Details

Here are my notes from the appointment today...this doesn't let me format paragraphs, so forgive the formatting... Cancer formed with gland forming cells are adinocarcinomas. Lining cells are called squamous cells. Steve has squamous cell carcinoma. It is very rare. .25% of all rectal cancers. The Doc has never treated this particular cancer. He is reaching out to colleagues in various areas to make sure we get multiple opinions. We liked how thorough he was and he was very attentive. There are 3 things they use to stage rectal cancer...1) How far is it into the wall? Steve's is all the way through the wall, but not growing onto other things on the other side. That is T3. 2) Is it in the Lymph system at all? His is in 1 lymph node. That is N-1. 3) Has it metastasized? (Spread?) His has not. That is M-0. So, all together that makes him Stage 3a. The treatment will be simultaneous chemotherapy and radiation. The idea is that the chemo attacks the fast growing cells and makes them weaker...then when the radiation hits, they will be more likely to die.

 He'll have a PET scan on Friday morning at 8am. That will be for 2 reasons. 1) To confirm that the cancer hasn't spread and 2) to confirm the site of origin. There's a chance the cancer originated somewhere else and moved to the rectum.

 Next Thursday we will meet with Dr. Clark, who is the radiation oncologist. Then, likely on Friday they'll place a port (implantable IV) and the following Monday (May 16th), he'll start chemo and radiation.

They will use 2 different chemo drugs. The first one is 5FU (Appropriately named...short for Fluorouracil). That will be a 96 hour infusion...basically M-F. Then, the next Monday he'll get mitomycin C. Then on day 29 he'll get 5FU for another 96 hours, then on day 36 he'll get mitomycin C again. He'll get radiation every day M-F for 7 weeks. The radiation will be short, but will be quite exhausting for him. The chemotherapy kills cells that grow fast...those cells include hair (hair loss will result), lining of the mouth and gut (sores and nausea are potentials), bone marrow (his immune system will be repressed), and platelets (they'll watch for bleeding issues). The chemo will damage the cancer cells and also, since it will travel through his system, it will hopefully kill any traveling cells looking for another place to make home. 

We anticipate Steve continuing on long term disability. After the 7 weeks they will wait 12 weeks for a follow up PET scan and colonoscopy. He will then have annual colonoscopies for a while. The goal of avoiding surgery is to avoid a colostomy bag. We will wash our hands a lot and try to avoid germs wherever possible. Steve's hair will likely fall out during week 3. He's very sad about that. I would be, too.

 We had more angels come today...some came to fix our sprinklers and did a hole for a tree that I've been wishing for, one offered dinners every Monday until June, one took us up into the mountains to forget our worries for a while, and one brought us dinner. We did get some really fantastic news today...Caitlin made student council for next year. She is really super excited. She also had her first track meet ....which some angels took her to....and Kenneth played in a soccer game against Lehi and they tied. Daniel, Kenneth and I are preparing a beautiful rendition of "I Am a Child of God" for Mother's Day. Kenneth is accompanying Daniel and I playing our violins. It's been nice to rehearse each evening and feel the Spirit of the song. We are children of God, and we are grateful for our Heavenly Father who watches over and blesses us. We are glad to have some idea about the treatment and we are so grateful for good doctors. We've enjoyed having Pat & Nancy here, and we'll miss them when they leave in the morning. Steve gained 3 pounds at his weigh in today and it's all due to Nancy's wonderful cooking (and yummy cakes!). I've really enjoyed her fabulous hot chocolate and their company.