Radiation

I've really struggled with writing this post. It's easier to ignore unpleasant things than face them, however, the cancer world seldom allows this thought process to sustain. We were extremely hopeful and slightly naive in thinking that Co's big belly surgery would be curative. Alas, cancer rarely plays by the rules. 

After nine hours of operating, Dr. Smoot called me to give me an update. I could instantly tell by his tone that he wasn't happy about the news he had to deliver. I've heard it so many times throughout my career in both veterinary and human medicine; the tight, apologetic tone never bears good news. He went on to explain that Cody did great throughout the surgery and was in the recovery room, everything progressing well, however, that's not the part that concerned me. I was looking for those two magical, triumphant words: "clear margins".  I have faith that one day we will hear those words or something similar, but that day has yet to come. 

Dr. Smoot explained that this type of tumor is incredibly difficult to treat because it hides so well on the scans that it's almost impossible to determine the true size of the mass. Every scan at three separate facilities in two different states showed a 1.7cm mass immediately prior to surgery. This was an improvement from the original tumor measurement of 3.5cm. When the tumor was revealed during surgery it showcased an impressive 5.5cm. This threw the team for a loop as they were not expecting a mass of this proportion or for it to be so deeply entangled into the right hepatic side. Dr. Smoot and his team took as much liver/mass as they possibly could, but the pathology was still showing "a handful of single malignant cells" that had to be left behind. They also removed 8 surrounding lymph nodes, two of which had cancer either on it or within it. The operation involved taking all of the left lobe of the liver and as far into the right side as possible before running into the right hepatic artery. Simply put, they took as much as they physically could while still being able to put him back together. 

Immediately upon waking from anesthesia, Cody always asks me one of three questions sometimes all three:
  1. Did everything go okay?
  2. Was I good? (As a typical young male, he sometimes wakes up rowdy so I always tell him to "be good" when they wheel him back)
  3. Do I still have cancer? 
Number three always guts me. It's been 11 months and answering that question never gets any easier. Like clockwork, as soon as he saw me in his room he went straight for question number three. I put on my nurse face and dug real deep as I steadied my voice to tell him that we were still waiting on the final pathology reports, but he did great. All of that was true...but after the day he had, I just didn't have the heart to tell him the full truth. Besides, there would be plenty of people in pearly white coats coming in shortly to share with him the news that was already burning in my brain. 

So, where are we now? Back in the bustling city of Rochester, Minnesota. Dr. Smoot and his colleagues at Mayo recommended radiation therapy following his operation with a chemotherapy treatment as well since there was evidence of lymph node involvement. Fortunately, the recommended chemotherapy is in a pill form instead of a 9-hour infusion and the side effects are minimal. Thank goodness because I've become quite fond of that beard...and he doesn't have to suffer all of the negativity that comes with chemo infusions, of course.

We consulted both MDA and Mayo for treatment options post-resection. I'll have a post solely dedicated to the care we received at Mayo and a separate post that lists the comparisons of the two facilities. For the sake of getting too wordy, I'll simply say that based on the quality of care we received at Mayo while we were here and while we were at home dealing with the abscess we decided to venture back to Minnesota for the continuation of care. They are that good and it is worth it for us to travel to BFE Minnesota to been seen by the best of the best. 

Co's current treatment plan: 
  • 5 weeks of Photon Radiation Therapy
  • 1 treatment/day - 5 days a week - weekends off
  • Chemotherapy pill on radiation days.
We flew up to Minnesota this past Sunday for follow-up appointments and for radiation consults. Co started radiation this Thursday(yesterday) and completed his second treatment today. After nine months of chemo hell, radiation is a BREEZE! His appointments take roughly 15 minutes and he says he doesn't feel a thing! He's a little bummed about being gone from home for so long, but it's a small price to pay if we get to keep him here with us on Earth for a bit longer. Unfortunately, I have to return to work on Monday and will be flying back to Texas tomorrow. I think that's part of why I've procrastinated this post all week. Fortunately, Co's mom, Candace is able to work remotely and stay in Minnesota with him so he's not alone. I hate having to leave and the lump in my throat is getting harder and harder to swallow when I think about it. I don't know how to be without him anymore, how to not be a nurse wife. I've been to every appointment and every treatment for almost a year. It's become a normal daily or weekly affair. This cancer has leeched into parts of me and I'm not sure that I even know how to function anymore without being at its beck and call. I guess we'll find out. He won't tell you, but I think he's struggling with my leaving too; turns out he actually likes me just a little and might even miss me. ;) 





The time will pass and when he's home again he'll hopefully be free of those last few malignant cells. As for the prognosis after these five weeks of treatment, we don't really know. We've done all we can do. It will be a waiting game to see if/when it decides to rear its ugly head in the future. Until then, we're going to keep trucking along and fighting the good fight. Cody's fight. 

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