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Cancer update

Sunday, May 11, 2014

It looks like we're in for the long haul. The official diagnosis on my husband is stage IV clear cell renal carcinoma - aka metastasized kidney cancer. He had his left kidney and adrenal gland removed three weeks ago - the main tumor was a full 10 lbs. There was a separate tumor in the removed adrenal gland, and probably one in the other adrenal gland as well. It's a weird presentation, because there's no signs of other metastases, even though lung, heart and bone tissue are all much more friendly to RCC then adrenal glands. The oncologist is a mite puzzled, and his case will be presented to our local oncology review board in the hopes that someone else might have a better notion of what the heck is going on.

Once the surgery is healed - another couple of weeks - he'll be starting antiangiogenic chemotherapy, which is a drug designed to halt formation of new blood vessels and thereby prevent metastases from forming. It's supposed to be well tolerated, except that it stops healing from injuries nearly cold. After three months we'll be rechecking to see if we have growth or shrinkage, and if any other mets have shown up. If long enough goes without any more mets, then we'll probably take out his remaining adrenal gland - with RCC, capture is cure- if you can get all of the cancer out surgically, it's gone. But we don't dare do that unless we're certain, because once the adrenals are gone, it's an instant case of Addison's disease - and if that happens, then most of the therapies they would use for metastatic spread can't be used.

Basically there's a whole lot of uncertainty, and a lot of waiting in our future. Unless something else goes wrong, I will still be going to Okinawa - that should be in the middle of the 3 month waiting period, and reasonably safe to leave for a couple of weeks. Plus my very sweet brother-in-law will be coming down to stay with Rob and the boys during that time.

By the numbers, this really, really bad. The five year survival numbers on Stage IV RCC suck in terribly scary ways. The strange presentation is a good thing, in that sense, because it means that my husband isn't an average case - which has a two-year expected survival. The weirdnesses, however, mean that we really don't know what to expect, or how warranted hope might be.

On the more minor end of things, my foot is mostly healed. The bone is good, and all that's left is a little soft tissue damage that still twinges when I overdo. I really need to get back to working out and cooking, and all the other things that have fallen by the wayside over the last two months - eating well and being as healthy as possible has become strikingly more important in our lives. Nutrition research is a major feature of my reading right now.

I hope you are all doing well. I'm sorry I'm not around to cheer you on.
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