Wednesday, April 29, 2009
The Time Has Come...
Now for the big news that almost ensures my blood pressure will be high for the next 3-4 weeks. I will be getting two more doses of chemotherapy (5/1 and 5/8) and then it's time for the surgery I have been anxiously awaiting (and dreading) since October 13th. I don't have an exact date yet (we expect that by Friday) but it will be very close to Memorial day. I will have chemo on May 8th and must wait 10-14 days after that treatment for surgery so it will fall in that window. I will use my next blog post to update you on why Dr. Butrynksi is recommending we stop chemo (temporarily) for surgery, as this obviously comes with some risk. I have to admit that I was surprised as I completely expected to be coming home for another cycle (12 treatments) of chemo.
We actually spent a lot of time with the surgeon today (Dr. Shakar). Just talking to him about the surgery eases some of the anxiety as he is very knowledgeable and confident. Lucky me, I actually get two surgeries at the same time. The main surgery involves resecting the tumor from my heart and rebuilding my right atrium. They will also remove any scar tissue that exists as a result of the shrinking tumor. To rebuild the atrium they will either take a piece of my pericardium (the sac around my heart) or use a piece of either a pig or cow heart (cool!). This depends on how much of my atrium they have to remove, and they won't know that for sure until they get in there.
The second thing they are doing is addressing the cancer that's attacking (or past tense attacked...hopefully!) my sternum. I was surprised to learn today that they are going to actually remove my entire manubrium, which is the large bone at the top of the sternum that anchors the collar bones and top two ribs. They will have to stabilize my collar bones with a plate and won't need to re-attach those two ribs to anything. I was told this will leave a big depression (dip) in my upper chest as the plate will only be used to stabilize the collar bones and won't cover the entire area.
The surgery itself will take from 4-6 hours and I will be put on the "Heart and Lung Machine" while they work on my heart. We were told that I would be in the Intensive Care Unit for 1.5 days after surgery and then at the hospital for 6 days after so it looks like I could be in the hospital for up to 8 days. There is a chance I will need a pacemaker immediately, and if that's the case it will be done a few days after surgery, and may extend my stay by a day or two. I was told that I would be "out of commission" for 6-8 weeks which doesn't seem bad considering the type of surgery. I am positive I will be on the low end of that and plan on being back on my feet much sooner...
So, there's that...the day I have been waiting for since getting diagnosed is less than a month away. As I learn more about the surgery and what I should expect, I will keep updating (if people keep reading!). Thanks Shana, Mom, Dad, Matt, Liz, Joan and Michelle for coming to Boston with me...in between all the tests, injections and appointments, we all found some time to have fun. We went to the Yankee/Red Sox game on Sunday night...all of us decked out in our Yankee gear (except Shana with her Sox stuff) and we were actually treated pretty well (maybe the felt bad for us with the sweep and all...). Check back over the weekend!!
Friday, April 17, 2009
Finished Round Four!!
I completed my fourth round of chemo today and as of right now I have no more treatments scheduled, which is kind of a cool feeling (that will change on 4/28). This was my 24th treatment (we consider six treatments a "round" since I have to take a week off every six treatments) and I still feel good, overall. We went to Myrtle Beach this week and had a great time….just basically relaxed on the beach/balcony and ate a lot and had a much needed rest, away from all the troubles back home (ok…only one trouble, the cancer). It was really great to get away for a few days and have nothing to worry about other than where to get "all you can eat" crab legs.
We're off to Boston next week as I will get another heart MRI (almost two hours in the MRI coffin, I need two Xanax for that), a full body PET/CT scan and talk to Dr. Butrynksi and Dr. Shakar (my oncologist and surgeon respectively). Everyone in my family has been trying to "guess" what will be next…another 6 or 12 weeks of chemotherapy or my surgery and I honestly can't decide what to hope for, so I will just hope for clean scans. I am thinking that if they opt for surgery it will happen that week, so that's kind of scary.
Since there is a good chance they will order another round or two of treatment I have to start thinking about some other things. We have begun to do some research on the long term effects of Taxol, and if it continues to work as well as it is, who knows how long I will be on it (could literally be years, I guess). Eventually, we are told, I will need bone marrow transplants as the Taxol will cause my bone marrow to stop producing blood cells. This can be problematic for long term chemotherapy patients (which I will be happy to be if that's what it takes!) and we are going to start looking into "harvesting" of my bone marrow for future transplant. People in my family can also get tested for compatibility, in case I ever need it from others. It doesn't hurt to be prepared, right?
Also, since I have been diagnosed, I have been given a bunch of books on cancer and survival. I've spent the last six months researching my specific cancer, treatment options, case studies, etc that I really haven't had time to read them, and I have decided that if I am going to continue on this road I have to start paying attention to what most of these books say. As we all know, there are many factors that will impact the outcome of this cancer…for six months I have been getting by on excellent medical care and an excellent attitude, both of which are extremely important and will go a long way in my survival. I also know that my general health is VERY important in my bodies ability to fight and handle treatment. I have to start focusing on my diet and exercise and how I can use those to my advantage. There are hundreds of books written on "cancer diets" and what foods and nutrients have been proven to help fight cancer cells and maintain a healthy immune system. I have gained 30+ pounds since this ordeal started (and I love blaming it on the steroids I am on) and I have to focus on getting that weight off (and then some!). So we are going to start paying more attention to that. I have been given 10 different books on this topic (or other topics including faith/religion, attitude, etc) and I am going to read them all over the next couple of months, including a couple others I have found. The bottom line is, I need a better "plan" that addresses every aspect of my life that can impact the outcome of this…whether that outcome is good or bad, I know I can impact it and I have to do everything I can…once again, it's all about what I can control and I know there are some things I have been ignoring.
I want to thank everyone who continues to support me. I feel great about reaching the six-month anniversary of my diagnosis (that was April 12th) and I know I couldn’t have done it without all my family and friends. Shana and I are so filled with gratitude and I feel very confident when I say that I don't think I would be where I am right now (winning) without ALL the support we have received. We have some amazing people in our lives, hundreds of them, and I want you all to know how much it and you mean to me. I love all the comments on the blog, the emails, the texts, the cards, the calls…it doesn’t seem to stop and the encouragement and concern of everyone means the world to me. Also, the Heart Walk is tomorrow and THANKS so much to everyone who contributed to help us reach (and exceed) our goal. I have sent some thank-yous and have some more to write…but thanks, thanks, thanks!
Saturday, April 4, 2009
Radiation & Other Stuff
I am proud to say that through a month of daily radiation and weekly chemotherapy I haven't missed a day of work and continue to just push forward. I am convinced that the key to beating this cancer is to stand up to it by living my life as if I wasn’t sick and I think it's working. That combined with very talented doctors, lots of prayers and the love and support of my family and friends is exactly what's got me this far. I tell myself that every day and I firmly believe it.
April is a very important month. First, on 4/12, it will be six months since my diagnosis. This is an important milestone for me, personally, as much of the research I have done on cardiac angiosarcoma seems to point to five or six months as the average survival time after diagnosis (other studies won't give an average since it's so rare). Of course, there are so many variables that can impact that (and those statistics) that we've learned to take them with a grain of salt. Each case is very individual and so far everything, with a few minor exceptions, has gone my way so far. Another reason April is significant is that at the end of the month I will have complete follow-up scans, and meet with my oncologist in Boston to find out what's next. The options should be another 12 weekly chemo treatments or open-heart surgery. I'm not sure what to wish for this time…so I will just hope for clean scans and more shrinkage of the tumor and let the doctor decide the next steps.
Saturday, March 21, 2009
Radiation Update
The side effects of the radiation are exactly as described. I was told that radiation doesn't have many, except when done at the same time as chemo, as it kind of intensifies those side-effects. So I am basically more tired and fatigued now, and sometimes my body feels like it's just getting old (I move slow, my joints are sore, etc). On top of that, since the radiation field passes through my esophagus , I get a sore throat once in a while. I am told that this will get worse over time, and will eventually make it difficult to swallow, but will go away soon after I stop radiation (my last dose is on April 7th). I really just don’t like the idea of radiation, but I do like the idea of it stopping the cancer from doing further damage to my T4 vertebrae, as the issues that it can cause in this specific area of my body can be pretty serious.
I had my 20th chemo treatment on Friday. Four more to go before we head back to Boston for another full set of scans and to learn what's next in my treatment plan. I am not even going to try to predict what's next…but I know we are meeting with the surgeon, so there is a chance that we go in that direction next. I am curious to know how the discovery of another spot (my L2 vertebrae) will impact their decision. The reason they don't want to do surgery now is because they are worried about taking me off chemo…they are worried that the cancer will spread more as it's usually very aggressive. Of course that's what I am worried about too, but part of me still wants to get this surgery over and done with, and behind me.
Remember to check out my Heart Walk webpage for the Syracuse Heart Walk that's on April 18th. You can check it out at http://heartwalk.kintera.org/syracuseny/willmccaffrey.
I figured I would throw this in at the end of my post this week. A few people have asked me what the difference between chemotherapy and radiation therapy are. To be honest, until my Pa (god rest his soul) got cancer in 2007 I didn't know the difference either. So, in case anyone is wondering here is the most basic explanation I can give you. Chemotherapy is a medication that is given either orally or through direct infusion into the blood (which is how I get it). It's a systemic treatment that treats your entire body. It's basically a poison that kills fast growing cells, which include cancer cells (as well as other, healthy cells, like hair, blood cells, etc). Radiation therapy is a local treatment, that targets a specific site in your body and uses radiation "beams" to burn/kill cancer cells to stop them from growing. Unfortunately, radiation can also damage healthy cells, but as the technology gets better they are better able to control and minimize this.
Finally, I want to continue to thank all of the people in my life who continue to help me through this. There are way too many people to name, but as I have said since October, I am the luckiest person alive because of the support system I have. My wife, parents, siblings, nana and family (all of them including my aunts, uncles, cousins and in-laws) have been so good to me that I know I have come this far because of them. My employer, The American Heart Association, and my boss Marty and some of the other great friends and co-workers I have there have been so supportive and flexible through this ordeal. Being able to live my life and work full time has been a huge part of the progress I have made since this began as the best way to fight and win this battle is to continue to live my life and not let the cancer beat me. Thank you so much to everyone…I am so full of love and gratitude to you all that I still can't put it into words.
Tuesday, March 10, 2009
A little bump in the road...and some other stuff.
After a long streak of good news so far with this battle, Dr. Kotlove (my radiation oncologist) gave me some not-so-good news today after my mapping. He told me while examining my scans to pinpoint the exact spot on my 11th rib to radiate he found another spot. He contacted Dr. Butrynski (my oncologist in Boston) and discussed it with him before talking to me about it. This spot had actually shown up on a previous scan but it was dismissed as something else, but after further examination they agreed that it was most likely another metastasis. It's located on my L2 vertebrae, which is in my lower back. This spot was definitely not present on my October scans, but was there in January and there again in last weeks scans (and as I said was flagged but not determined to be cancerous at the time). It's about a quarter of the size of the spot in my T4 vertebrae so it's pretty small. This doesn’t change any of the plans and they aren't going to treat this with radiation yet because they feel that radiating three spots while I am on weekly chemo is too much. The spot is small enough where they are comfortable just monitoring it for now. This didn't upset me too much as I feel lucky that in five months this is the worst news I have received.
Dr. Kotlove spent a lot of time with me today showing me the pictures of all the lesions in my bones (which are now located in 4 spots; my T4 vertebrae, L2 vertebrae, sternum and 11th rib). He showed me pictures from October, January and March (so I could see how they have stayed the same) and showed me how a CT scan works. It was really cool, especially because I got to look at hundreds of pictures of my bones and organs. It was the first time I have actually seen pictures of the cancer in my bones and I was really happy that he spent the time to show me these. He didn’t show me pictures of the tumor in my heart, but I have seen those a few times.
I wanted to post a link to an article that caught my attention today. Articles like this really give me hope, as they showcase how amazing the medical field really is and how advanced treatment options are becoming. It seems like every month the treatment, medication and technology for treating cancer (and other diseases) gets more advanced. A few months ago my friend Andrea sent me an article about something called "autotransplant" surgery. It talked about the case of a guy who had heart cancer and because of the location of the tumors they actually removed his heart from his body, repaired it, and put it back in. This surgery is the same as transplant surgery but the heart that goes back in is the same heart that's taken out (instead of from a donor). I don't need this kind of surgery, but it's nice to know it's an option if it were to ever come to that. I have read cases of people with my type of cancer getting heart transplants, but because mine has metastasized I am not a candidate for that (probably because only 10% of people who need heart transplants actually get them, so they wouldn't give a heart to someone with metastatic cancer for obvious reasons). This article is about a seven year old girl who had a tumor in her abdomen that was intertwined throughout her organs and they performed an "autotransplant", removing most of her abdominal organs, removing the tumor and then putting them back. It's AMAZING and I pray she does well. A chaplain that we talked to while at Dana Farber in Boston told us that while we all hope for miracles, it's important to realize that the skills and abilities of the doctors that treat this kind of stuff is a god given miracle and I think she was absolutely right. Stories like this give everyone with incurable diseases hope that in the future they can be cured (or at least managed to the point where they are not terminal).
The article can be found here: http://www.cnn.com/2009/HEALTH/03/10/multiple.organ.removal.tumor/index.html
When thinking about stuff like this I realize how lucky I am to work for an organization like the American Heart Association. The mission of the AHA has always been important to me, but it's more personal now than ever before. I don't have heart disease, but because of the location of my tumor and the surgery I need I will certainly benefit from the amazing work the AHA has done. The first few days that I was going through this, when people at the hospital (doctors, nurses, etc) would ask me where I worked, they would do a double take when I said "the American Heart Association". I must have had 50 people mention how ironic it was that I worked for the AHA and got cancer in my heart. In the past few months whenever I get assigned to a new project, or see the work I have done come to fruition, I think about my situation and the millions of others that face the same types of things I face right now. And I think about all of those that the AHA has helped, and will help in the future. It's very rewarding to work for an organization like this. Besides working for the AHA, I also support them by walking and raising money for the Syracuse Heart Walk (this will be my sixth year). The walk is on 4/18 this year and if you are interested in walking or donating you can check out my personal webpage here: http://heartwalk.kintera.org/syracuseny/willmccaffrey. Let me know if you have any questions.
Sorry again for such a long post and thanks for all of the encouragement, emails and prayers. Shana and I talk every night about how lucky we are to be surrounded by such great people…our family, friends and coworkers are amazing. We take this battle day by day and so far we couldn't be happier with the results. We return to Boston at the end of April for more scans and a meeting with my oncologist and surgeon (I think I will wait until mid-August to get anxious about that!) and I am crossing my fingers that surgery could be in the near future (it's a good sign that they scheduled a meeting with the surgeon). I will post again in a few days about how the radiation is going. I hope everybody is well!
Tuesday, March 3, 2009
Good News Again!
The scans I get every six weeks are to ensure that the cancer hasn’t spread, to check the tumor and ensure it isn't growing and to determine whether or not we are still on the right track. Today's scans showed no new lesions or tumors and showed that my tumor has shrunk more since the last set of scans. The current size is 3.9 x 3.4 cm (in October it was 8.4 x 5.2 cm) which means that the chemotherapy is still working to both stop the spread of the cancer and keep the tumor under control.
I am not sure why I was so anxious going into my scans today. I think it's a combination of the fact that I haven't been feeling well lately (chemo sickness, pain, etc), some new pains I have been getting (every strange feeling I get gets my mind wandering) and some new information/research I have received about my kind of cancer (which wasn't very elevating). I came across a study released in June 08 by the Cancer Society and the Mayo Clinic that is a study of every case of malignant primary cardiac tumor seen at the Mayo Clinic since 1975 (which is a whopping 34 cases). Reading it was very informative, but also not very uplifting (I've been aware of the survival rate all along and have never let it get to me, and don't plan to!). One thing that struck me though is the median survival time for cardiac tumors with metastasis (that's me). In this study (and many other's I have come across), it's five months. I will be at the five month mark in two weeks and after getting the good news I got today I am starting to feel comfortable saying that I am winning this battle. I know I have a long way to go, but I feel that today's results were a big milestone for me, especially because my disease hasn’t progressed (in fact it's regressed) in 20 weeks and these results cleared the way for me to begin radiation next week (which is another milestone I am excited about). My doctors rock.
The worst part about this is, to date, is waiting. It's like I am living my life six weeks at a time right now and can't think much further ahead than that. I have six more chemo treatments (I get this Friday off and start again on 3/13) and after that we go back to Boston to find out what's next. It's unsettling to know that I might be having surgery…but I might not. I think I will have it in May...but it might not be until July. It's hard to make plans and look into my future much more because of all the uncertainty around this. I don't know if I should register for school (I am three classes away from my M.S. degree) or if I should book a trip to Vegas this summer (and I have to plan a trip to Yankee Stadium!). I shouldn’t complain though, because if that's the worst part of what I am going through right now I guess you'd say I am doing pretty good.
I will post later this week when I know more about radiation and what's going on with that. To be honest, I haven't done too much research on it but I need to get on that. I go on Wednesday to be "mapped", which is another CT scan (or set of scans) that maps out where they are going to hit me with radiation starting next week. Thanks again to everyone for all you are doing for me. We have so much support and love and it never slows down and I absolutely believe that it's a huge part of where I am right now with this.
Saturday, February 14, 2009
Feburary 15th Update
I received an email this week from a woman named Sandra who found my blog while searching for information on Cardiac Angiosarcoma. As many of you know, I have been trying to find and connect with someone else with this specific cancer since my diagnosis and haven't been able to find anyone (though I have met some amazing and inspiring people with other types of cancer and even some others with other types of Angiosarcoma). Sandra's son, Ruben, was diagnosed with Cardiac Angiosarcoma just after his 16th birthday and he is now in remission at age 18. It's safe to say Ruben is an inspiration to me as he fought and survived Cardiac Angiosarcoma just like I plan on doing. I posted a link to his website under the "Links" section on the right of the blog (you need to register to view his site).
I have been emailing back and forth with Sandra all week and though I find it tragic that such a young man has had to endure what Ruben has, and wish he didn't have to, I have really enjoyed sharing experiences with his mom. It's very therapeutic to talk to, and learn from others who have been through this, especially when you know it’s the exact same thing. She told me that she has also been searching for someone with this diagnosis and in almost three years, I am the first she has been able to find. That's not a surprise to me though and I am very thankful that Sandra found me. I am sure, as long as it's OK with her, I will post more about Ruben as I learn more about what he went through.
On to how I am doing…I know I mentioned in my last post that I may have to skip a treatment because I was sick with bronchitis, but I didn't . My blood counts just made it (they have cutoffs for some of the things they measure) and I was able to get my treatment. I had chemo #16 this past Friday and each week it hits me a little harder and I feel a little sicker, but I still just go about my life telling myself that this is what I need to do to get better…and I am still doing better than most people who get chemo, and I am very thankful for that. I just wish I didn't need 10-12 hours of sleep sometimes to actually function during the day! I am meeting with the Radiologist on Wednesday to discuss the radiation regimen that they want to start and will post about that when I know more. I am kind of looking forward to it because I just feel like radiation will be progress, and get me a little closer to being where I want to be with this. They also tell me the radiation will help with the pain that I am feeling in my ribs and back, which would be nice.
Since it's Valentines day (or was yesterday) I just want to take a second to thank my two valentines…Shana and my mom. I love you both so much and I appreciate everything you do for me. Thank you and Happy Valentines Day!
Thursday, February 5, 2009
February 5th Update
I have been feeling the effects of the chemo more often lately, but it’s still overall pretty mild compared to my expectations and what I have heard from others. I am having some nausea and joint pains, which are well controlled with medication and like always just feel fatigued mostly all the time. There is still a lot of pain and stuff going on in my chest/abdomen, but I am getting used to that, in fact it almost feels strange when I don’t get it. It’s hard to believe it’s been 16 weeks since my diagnosis – it feels like it’s been 16 months and this has certainly become a way of life for us.
A couple of weeks ago we met with a radiologist and they are considering doing some radiation therapy during my next break from chemo (my one week break that would occur at the end of this month). The radiologist was waiting for some images/scans to arrive from my last round in Boston before making a recommendation – I am hoping to find out about that soon. It sounds like they are unsure whether or not it’s needed at this point. Since we found out about how major the surgery on my vertebrae would be, and they’d like to avoid it if possible, radiation becomes the only option for treating that area. The amount of radiation they can use on that area (like any) is limited, so they are unsure if they want to treat it now or wait until (if ever) that spot starts growing/spreading. They would use a radiation technology called cyberknife on that spot. It’s robotic and seems pretty cool.
At the end of this month I will have another set of CT scans done (during my week off of chemo) just to make sure nothing has changed before having six more treatments taking me to the end of April.