved through Selective Internal Radiation Therapy.
Based on their intial observations it appears Dennis has achieved between 75-85% reduction in tumor activity in his right lobe-good news! Bad news is that his left liver lobe without treatment for this period of 8 weeks has progressed rapidly with cancer. Fortunately the cancer has not advanced beyond his liver!
Dennis's liver function is "marginal" and his liver is struggling.
Dr. Gulec will be looking at the scans during the next few days and waiting for the final report from Chicago. Since the response from this treatment has been extremely good he hopes to treat the left lobe quickly if possible. The only hesitation is Dennis's liver's ability to withstand another procedure. As I have been advised throughout this last year, the goal is always to kill the cancer and not the patient.
We will meet with Dr. Gulec next Wednesday morning to see what our next step will be.
-"When you get into a tight place and eveything goes against you,till it seems as though you could not hold on a minute longer,never give up,for that is just the place and time that the tide will turn."- Harriet Beecher Stowe
Sunday, April 26, 2009
Back to the hospital
Saturday had a return to Jackson North due to development of Ascites.
Ascites is fluid build-up in the abdominal cavity, caused by fluid leaks from the surface of the liver. Dennis's symptoms of ascites include a distended abdominal cavity, which causes discomfort and shortness of breath. This has also affected Dennis's appetite due to the pressure from the abdomen on the stomach. CT scans and blood work at the hospital confirmed the diagnosis. Dr. Gulec stated that Dennis's liver is swollen and the blood flow through the liver is restricted and causing the ascites.
Dennis received IV medications and diuretics in the hospital to relieve symptoms and to prevent further progression. We were discharged on Sunday morning and Dennis is resting today. He will continue medications at home and will have a follow up appointment on Thursday.
It will be 4 weeks until we will take scans to see what benefits we have gained through the microspheres. Scans are scheduled for May 22 and we will meet with Dr. Gulec the following week once results are available.
Hopefully we'll enjoy a "quiet" week.
What would you attempt to do if you knew you would not fail?
~Dr. Robert Schuller
Ascites is fluid build-up in the abdominal cavity, caused by fluid leaks from the surface of the liver. Dennis's symptoms of ascites include a distended abdominal cavity, which causes discomfort and shortness of breath. This has also affected Dennis's appetite due to the pressure from the abdomen on the stomach. CT scans and blood work at the hospital confirmed the diagnosis. Dr. Gulec stated that Dennis's liver is swollen and the blood flow through the liver is restricted and causing the ascites.
Dennis received IV medications and diuretics in the hospital to relieve symptoms and to prevent further progression. We were discharged on Sunday morning and Dennis is resting today. He will continue medications at home and will have a follow up appointment on Thursday.
It will be 4 weeks until we will take scans to see what benefits we have gained through the microspheres. Scans are scheduled for May 22 and we will meet with Dr. Gulec the following week once results are available.
Hopefully we'll enjoy a "quiet" week.
What would you attempt to do if you knew you would not fail?
~Dr. Robert Schuller
Thursday, April 23, 2009
Procedure went well
Another early morning but things were delayed as we waited for the microspheres to arrive from Boston via FEDEX. We got word that they arrived at 1000 and they transferred Dennis to the procedure suite at 1100. I asked him how he felt and he said,"scared to death" but ready to proceed.
Everything went well and the procedures finished at 1400. Now 1500 he is in his hospital room for an overnight stay. He said he feels "like I got hit by a truck" and has been given medication for pain relief.
He's sleeping now and probably will be out of it for the rest of the day.
Here's praying that the microspheres are busy doing their work!
"Bricks Walls are there for a reason: they let us prove how badly we want things".
-Randy Pausch
Everything went well and the procedures finished at 1400. Now 1500 he is in his hospital room for an overnight stay. He said he feels "like I got hit by a truck" and has been given medication for pain relief.
He's sleeping now and probably will be out of it for the rest of the day.
Here's praying that the microspheres are busy doing their work!
"Bricks Walls are there for a reason: they let us prove how badly we want things".
-Randy Pausch
Tuesday, April 21, 2009
Preliminary Procedures Completed
We arrived at Jackson North Hospital at 0600 for Dennis's 0800 procedure.
After bloodwork and a physical exam Dennis went to the Angiogram suite for his procedures. I had an opportunity to see the room and the equipment was quite impressive. I can see why it's a $125,000 procedure. The procedures today took 3 hours to complete and then Dennis needed 3 more hours of observation before we were released to go home. Everything looked promising so we will return Thursday at 0600.
Bloodwork showed Dennis's CEA at 290 which is an increase but not as much as we anticipated since he has been off chemotherapy for 3 weeks.
Dennis is "taking it easy" for the next 24 hours in preparation for Thursday's SIRT procedure.
-In loneliness, in sickness, in confusion---
the mere knowledge of friendship makes it
possible to endure, even if the friend is
powerless to help.
It is enough that they exist.
-Pam Brown
After bloodwork and a physical exam Dennis went to the Angiogram suite for his procedures. I had an opportunity to see the room and the equipment was quite impressive. I can see why it's a $125,000 procedure. The procedures today took 3 hours to complete and then Dennis needed 3 more hours of observation before we were released to go home. Everything looked promising so we will return Thursday at 0600.
Bloodwork showed Dennis's CEA at 290 which is an increase but not as much as we anticipated since he has been off chemotherapy for 3 weeks.
Dennis is "taking it easy" for the next 24 hours in preparation for Thursday's SIRT procedure.
-In loneliness, in sickness, in confusion---
the mere knowledge of friendship makes it
possible to endure, even if the friend is
powerless to help.
It is enough that they exist.
-Pam Brown
Saturday, April 18, 2009
Small Beads,Big Hope
Everything is in place to have Dennis's Selective Internal Radiation Therapy(SIRT) next Thursday.
During this minimally invasive procedure, millions of radioactive microspheres are placed in the liver via a catheter infusion. Once inside, they selectively target tumors with internal radiation doses, and SIRT can target and
destroy liver tumors inaccessible by other techniques.
The procedure is comprised of two major components: embolization and brachytherapy. It begins with a small incision in Dennis's upper thigh, which allows the interventional radiologist to place a catheter into the femoral artery. Then, utilizing fluoroscopic guidance, the radiologist maneuvers the catheter toward the hepatic artery, one of two blood vessels that supply blood to the liver.
The catheter is then guided into the hepatic artery branch feeding the liver tumor. The microspheres are injected through the catheter and into the tumor blood supply.The blood carries the microspheres to the tumor area of greatest vascularity where they become trapped.
Once trapped, the microspheres emit their beta radiation. This destroys the tumor by reducing its blood supply, which is the embolic effect, as well as by damaging the cancer cells’ DNA.
The targeted radiation is contained within the patient’s body and delivered over a two-week period.
Careful preparation is needed before microsphere treatment because the technique is driven by the vasculature.The microspheres can potentially travel anywhere throughout the body. To prevent this from happening Dr. Gulec will on Tuesday perform a couple of procedures. These include an angiogram to determine if any vessels leading to other body areas need to be coiled.
Also, to prevent any damage to the lung, the Dr. Gulec will perform a nuclear technetium-99m macroaggregated albumin (MAA) study. Physicians use it to assess the proper placement of venous and arterial access systems. This avoids a risk of leakage and ensures that therapeutic agents are delivered as intended.
Angiograms examine the arterial anatomy to make sure the microspheres only go to the liver and not the intestine, lung, or other places.
Beyond the preparation, the actual treatment doesn’t take long. Preparation is what takes up time. The actual microsphere delivery on Thursday takes about only 20 minutes to a half hour.Treatment will be performed on an outpatient basis at the Jackson North Hospital with Dennis remaining conscious during the procedure.
Chemotherapy will be used in conjuction and Dennis will start chemotherapy on Wednesday for 2 weeks.
While it is not considered a cure, this treatment can shrink cancer when combined with chemotherapy.
Dennis will have scans taken 4 weeks after the procedure and then Dr. Gulec will treat the left lobe of the liver.
We will update next Thursday from Miami.
-Most of the important things in the world have been accomplished by people who have kept on trying when there seemed no hope at all.-Dale Carnegie
During this minimally invasive procedure, millions of radioactive microspheres are placed in the liver via a catheter infusion. Once inside, they selectively target tumors with internal radiation doses, and SIRT can target and
destroy liver tumors inaccessible by other techniques.
The procedure is comprised of two major components: embolization and brachytherapy. It begins with a small incision in Dennis's upper thigh, which allows the interventional radiologist to place a catheter into the femoral artery. Then, utilizing fluoroscopic guidance, the radiologist maneuvers the catheter toward the hepatic artery, one of two blood vessels that supply blood to the liver.
The catheter is then guided into the hepatic artery branch feeding the liver tumor. The microspheres are injected through the catheter and into the tumor blood supply.The blood carries the microspheres to the tumor area of greatest vascularity where they become trapped.
Once trapped, the microspheres emit their beta radiation. This destroys the tumor by reducing its blood supply, which is the embolic effect, as well as by damaging the cancer cells’ DNA.
The targeted radiation is contained within the patient’s body and delivered over a two-week period.
Careful preparation is needed before microsphere treatment because the technique is driven by the vasculature.The microspheres can potentially travel anywhere throughout the body. To prevent this from happening Dr. Gulec will on Tuesday perform a couple of procedures. These include an angiogram to determine if any vessels leading to other body areas need to be coiled.
Also, to prevent any damage to the lung, the Dr. Gulec will perform a nuclear technetium-99m macroaggregated albumin (MAA) study. Physicians use it to assess the proper placement of venous and arterial access systems. This avoids a risk of leakage and ensures that therapeutic agents are delivered as intended.
Angiograms examine the arterial anatomy to make sure the microspheres only go to the liver and not the intestine, lung, or other places.
Beyond the preparation, the actual treatment doesn’t take long. Preparation is what takes up time. The actual microsphere delivery on Thursday takes about only 20 minutes to a half hour.Treatment will be performed on an outpatient basis at the Jackson North Hospital with Dennis remaining conscious during the procedure.
Chemotherapy will be used in conjuction and Dennis will start chemotherapy on Wednesday for 2 weeks.
While it is not considered a cure, this treatment can shrink cancer when combined with chemotherapy.
Dennis will have scans taken 4 weeks after the procedure and then Dr. Gulec will treat the left lobe of the liver.
We will update next Thursday from Miami.
-Most of the important things in the world have been accomplished by people who have kept on trying when there seemed no hope at all.-Dale Carnegie
Friday, March 27, 2009
Change in direction
Sorry for the lack of updates but we have been doing alot of researching and consulting with "experts". It gets more challenging the higher you go in this game.
Yesterday's CEA showed an increase to 244 from 171 so it is time to move forward.
After discussions with University of Pittsburgh,Duke University,University of Miami and Jackson North in Miami Dennis has decided to go forward with SIRT treatment with Dr.Seza Gulec in Miami.He is not part of the University of Miami Sylvester Cancer center but Dr.Ardalan will work together with Dr. Gulec in this new effort. Dr Gulec has a impressive resume:
www.southfloridahospitalnews.com/specialfocus/default.asp?articleID=3823 - 20k
Information on this treatment is well explained on the following 2 websites:
http://www.sirtex.com/
http://www.y90support.org/yes/index.html
We are finishing up chemotherapy in Miami today and Dennis will need at least a 2 week break from chemotherapy prior to this Internal Radiation Treatment.
Dennis plans to take advantage of this time to drive his truck out to Wyoming after his April 2 appointment with Dr.Aron Berkman,the Oncologist working with Dr. Gulec. Dave Thompson and John Molenar enthusiastically offered to fly to Florida and drive out with Denny.
It's a 3 day drive and sure to be fun for them. We will be in Wyoming until 13 April and fly home to begin tests and treatment 14 April. The actual radiation treatment will be during the later part of the week of April 20th.
Thank you for all your prayers and support!
I have heard there are troubles of more than one kind. Some come from ahead and some come from behind. But I've bought a big bat. I'm all ready you see. Now my troubles are going to have trouble with me! -Dr Seuss
Yesterday's CEA showed an increase to 244 from 171 so it is time to move forward.
After discussions with University of Pittsburgh,Duke University,University of Miami and Jackson North in Miami Dennis has decided to go forward with SIRT treatment with Dr.Seza Gulec in Miami.He is not part of the University of Miami Sylvester Cancer center but Dr.Ardalan will work together with Dr. Gulec in this new effort. Dr Gulec has a impressive resume:
www.southfloridahospitalnews.com/specialfocus/default.asp?articleID=3823 - 20k
Information on this treatment is well explained on the following 2 websites:
http://www.sirtex.com/
http://www.y90support.org/yes/index.html
We are finishing up chemotherapy in Miami today and Dennis will need at least a 2 week break from chemotherapy prior to this Internal Radiation Treatment.
Dennis plans to take advantage of this time to drive his truck out to Wyoming after his April 2 appointment with Dr.Aron Berkman,the Oncologist working with Dr. Gulec. Dave Thompson and John Molenar enthusiastically offered to fly to Florida and drive out with Denny.
It's a 3 day drive and sure to be fun for them. We will be in Wyoming until 13 April and fly home to begin tests and treatment 14 April. The actual radiation treatment will be during the later part of the week of April 20th.
Thank you for all your prayers and support!
I have heard there are troubles of more than one kind. Some come from ahead and some come from behind. But I've bought a big bat. I'm all ready you see. Now my troubles are going to have trouble with me! -Dr Seuss
Wednesday, March 4, 2009
Hopefully heading in the right direction
Sorry for the lack of updates...it's been quite the rollercoaster ride here!
After switching to the new "chemo cocktail" Dennis's markers continue up to 237. Not the result we had hoped for. Second round of therapy the marker went down to 232,a slight decrease but at least not rising. This week after treatment #3 we got the break we had hoped for...178! This is such a relief! This chemotherapy is LONG and quite toxic and is kicking Dennis and hopefully the cancer as well. Dr. has ordered a week break due to toxicty so we will be off now until 19 March! We are looking forward to Natalie and Brian coming home for spring break on 13 March and heading to Key West and the Dry Tortugas for a few days.
Dr. Ardalan has discussed that we have run through all applicable drugs for Dennis and from here we will be looking at radiation therapies and clinical trials once these drugs become ineffective. He is referring us to a Dr.here in Miami for an Interventional Radiology consultation.I have been researching options,gathering records and making appointments for opinions at University of Pittsburgh Medical Center,PA, Duke University in NC, H Moffitt Cancer Center in Tampa,U of Florida Shands Hospital in Gainesville,and Wake Radiology in NC. All those expert opinions should help decide what should be our next move if these drugs don't do the trick. Dennis should be taking scans in a few weeks and that will tell what is really going on in his liver.
Thanks again for all your prayers and support.
After switching to the new "chemo cocktail" Dennis's markers continue up to 237. Not the result we had hoped for. Second round of therapy the marker went down to 232,a slight decrease but at least not rising. This week after treatment #3 we got the break we had hoped for...178! This is such a relief! This chemotherapy is LONG and quite toxic and is kicking Dennis and hopefully the cancer as well. Dr. has ordered a week break due to toxicty so we will be off now until 19 March! We are looking forward to Natalie and Brian coming home for spring break on 13 March and heading to Key West and the Dry Tortugas for a few days.
Dr. Ardalan has discussed that we have run through all applicable drugs for Dennis and from here we will be looking at radiation therapies and clinical trials once these drugs become ineffective. He is referring us to a Dr.here in Miami for an Interventional Radiology consultation.I have been researching options,gathering records and making appointments for opinions at University of Pittsburgh Medical Center,PA, Duke University in NC, H Moffitt Cancer Center in Tampa,U of Florida Shands Hospital in Gainesville,and Wake Radiology in NC. All those expert opinions should help decide what should be our next move if these drugs don't do the trick. Dennis should be taking scans in a few weeks and that will tell what is really going on in his liver.
Thanks again for all your prayers and support.
Sunday, February 15, 2009
It was a Great Birthday
February 6th was a magical evening.
Pictures are up on photobucket:
http://s214.photobucket.com/albums/cc240/marykaywest/Birthday%20Celebration/
It was great to be together for what Dennis called "the best weekend of my life".
Tuesday February 10 had us back in Miami with disappointing news that the markers were now up at 199. Dr. Ardalan has switched cocktails to a combo of 4 drugs to try and knock the cancer. It does require an overnight stay at the hospital so we will be spending Tuesday nights in Miami. It is a LONG therapy but Dr. Ardalan said he wants to "throw everything at him" to get things going in the right direction. Dennis seems to be tolerating this therapy well. So we wait and hope.
Pictures are up on photobucket:
http://s214.photobucket.com/albums/cc240/marykaywest/Birthday%20Celebration/
It was great to be together for what Dennis called "the best weekend of my life".
Tuesday February 10 had us back in Miami with disappointing news that the markers were now up at 199. Dr. Ardalan has switched cocktails to a combo of 4 drugs to try and knock the cancer. It does require an overnight stay at the hospital so we will be spending Tuesday nights in Miami. It is a LONG therapy but Dr. Ardalan said he wants to "throw everything at him" to get things going in the right direction. Dennis seems to be tolerating this therapy well. So we wait and hope.
Thursday, January 22, 2009
Vacation is over...back to work...
Dennis had a great time in Wyoming playing in the snow!
We resumed treatment on Tuesday January 20th. We will attempt another 11-12 consecutive treatments and then a follow up scan to see where we are. CEA is now 96 and is still a decrease but a slower rate. I asked Dr. Ardalan if we could increase the dose to get a better result but his reply was "you don't want to kill him do you"? It made sense to me to up the dose...wrong!
I sent a copy of Dennis's scans and reports to Dr. David Geller in Pittsburgh. He is a liver cancer surgeon and is willing to take a look and see where we stand. He has an amazing reputation.
Dennis has a BIG birthday ahead...60...on February 6th. I guess we need to celebrate this milestone.
Thanks again for all your prayers!
We resumed treatment on Tuesday January 20th. We will attempt another 11-12 consecutive treatments and then a follow up scan to see where we are. CEA is now 96 and is still a decrease but a slower rate. I asked Dr. Ardalan if we could increase the dose to get a better result but his reply was "you don't want to kill him do you"? It made sense to me to up the dose...wrong!
I sent a copy of Dennis's scans and reports to Dr. David Geller in Pittsburgh. He is a liver cancer surgeon and is willing to take a look and see where we stand. He has an amazing reputation.
Dennis has a BIG birthday ahead...60...on February 6th. I guess we need to celebrate this milestone.
Thanks again for all your prayers!
Friday, January 9, 2009
Test Results
A review of Dennis's PET and CT scans shows less activity in the liver and no new cancers. A new term was discussed "SUV" (Standardized Uptake Value) of his tumors and they decreased from 11 to 6 since his last scan at the end of October. CEA is at 100 from 12/31 blood work and we pray for this continued downward trend. Dr.Ardalan has planned to continue current chemotherapy treatment to reduce tumors. Dennis had chemotherapy yesterday #11 of this regiment and will take a 1 week chemotherapy break to give his body a break. He will resume on January 22.
Dennis's bloodwork continues to be strong so he is able to withstand this toxic mix. Dennis is flying out to Wyoming today to enjoy the mountains and snow. A most deserving vacation after 2 months of treatment. Keep praying for continued progress.
"2009 is going to be fine".
Dennis's bloodwork continues to be strong so he is able to withstand this toxic mix. Dennis is flying out to Wyoming today to enjoy the mountains and snow. A most deserving vacation after 2 months of treatment. Keep praying for continued progress.
"2009 is going to be fine".
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