Monday, August 26, 2013

"Roberto Has a Big A** Tumor in His Chest" - Part Deux

Roberto got a third CT scan today.  I'm torn between completing the story from yesterday and showing you all the results of the CT scan!!!  I'm going to torture you for a bit and save the CT scan for tomorrow.  Muah hahaha  (Actually, I need time to create the .avi file.  *embarrassed smiley*)

 Roberto secretly had the sniffles since last Saturday (the day he got his Neulasta shot)!  I say secretly because he didn't say anything to me about it.  I started noticing more over the weekend and internally FREAKED OUT that I might have given him my sniffles!  He told me that he got the sniffles after the Neulasta shot during the first cycle too, so he didn't think much of it.  This time, the sniffles lasted a lot longer.  I'm not sure what's going on, but I'm forcing Roberto to take it easy and take naps when he can.  He's feeling a bit better today after all the naps.

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Now that we are about halfway through the chemotherapy treatment, I thought it would be good to recap what's happened, especially for those who haven't been with us from the beginning.  I first started this blog to keep close friends and relatives apprised of Roberto's status, but we've shared this blog with all who care about Roberto and they may not have the complete history of events.

*** I'M SORRY THIS POST IS SO LONG ***  but I really wanted to finish the story in two posts.

We left off with doing a CT scan in June and scheduling an appointment to see a thoracic surgeon.   

Thoracic Surgeon and the Biopsy


We first spoke with the Chief Resident and explained the symptoms Roberto was experiencing: a side ache and some pain when breathing in deeply.  The resident assured us that Roberto probably had a thymoma which is removed via surgery.  With our hopes up, the resident left us in the exam room to view the CT scan with the surgeon.  They rushed back in with very serious looks and explained to us that Roberto needed a biopsy immediately because the tumor was so large and pushing against his bronchial tube and the major vein of the heart (vena cava superior).  Lesson:  do not listen to what doctors say until they have *ALL* the information, especially if they are still residents (chief or not).

Roberto underwent a needle biopsy procedure the following Monday in the last week of June.  Since the tumor was so close (practically on top of) his lung, the procedure took some time.  They had to do a CT scan prior to the procedure to plan where they would insert the needle.  Then they did an x-ray to make sure they didn't puncture his lung.  While it was sort of complicated, the procedure didn't require Roberto to be at the hospital for more than a few hours.

One thing that piqued our curiosity was that Roberto over heard someone state that the tumor was a bit bigger than in the previous scan.  Unfortunately, we couldn't see that particular CT scan and wouldn't know the true extent of the tumor's growth for another couple of weeks.  (See this post for a comparison of the CT scans from June and July)

THE WAIT


We were told that the results of the biopsy would be complete by the beginning of the following week at the latest.  We tried to get on with our lives and patiently waited, and even went to Western States 100 to cheer on Pedro and Chris with Erin and Natalie (when we could find them).

During this wait time, Roberto's condition began to deteriorate  He was short of breath when climbing stairs on some days.  At Western States, we were up in the mountains and had to hike to one of the aid stations.  It was a short hike and certainly nothing that would challenge normal Roberto, but cancer Roberto had trouble with the half mile with some incline.  I made him stop a few times so he could catch his breath.  Moreover, his cough had worsen and it was difficult for him to speak without coughing every few words.  That was the most disconcerting. 

The start of the next week came and went, so phone calls were made to see what the &#$% was going on.  While the Sacramento pathologists are top notch (I was told this when my sister had a biopsy for her thyroid cancer two years ago), they were stumped by the cells they saw in the sample.  So, they sent the sample to the Stanford pathologists.

With the minimal medical knowledge we have, it was hard to gauge what that meant in terms of the possible outcomes of the diagnosis.  Does that mean it's benign?  Was the sample poor?  Is Roberto going to have a new disease named after him?  Okay, only I thought that last one.   Basically, we (I) went bonkers waiting and waiting to hear back from the doctor's office.  Having the Fourth of July holiday occur at the end of the week didn't help matters either.

We finally heard back on Friday, July 12th (over 2.5 weeks after the biopsy) when the surgeon personally called us to tell us the results.  

The Tumor is Revealed - Its Weakness is Love - And Lots of Chemo


The surgeon told us that the tumor is a seminoma with teratoma elements.  The seminoma is a type of germ cell tumor that grows rapidly but responds well to chemotherapy. The surgeon told us that chemotherapy is outside his jurisdiction so he was referring Roberto to an oncologist and got Roberto an appointment for the following Monday. 

This post is getting long, so I'll cut to the chase.  The oncologist told us a bit more about the tumor.  It's a type of tumor associated with testicular cancer, but there are cases where the tumor occurs outside the testicles - that's what Roberto has.  The oncologist put Roberto on a 12-week chemotherapy plan to combat the seminoma.  After the 12 weeks, Roberto will require surgery to remove the teratoma parts of the tumor; teratoma apparently does not respond as well to chemotherapy.

The 12 weeks consist of four three-week cycles.  For one cycle, the three weeks consist of: (week 1) receiving chemotherapy drugs intravenously; and (week 2 and 3) a resting period to regain lost blood cells.

Roberto is currently in the last week of the second cycle.  Now that I've written this post and had a chance to reflect back on all that has happened, it feels as though Roberto has been battling his cancer for such a long time.  To say that he is in his second cycle makes it feel as though very little progress has been made.

Let's use some math to put this back in perspective.  Roberto has completed 5 of 12 weeks of his chemotherapy.  That's about 41.6667% done, and is amazing.  Yay for math!

If you made it to the end of this post, kudos to you.  You get a gold star!  Stay tuned tomorrow for the CT scan.

Cycle 2 - Day 15

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