5 Radiation Days Left...

Chris had her regular radiation treatment Monday, Tuesday, and Wednesday, and a meeting with radiation oncology Tuesday morning.  She is still proceeding better than expected.  It's hard to believe there are only 5 radiation days left.  Chris has gotten through it great, so far, but the radonc docs are warning the side effects are still coming.

Tuesday night and Wednesday morning, it snowed 5+ inches in Raleigh, which is a LOT of snow for Raleigh in a single evening.  We got to Duke 3 hours late for the scheduled appointment, but  they were able to work Chris in, and she is still on schedule.  Most of the Raleigh area is closed for business, but Duke sends transportation to pick up their clinic employees if they cannot make it to work, which is great, because many of the patients are staying in local hotels to receive treatment.

Below is a picture of Chris, with Bill, and Chris' friend, Tina.  Bill is Dave's waiting room buddy.  His wife, Julia,  finished with radonc on Wednesday, hopefully forever!.

Chris, Bill, and Tina

We did have had some fun this week, too...

Sledding...

And a Canes game...

At the Canes/Senators game

74.075% Done with Radiation.

Twenty radiation days down, and seven left!  Chris is slowing down a bit more, but it is not as bad as we had been warned, or expected.  From what the docs are saying, her energy level will continue to decline for the next 2-3 weeks, before it starts to recover.

Looking toward the 2nd phase of treatment, Chris will have her next CT scan on March 4, with results on March 6.  Surgery is tentatively scheduled for Monday, March 17.  

Thanks to Erin and Wynn for 2 great meals, and to Wynn and Adele for driving this week!

Radiation Days 17 and 18

Chris completed radiation days 17 and 18, and the treatment is proceeding as expected.  She is still exercising and maintaining her daily schedule, but the chemo has slowed her somewhat.  Her doctor recommended that she exercise less vigorously, and take an occasional nap.

Tuesday, she had her weekly radiation oncology clinic visit.  Appointments were made for 3/6 with the surgical team to reevaluate Chris' condition (after radiation treatments), and discuss surgery dates. 

Thursday, Chis will have her weekly GI oncology clinic visit, blood test.

Over Halfway Through Radiation

Wednesday was day 14 of the 27 day radiation treatment plan, meaning Chris is past the halfway point. Thursday, Chris had a radiation treatment, followed by a blood test and a meeting with GI Oncology.  Friday was radiation day 16.  The Thursday blood test showed that some of the counts have dropped slightly below the normal range, as expected at this point in the treatment.  Chris was advised to duck when sneezes or coughs are aimed at her, and be a little more cautious with anyone she comes in contact with who might be sick.

Chris is also starting to feel more worn down in the evenings, which Duke attributed to the chemo, but getting up before 5AM every day probably doesn't help either.

Duke asked to move Chris' normal radiation appointment to 7:30.  Blah!  But, it gets her back home most days before 9, and  there is only one appointment ahead of her, so it is unlikely things will get backed up before her appointment.

Thanks to Wendy and Alicia for agreeing to drive with Chris, and thanks to Tina and Alicia for dinners!  Thanks also to Adele for picking up Erin on Tuesday and Thursday.  We really appreciate it!

Wendy and Chris

The "Varian Clinac Series 21 EX Linac", aka: The Green Monster

 All is still well after radiation days 11, 12, and 13.  Chris is doing great, and her energy level is high.  Today Chris had her weekly radiation oncology checkup, and things are progressing as expected, so no news on the medical front.  The only news we have is that Chris' mom arrived from Florida yesterday to help around the house, and make sure Chris is doing OK.  She is with Chris in the pic at Duke below:

With no news, some useless information:

There are several radiation rooms at the radiation oncology facility, all color-coded.  Chris' machine is in the Green room, and only the patient and Duke staff are allowed in. 

Chris took this rare photo of The Green Monster

Whomever goes to Duke with Chis is left in the waiting area for about 20 minutes while the treatment is performed.  That duty is not too harsh.  The waiting area has an open bar (a snackbar...), with coffee, juice, and light snacks.  There are also internet workstations, a pianist on a grand piano, TVs, books, WiFi, and the latest People magazines.  Upstairs, in the basement, there is a quiet room, where the partaker can sit in a lounge chair and select from a number of music and lighting moods to experience.  There is also complimentary valet parking.

Some random facts we have learned about radiation:

• Radiation works through oxidation.  Therefore, taking anti-oxidant vitamins is prohibited because it would counteract the oxidation process.
• The radiation oncologist told Chris not to use the "bun warmer" in her car seat on the high setting until the treatment ends.  The low setting is still OK.
• The radiation facility is housed in the sub-basement of the clinic to prevent radiation from leaking out of the facility.  The walls surrounding the rooms are 4 feet thick, solid concrete, and lined with lead.
• Adequate hydration is required and monitored.  Coffee does not count as part of the fluid intake.  Decaf counts 50%.  Diet Coke counts 25%.
• The radiation machine model is a "Varian Clinac Series 21 EX Linac". Chris actually asked for the make and model during her consultation, and the oncologist called the radiation room while we waited for the information.  The radonc tech originally told the oncologist the wrong model, and the oncologist called Chris at home later in the day to correct the information.  I wish I knew what he thinks we are doing with that tidbit of information.

January 10 Update

Wednesday morning was a quick trip to Duke for a radiation zap.  On Thursday morning, Chris had a radiation treatment, blood tests, and a visit with GI oncology.  All blood counts are still in the normal range, but dropping due to chemo.  This is an expected result.  Friday morning was supposed to be a quick radiation treatment, but due to technical difficulties, Chris had to wait 1.5 hours for the issue to get resolved.

During the GI Oncology visit on Thursday, Chris pressed to get more details on future treatment after the current round of chemo/radiation ends on Feb 4.  GI Oncology expects nothing to be done for 4 weeks after radiation treatment is complete.  This includes no trips to the Duke clinic, no bloodwork, no scans, no chemo, no radiation, etc.  Chris and GI Oncology will be thrilled not to hear from each other during that time.  During those 4 weeks, 'residual' radiation will still be working on the tumor.  After that, Chis will go in for another MRI and CT scan, which is intended to give the surgical team information on how to proceed. That's all we know!

Thanks to Wynn and Dianna for driving this week and to Alicia and Tina for two excellent dinners!  Thanks to Adele for driving Erin to school on Tuesdays and Thursdays!

Thanks, also, to everyone who has offered additional help and support.  We genuinely appreciate all the offers, and will accept, when we need it.  Chris is still showing very little impact from the chemo, and is functioning at 100%.  We also have the luxury of Chris' mom coming on 1/13 for a few weeks of added support.  We do anticipate we will need more help in the next phase (likely in March).

Chris and Diana

Chris and Wynn

Days 6, 7, and 8 Done.

Radiation treatment days 6, 7, and 8 (out of 27 total), are done, with minimal issues.  Chris met with the radiation oncology team this morning (1/7), and there is nothing new to report.  Chris has not had any changes in appetite, no major side effects, and remains active, as usual.  Because of the Christmas and New Year's holidays, this week will be the first full week of radiation.  Most of the treatments are now scheduled for 7:45AM, which means leaving home at 6:30.  That stinks, but traffic is much lighter.

Next up are 'regular' radiation treatments on Wednesday (1/8) and Thursday (1/9).  After radiation on Thursday, Chris will have her weekly blood test and meeting with the GI oncology team.

With nothing new to report below is a picture of what the Duke Cancer Center looks like when it is 10 degrees outside:

First GI Oncologist Visit Since Treatment Started

Chris went for radiation/chemo treatment, bloodwork, and a visit with the GI oncologist this morning.  Everything was normal, there is nothing to report.  Radiation/Chemo will continue daily through week of February 3.  We will meet with the GI oncologist every Thursday morning for a checkup and to check blood.  We will meet with the radiation oncologist every Tuesday morning to discuss progress.

How is Chris Feeling?

Everyone is asking how Chris looks and feels.  The answer is no different!  She is doing her daily power walk or exercise bike ride.  She had some minor nausea (which was controlled by meds), and has a minor metal taste from the chemo, but no other side effects, yet.  The pic below is from this past Saturday, on Moore's Knob, which was a 4 mile hike with a 1000' vertical elevation from the start of the trail.

Treatment Started

Treatment started on 12/26, with no issues.  The biggest hassle has been driving 30-40 minutes each way to Duke for a 15 minute procedure.  We're pretty sure the trip time will increase after the holidays.  We have been going in the early mornings, but they will likely move us to a different time slot after the holidays.

Everyone who works at Duke has been outstanding.   

 

The radiation oncology facility is in the "sub" basement.  The elevator has floor G for 'Ground', and 0 for basement.  We go to floor 00...

Chris takes chemotherapy (pills) on treatment days, once in the morning, and once in the evening.

The Treatment Plan

This is the current treatment plan, as proposed by Duke:

• 5-6 weeks of daily chemo (oral) and outpatient radiation to reduce the size of the tumor.  This started 12/26, and does not include weekends or holidays.
• Weekly blood tests and consultation w/Oncologist.
• 4-5 weeks of recovery.
• MRI, CT scan, and blood tests to determine if the radiation changed anything.
• Surgical removal of the tumor.
• 8-10 weeks of recovery
• 4 months of chemo to mop up any leftover cancer junk.

The Diagnosis....

Hi, and welcome to Chris' Duke Treatment Blog!

This is how we got the diagnosis:

In mid November, after seeing some minor bleeding in the bathroom, Chris saw her primary care doc.  He did not find anything unusual, so he referred Chris to a GI.  The GI also found nothing unusual, so he ordered a colonoscopy.  The colonoscopy was performed on 12/5, and revealed a tumor blocking 2/3 of the colon.  The GI ordered a CT scan of the liver (closest major organ), which showed no spread of the tumor.  The GI referred Chris to a surgeon to remove the tumor.

Chris consulted her sister-in-law (an oncologist), who strongly encouraged Chris to get a second opinion at Duke.  Duke performed a chest CT scan, a pelvic MRI, and several blood tests.  The MRI revealed that the tumor had likely grown past the colon, and entered the uterus.  Duke is not 100% sure of this, but said this is likely the case.  They are proceeding as if the cancer is Stage 3, which means it has grown past the original site (the colon) and entered another local organ (the uterus), but it has not been found in a distant organ.  When she has surgery to remove the tumor (expected late Feb, or March), they will check the tumor's entry into the uterus.  The other possibility is that it could be normal thickening of the uterus wall, but they said this is not likely the case.