Okay, I'll get my ubiquitous apology out of the way. I can't believe it has been 2 months since my last post! A lot has happened, some really fun stuff, and I do plan to share about all that in a separate post or posts at some point. But today I'm letting you all know the latest news on Biff's health.
The bottom line is the cancer has spread to some small spots in his lungs, and Biff will be going into further chemo treatments starting May 15th. The plan is 6 sessions, one every 3 weeks. There will not be any surgery or radiation this time around.
If you are interested in more details, click on the Read More link below...
Just a couple of days after the radiation treatment ended in late February, Biff had a lung scan. It was a follow up from back in October. A routine scan monitoring his lungs had shown a couple of small spots. Too small to biopsy at that point, and the neck biopsy had shown cancer, so he was heading into the surgery and treatment for that. They scheduled a follow up scan a few months out, to monitor those spots.
As it turned out, those spots had grown, now big enough for a biopsy. It was devastating news, especially as we had just finished the radiation/chemo treatments and were just getting into the hardest couple of weeks in terms of side effects from that radiation treatment. Because he was just beginning his recovery, they wanted to wait on doing the lung biopsy for a month.
In the meantime, follow up appointments with the radiation and chemo doctors explained to us what those spots most likely meant, which was not great. However, since we wouldn't know anything for sure until after the biopsy, Biff wanted to hold off on telling anyone about this until after we knew more specifics.
I'll admit, it was not easy to keep it to ourselves at times. And it made it harder for me to post updates, even though I had things I could share, some very fun things, but, well, it was a strange limbo I felt a bit stuck in.
The biopsy was March 30th. We learned shortly after that the biopsy confirmed those spots were a spread of the original cancer. A meeting with the chemo oncologist explained that the ballgame is wholly different now. We discussed options for treatment, organizing preliminary appointments and procedures.
All the while, Biff was still recovering, had grown stronger and was regaining his taste and eating better, able to maintain his weight, etc. We had already decided to attend a wedding in April of a cousin in San Francisco that had been postponed for 4 years due to Covid. We turned it into a road trip up the coast, staying a couple nights in Cambria, then on to SF for the wonderful, grand event - and a chance to see family we hadn't been able to see in so long. Then we stopped for a night in San Simeon on the way back. It was a great week, which I truly do plan to write about here in another post.
Because of those plans, we chose to continue keeping the latest news to ourselves, not wanting to layer any shadows over the joyous festivities.
The doctors fully supported our travel plans. We would wait until after the trip to get going on the next leg of the now ongoing journey.
I worked on moving the PET scan that had been scheduled for the end of May up to May 1st, after our return from the trip. The scan creates a baseline for going forward. The good news there is that there were no surprises. The treatment aimed at his neck/throat worked well and looks clear of cancer. And, other than those spots already found in his lungs, no other cancer was detected!
I got Biff scheduled to have a port installed. The port is about the size of a quarter, and it will be installed under the skin on his upper chest, above the breast area, as a built in access point to a vein where future infusions can be done. This will avoid them having to "find a vein" over and over again in his arm and hands for the upcoming treatments. That will happen on May 12th.
Once we were back from the trip, and after the PET scan, we spoke with the radiation oncologist, who was very pleased that the previous treatment worked well, eliminating the worry about anything becoming a problem in his throat/head as we go into the next treatment. The next treatment will not include radiation.
We met again with the chemo oncologist. Surgical intervention is not an option in this case. And there is no longer talk of a cure. Now the focus is on management.
Biff will go forward with immuno therapy ("Keytruda") - an infusion therapy every 3 weeks likely for the rest of his life. This therapy helps people with cancer live longer, healthier lives. There are fewer expectations for side effects.
The harder element was settling on the chemo therapy part. He has decided to go forward with Carboplatin (on-site infusion) and Fluorouracil, which will require a pump to be attached and worn for 4 days - one every 3 weeks for 6 sessions. So, we're looking at 4 to 5 months for this round of treatment.
Starting Monday, May 15th, he'll go in for an infusion session and the Fluorouracil pump attachment, and we'll go back on Friday to have the pump removed. They anticipate the worst days of any side effects would be the week after that (the "Nadir"), then he should feel better the week after that (the 3rd week), and then the process starts over again the week after that.
The infusions will go through the port, and the chemo pump will be attached there, with a tube to the pump he'll carry at his waist for the 4 days each session. The doctors explained that this therapy is most tested, generally causes less side effects for most people, and is usually most effective for most people.
And, otherwise, we just have to find out how well he tolerates it and how well it works for him. There will be lab tests prior to each session and regular scans to check those spots every 2 or 3 sessions. The primary goal is no more growth, hoping for size reduction, and possibly even having the spots disappear. Even if they do disappear, it doesn't mean he's cured, but it does mean the management plan is working well.
How he tolerates the treatment is the rough spot for now. How bad those worst days might be. Possibly even deciding it is intolerable and switching to another chemo option. If this treatment doesn't keep the spots from growing, the ballgame will change again, but we'll worry about that if we have to - not now.
They will start him on a lower dose and increase it after seeing how he tolerates the treatment.
Biff says he's still having a hard time wrapping his head around it. It's a lot. And he hasn't even read all the handouts describing potential side effects - we agreed it's probably best he doesn't get all that stuck in his head. He knows some, and I'll be monitoring everything as we go along. Some nasty possibilities, but fingers crossed he'll handle it well. He's already proven stronger and more resilient than he could have been for the previous treatment. 🤞🤞🤞
They are taking him off one of his blood pressure medications. His BP has been consistently low for weeks now. If he stays low, they will stop the other BP medication he's on, too. Hoping this helps with some of his periodic weakness and lightheadedness!
We're doing our best and hanging in there. Of course we had hoped we were on the other side of all this. And Biff was so anxious to get back to work, which, in all likelihood, really isn't an option now for at least the next several months.
It's been an anxious couple of months, especially the last couple of weeks. I decided to go back on antidepressant/anti-anxiety meds, and I'm back in talk therapy. The new therapist is great: we focus a lot on anxiety management and do breathing exercises. Very helpful. I guess, in all honesty, I'm having a hard time wrapping my head around everything, too. The hardest part is knowing we can't know exactly how it will all go - you just have to take each step, see how it goes, make adjustments as necessary, and then take the next step. It can be nerve wracking, to say the least.
I'm also going to be looking into some cancer support resources for both of us. And, of course, we are both grateful for the support of our family and friends. Hopefully, we can set up some visits with folks once we see how this new "adventure" works out.
In the meantime, don't hesitate to call or text or email - especially if I haven't updated this blog in a while. Believe me, we aren't wallowing in misery at all times. Biff enjoys hearing from his family and friends! So do I. We don't always think to reach out, wrapped up a bit in our little cocoon. But we do appreciate all the warm wishes and support. And we like to know what's happening in your lives, too!
I promise, if we aren't available to answer a call or immediately respond to a text or email, we won't. But we will as soon as we possibly can.
And I promise to respond as quickly as possible to comments posted here, too!
Remembering to breathe. Onward and onward.
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