Chemo Round 4

Matthew is finished with round 4 of chemo and it was not too bad.  They took out one of the drugs in preparation for the liver surgery (which has tentatively been scheduled for September 21st).  Matthew said this time his head didn't hurt as bad, and he didn't have the headaches.  While he had some nausea, he was still pretty productive all 3 days.

My dad has been busy with repairs that are necessary to keep the insurance on the house.  Mom has stayed busy with Grandma and Isaac will be registered for school next week.  He will be attending 5th grade at Clute Intermediate, which is just down the street from Matthew's house.

I will update as soon as we hear anything new.

Some results

OK, I got lots of information from about 5 different phone calls today....so let's see if I can get everything straight.  I will go in the order that I got the information.

The first was about Lynch Syndrome.

Lynch syndrome, often called hereditary nonpolyposis colorectal cancer (HNPCC), is a type of inherited cancer of the digestive tract, particularly the colon (large intestine) and rectum. People with Lynch syndrome have an increased risk of cancers of the stomach, small intestine, liver, gallbladder ducts, upper urinary tract, brain, skin, and prostate. Women with this disorder also have a high risk of cancer of the endometrium (lining of the uterus) and ovaries. Even though the disorder was originally described as not involving noncancerous (benign) growths (polyps) in the colon, people with Lynch syndrome may occasionally have colon polyps. In individuals with this disorder, colon polyps occur at an earlier age than in the general population. Although the polyps do not occur in greater numbers than in the general population, they are more likely to become cancerous.

Due to Matthew's age, the doctors felt strongly that there was most likely a genetic connection.  However, they screened Matthew, and Matthew had NONE of the 4 Protein markers for Lynch syndrome, and pathological examination of the cancerous tissue did not appear to be indicative Lynch either.

Next, was the results about the chemotherapy.  It appears that the tumor on the liver IS RESPONDING to the chemotherapy, and has shrunk about 10-20%.

Which leads us to what is next.  Due to the location of the tumor, Matthew will have to have about 60% of his liver removed.  That's a lot right!  However, it is actually possible to remove up to 75% of the liver because it regenerates.  Matthew's liver will actually regenerate in about 8 weeks.

Here is where the question marks, and the word BUT comes in.  The scan showed a "suspect lymph node" in his pelvic region.  The liver surgeon and liver oncologist need to confer with the colon oncologist to find out what to do about it.  It is possible that it is nothing of concern.   If this is the case, Matthew will have surgery to remove the tumor on his liver in about 6 weeks.
If the lymph node presents a problem, we are not sure what will happen.  There are several possibilities.  They could do more chemo, they could do radiation, they could do surgery on the lymph node, they could possibly remove the liver tumor and the lymph node at the same time.  We won't know for about a week. The concern with more chemo is that it actually causes the liver to shrink, which would be a problem considering the amount of his liver that has to be removed.  The concern with doing the surgeries separately is recovery time and scar tissue.

So for now, the news is pretty good, but we still wait for all the answers.

Now, I am going to go off on a little rant about the way insurance works.  As I have stated before, Matthew only had/has a catastrophic incident health insurance policy.  So, Cancer is catastrophic right!?  Well apparently, the policy only allows for a certain number of doctor's visits, and Matthew has exceeded his limit. This is where it gets messed up!  If you have coverage, M.D. Anderson accepts whatever the insurance pays, and bills you no further.  However, if your insurance will not cover the costs, M.D. Anderson requires you to pay UP FRONT, before you can see the doctor.  Believe me, one day of appointments, with 2 or 3 doctors at the top cancer treatment facility in the country DO NOT COME CHEAP.  The part that makes me most angry is Matthew's bill for today was probably higher than what they would accept as an insurance payment, and of course this hits the people that can least afford/or don't have access to insurance the hardest.  So, insurance is a huge issue that should not be ignored just because you have coverage (I know I am guilty of this.) ......*steps down from the soapbox*

On a final and unrelated note, today is my parents' 39th Wedding Anniversary.  This is a  huge accomplishment and great example.   For better, and for worse, may they have many more years together (but let's hope they are better!)  

Another Round of Appointments

It is time for another Round of appointments.  Matthew has appointments at M.D. Anderson over the next 3 days.  He will have an MRI, scans, and other tests to find out if the chemo is working, and as part of the studies he is involved in.  His doctor's appointment is Friday morning.  We are hoping that the chemo is doing its job quickly and that the liver tumor will be small enough to remove.

At this point, I am unsure what will happen if the tumor has not shrunk to the desired size.  I will update as I get more information.