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
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