When we started down this road with Francis’s colon cancer diagnosis, we often discussed going to the best facilities and the best specialists. The long term prognosis for advanced stage colon cancer like Francis’s is frightening, and we’re determined to try every option we have available to us until we find a cure.
After several rounds of chemotherapy and a couple of CT scans, we began to discuss more seriously the likelihood of a trip to Houston, Texas, to visit MD Anderson Cancer Center. Ranked as the #1 best hospital for cancer care by U.S. News and World Report, we began to work toward getting a second opinion from their doctors.
After eight rounds of chemo, Francis had to take a break from treatment. Among the variety of outwardly visible side effects are a myriad of unseen side effects of chemotherapy. Chemo causes the body to have difficulty producing red blood cells, white blood cells, and platelets. The morning of the ninth planned round of chemo, Francis’s blood work showed a low platelet count. It wasn’t completely unexpected, but it’s still not what we wanted to hear. Fortunately, the level was not dangerously low and his blood work was otherwise normal.
Francis was grateful for an extra week “off.” The outward side effects from the particular chemo regimen he is on cause him to have gastrointestinal upset, neuropathy (tingling and numbness) in his hands and feet, and peeling skin and blistering on his hands and feet. There are other side effects that may or may not make an appearance after each round.
It is common at some point during the three week treatment period for Francis to experience nausea. It’s never the same, and it can come on with little or no warning.
After the first round of chemo back in June, we rushed to the car and drove straight back to Tallahassee from Mayo in Jacksonville (about 3 hours). Pulling into our neighborhood, Francis mentioned that he was beginning to feel ill. We raced onto our street and into the driveway. Francis couldn’t make it into the house, jumping from the car to get sick just outside the garage. Fortunately, that’s the last time that has happened like that.
He’s gotten sick a few times since, but thankfully the anti-nausea medications he’s been prescribed help us keep the nausea mostly in check.
During Francis’s week off from chemo, we heard back from MD Anderson that Francis would have a series of appointments the following week. We quickly made travel arrangements and my mom did the same so that we could meet in Houston in just a few days time.
After reviewing the scan, we met with Dr. Fournier to determine whether Francis would be a candidate for a radical and somewhat controversial surgical procedure known as tumor debulking and hyperthermic intraperitoneal chemotherapy (HIPEC).
Debulking and HIPEC takes an average of 10 hours and is followed by an average hospital stay of 22 days. The procedure requires the opening of the abdominal cavity and removal of each individual cancerous spot in the cavity and removal of any affected organs that aren’t necessary for the body to function.
After the tumors are removed, the abdominal cavity is flooded with liquid chemotherapy that is heated to approximately 107 degrees while the patient lies on a cooling pad to maintain a safe body temperature. The chemotherapy stays in the abdomen for approximately 90 minutes before being flushed. Radiation may also be done during this treatment phase of the procedure. After the surgeon is pleased with the progress and outcome of the debulking, the abdomen is closed and the patient is moved to recovery.
In many cases, the patient is placed into the intensive care unit of the hospital. There is a high likelihood of complications from the procedure. Many patients experience infections at the wound site because chemotherapy prevents the skin from healing normally.
It seems that this is the best hope for removal of the cancer, and while Francis is feeling well, we want to be as aggressive as possible. Outcomes from this procedure aren’t well documented, but the statistics we’ve seen are very promising and have given us a lot of hope for beating this horrible disease.
So this brings me to today. Francis and I have left our babies in good hands (Mawmaw Holdman’s) in Tallahassee to make the trip to Houston for an exploratory procedure to determine whether Francis is a candidate for the debulking and HIPEC. Dr. Fournier wants to get his own eyes on the cancer to make the determination.
We’re excited, nervous, hopeful, anxious, cautiously optimistic, and desperately missing Couper and Riley. To be frank, we need to be excited, nervous, hopeful, anxious, and cautiously optimistic before a much bigger procedure (debulking and HIPEC) happening sometime early next year. After what feels like a whole lot of bad news about Francis’s health this year, we could really use some good news.
Many people have asked what the goal is and how to pray for us, so this is what we need now. We need to get through tomorrow’s procedure safely without any complications so we can head home and then enjoy a wonderful Christmas with family. We need good news that Francis is a candidate for the debulking and HIPEC procedure. If not, we need guidance on what to do next.
Thanks in advance for thoughts and prayers. I will do my best to update everyone as soon as we have any news. We are hopeful that we’ll have the surgeon’s decision after the procedure, but we may not get that until after the holidays. In the meantime, we wish you all a very Merry Christmas and a happy and healthy 2013 (assuming the world doesn’t end this week)!