Wednesday, February 25, 2009

Minor Surgery --> Chemo

Dear reader

Today Dianne had a busy day, and spent most of it in one hospital or another.  This morning, she went to the Royal Alex to get prepped for the Sentinel Node biopsy.  (Wow, has shown me how to finally spell this right lol) The prep consists of being injected with a dye that would trace its way to the first lymph node which would be affected by the cancer, which is the sentinel node.  We had expected this to be done in a relatively short time frame….yeah right.

After the injection, the technicians at the RA take pictures to make sure the dye has reached it’s destination, which then would allow the surgeon to cut the right node to pieces in order to biopsy it.  Well, it didn’t quite work that way.  What was supposed to be a quick 1 hour thing turned out to be 3 1/2 hours of waiting, posing for the pictures, getting to see really cool equipment and ultimately…..nothing.  By the time Dianne left, the dye still had not reached the node.

So, off to the Sturgeon Hospital for the surgery.  But wait?  They can’t do the Sentinel Node biopsy because they don’t know which node to hack at!!  So, what was supposed to be a minor operation under general anesthetic turned into an even more minor operation under local anesthetic.  The surgeon did remove a part of the tumor in order to test for HER2 (Human Epidermal growth factor Receptor 2, which is a protein giving higher aggressiveness in breast cancer).

So, this all begs the question:  Why did the dye not reach it’s destination (remember the sentinel node?).  It could be one of two reasons, neither of which are real encouraging.  Reason 1:  The tumors are blocking the dye because of their size (not great, but not unexpected….we already knew the tumors were large).  Reason 2: There could now be tumors in the lymph nodes, but no way to prove it.

Which now leads us to more questions.  If reason #1 is the cause, what happens?  Well, chemo therapy (aka: pyrogy treatment) is going to start within the next 10 days.  The actual date has not been confirmed as of this writing.  You know something, dear reader…I am actually not really liking the term pyrogy treatment.  I love pyrogies, either fried or boiled.  Topped with gobs of sour cream, bacon and / or sausage.  Yummy!!  But, I digress.  The chemo will hopefully shrink the tumor, and lead into surgery.  Reason 1 is really where we’ve been all along, so it is not all bad, except for a large tumor (well, 2 tumors actually).

Reason 2 is a bit more disconcerting.  If there are now tumors in the lymph nodes, that potentially means the cancer is moving on.  Not good!!  It can’t be proven that this is the case, so I think that the surgeon will, in due time, remove all the lymph nodes as well when she does the surgery on the breast (or breasts, but that’s a whole new conversation that doesn’t need to take place quite yet).  There is really no point in fretting over this one, because nothing can be proven.  And we know that the surgeon has a plan for this as well, so really it becomes  a case of what you don’t know, don’t worry about.

And that, dear reader, should have put you to sleep.  I highly recommend that these entries get read just before bedtime….it helps, especially if you’re insomniac.

I know I usually do my emails first, and then copy and paste it to this blog, but I’m switching things up.  Some of you will read this, and also get an email with essentially the same information, but in a different layout.
Thanks again for all the support, in whatever fashion it is coming (prayers, positive thoughts, kind words, encouragement, meal offers, ride offers etc etc).  We appreciate every bit of it, and are very thankful to have a wonderful community of fellow believers, friends and acquaintances.

Thank you, and sweet dreams.


Monday, February 23, 2009

A week in the life of Dianne

Ok, so the saga continues.  This week has a couple tests that Dianne has to go through.  Today (Monday) she is going for a CT scan at the Sturgeon in St. Albert.  This test is one of the tests that will determine if the cancer has spread.

On Wednesday, she will be having a minor surgical procedure known as a Centenal Node Biopsy.  I mentioned this one in an earlier blog entry.  This procedure is done to determine if the cancer has spread into the lymph nodes.  The surgeon will remove part of or all of a lymph node in the armpit in order to biopsy it.
That is it for tests this week…next week is two more (we think).

Overall, I can say we are doing good.  We have received a lot of support already, plus a lot of offers for support.  We have had visitors, baking, a meal made for us, babysitting services…..the list goes on.  We truly do appreciate everything that everyone is doing for us.  I have no problems in asking people that if they want to make us a meal, or bake for us, that it wait for a month or 6 weeks.  Right now, Dianne is feeling well enough to do these tasks. However, that will change once she is into her 2nd or 3rd round of pyrogy therapy.  Oops, pyrogy therapy should have read Cheemo therapy, erm I mean chemo therapy.  *sigh* I love trying to do this on a Monday morning.

Dear reader, that last sentence or two should tell you how we are trying to deal with this thing.  Yes, we inject a wee bit of humor into it.  Really, what else can we do?  Should we mope around and feel sorry for ourselves?  I don’t think so..that is not Dianne’s style.  Just wait until she loses her hair….people will soon realize that the kids get their foreheads NOT from the Kok side of the family.  LMAO.  (Don’t smack me for that one, Dianne….you know I love you!!!!)

It is time for me to get back to work, so I’ll quit rambling now.  Continue to watch this space for updates…I don’t know when they’ll happen or what they’ll contain.  It may be an important informational type update, or it may be a personal perspective on this whole thing.  Or I may just wear my heart on my sleeve and tell you how I really feel.

Thanks to all who have supported us this far with prayer, kind words, thoughts, a meal (thanks Michelle!!!), baking (Thanks Mrs Veldkamp!!!!!), rides, babysitting and hugs.  The communion of saints is alive and well, and we give thanks to God for that gift.


Wednesday, February 18, 2009

Cancer Update

Hi all

Dianne (and I) went the Cross Cancer Institute this morning for an appointment. Here is the information we received (and remembered).

- The results of the bone scan are very good. There is no sign of the cancer in her bones.

- Dianne had undergone a heart test to make sure her heart was strong enough for the drugs used to treat this thing, and it showed that her heart is fine. This also, is very, very good.

- Dianne’s cancer has advanced far enough for it to be considered a Stage 3 (out of 5) cancer. This shows that it is further advanced than what was initially suspected. Of course, if the cancer is as aggressive as they think, then this could be reflecting the changes between the initial diagnosis and now.

- The Dr. that measured the lumps today reckoned they were about 6cm x 8cm, which is up significantly from the last measurement taken (5cm x 5cm). The Dr did, however mention that he might be measuring differently from what the surgeon did, so it might not be totally reflective of growth.

- The tumor is graded at a Grade 2 tumor. The way the Dr explained it was on a scale of 1 to 3, this was a 2, and further explained it as least ugly (1) to most ugly (3). So, it’s not real ugly, but still ugly.

So, what does this mean in terms of ridding her of the cancer? Here is what is going to happen.

1) Dianne has to go for a Centenal Node Biopsy so they can determine if the cancer has spread to her lymph nodes. As of this writing, we are waiting to hear from the surgeon as to a date for this procedure to happen
2) On March 5th, Dianne will be going for a chest x-ray and a abdominal ultrasound to determine if the cancer has spread to other organs.

3) Dianne will be starting chemotherapy in March. She will go through 12 weeks of one type of chemo (FEC), followed by 12 weeks of another type (docetaxil). She will be going to the Cross Cancer Institute for a ½ day in 3 week intervals. The day prior to her chemo treatment, she will also have to go to the CCI for an examination and blood work. If the Dr decides at any of these intervals that the tumor is not shrinking, or responding to the treatment as well as they hope, they would then stop the chemo treatments and send her into surgery.

4) Surgery? The choices she (we) will be faced with is a full mastectomy or have them try save part of the breast. She has not made up her mind yet, but we are leaning towards the full removal, to lessen that chances of the cancer coming back.

5) Following the surgery will be radiation.

All in all, it looks like Dianne and our family are in for a very long year. Up to 6 months of chemo, followed by surgery and radiation. We know that we are in the best hands possible in the team at the CCI, along with the surgeon in St. Albert. And of course, we know that their hands are guided by our Lord so ultimately, we are in His loving hands. There is no better place to be.

We thank you for your thoughts and prayers, and ask that you continue to remember Dianne in prayer.

Wednesday, February 11, 2009


Dianne and I attended a consultation with the surgeon today, with a view towards what is going to happen over the next little while.  The Dr is thinking at this point that it is an aggressive form of cancer, based on the size of the tumor(s) today as compared to when the original ultrasound was done.

There are several things that need to be done now.  Dianne needs to go for blood work (done today), and she also needs to go for a CT Scan, bone scan and an ultrasound (scheduled for this coming Friday).  These tests are to determine if the cancer has spread to the internal organs.  If the ultrasound cannot confirm if the cancer has spread to the lymph nodes or not, then she will also have to go for a centenal node biopsy.

She will also be meeting with a Dr at the Cross Cancer Institute in the next week or so.  This is to get their opinion on the use of chemotherapy.  If the Drs think that chemo would help shrink the tumor before they operate, then we are looking at about 6 months before surgery.  If the Drs don’t feel that chemo would be of benefit, we would be looking at surgery within the next 4 weeks.  They are unsure as of right now whether to do a partial removal of the breast or a complete removal.  It is going to depend on some of the test results.

I will keep you updated as we learn more about this.

Thanks for all your support…it is much appreciated by my wife, by myself and by my family.