Walking The Road

Hi Everyone- This morning my husband had his final IMRT (radiation) session and this evening he will take his final dose of Xeloda.  He had a total of 30 sessions and the Radiation Oncologist said that the final five treatments were a “boost” session where they narrowed the treatment field to the area that they were most concerned about in terms of recurrence.

Fortunately he handled everything quite well other than the expected Hand Foot Syndrome.  We knew it was coming so we started with the lotion and cotton socks about three days before he took his first dose of chemo.  The oncologist did decide to give him the weekends off from the Xeloda for the final three weekends and that helped as well.  So he has successfully completed the SWOG S0809 protocol — sigh of relief!

He will have a CT scan in mid-December as we move into surveillance mode.  I’m really glad that he’s no longer dealing with the demands of active treatment, but it will take some mental adjustment to be living in this watching and waiting world.

Here is what my husband posted to friends and family this morning under the heading The Clean Spleen Scan:

“I had my PET-CT scan very early this morning, and thankfully the radiologists were able to read it right away. Here’s what the radiation oncologist said to me in his e-mail: “I’m happy to let you know the PET/CT scan did not show suspicious activity in the spleen, so we can proceed with radiation and chemotherapy as planned.”

It feels strange to say “Hooray! I get to take more chemo and get irradiated,” but in the upside-down, weird-looking world of cancer treatment this is definitely good news.”

Thank you all for your prayers and support. Bravely onward! Tilly

As a refresher: my husband has extra-hepatic and/or gallbladder CC, Whipple procedure in April, currently on the SWOG S0809 protocol (12 weeks of Gemzar & Xeloda, then 5-6 weeks Xeloda and radiation). He had what we thought was a good CT scan two weeks ago and that he would be starting radiation very soon. Yesterday we got a major curveball thrown our way.

Yesterday morning we met with the radiation oncologist, and soon after introducing himself and his nurse practitioner, he started speaking with us about a finding on the August CT scan that concerned him. Peter has a 3-cm lesion on his spleen that was originally detected on his first CT scan, in early March. At that time the radiologist suggested that it might be a hemangioma, which normally is a kind of benign tumor. However, no follow-up was done based on that finding, and the lesion remained about the same size in his June pre-chemo scan. What caught the radiation oncologist’s attention is that it shrunk a little since he completed chemotherapy—and he can’t tell exactly what it is with the type of scans that have been done thus far. So he wants to be cautious and order another diagnostic scan before starting radiotherapy treatment.

The best news would be that the scan confirms what Dr. Katie Kelley at UCSF (who we are consulting for second opinions) and his primary oncologist, have said: that it seems to be an incidental finding, that it’s unusual for biliary tract cancers to travel to the spleen, and that hemangiomas can change shape over time. In that case, he will move on to radiotherapy as planned. The worst news would be that the splenic lesion is in fact cancerous and that it has been sitting there since March. In that scenario it’s gotten smaller but it’s still there, and that means the treatment game plan will likely change. Yesterday we were a mess. Today we are trying to stay hopeful and get through the weekend to the PET/CT which will be very early Monday morning. Please keep a good thought for us everyone. Blessings, Tilly