By May, no hyper-metabolic activity was detected. Let me say it this time: Whoopee! That qualified Irene for an immunotherapy study. Irene had the preparatory and painful femoral artery invasion, leukapheresis, by that physician’s assistant I told you about earlier who caused her to scream in pain. Tissue and blood work was forwarded to Duke University where they concocted a serum.
Once started, the study lasted four months with regular visits to the clinic for tests and injections. Irene didn’t have any chemo sessions during this time, just injections. That period was a relief but ended in disappointment. The lesions returned. Hopes get up then are dashed.
Bi-weekly chemo sessions began again by fall. After the infusion at the hospital, Irene came home with a bag containing 5-FU attached to her port. It infused over 46 hours then a home health nurse visited to detach it. The nurse drew blood and submitted it for examination. Four chemo sessions followed by the end of the year bringing the total to 98, not counting the home infusions each time. We also drove to numerous visits and diagnostic tests during that time.
2008: By January, 2008, Irene had a recurrence in her liver. She was infused with a cocktail that gave her a reaction that was too severe. She agreed to it even though she knew the effects were terrible. Finally, the doctors switched her to one that turned out to be less effective in the long run because in January, 2009, a year later, the nodule reappeared.
To give Irene periodic rests, we took a few treatment breaks. We arranged that by occasionally taking three weeks instead of two between infusions. The staging scans and blood work continued through the end of the year. By the end of 2008, Irene added approximately 20 sessions bringing the total to 118, conservatively speaking.
In December, 2008, Irene suffered very severe pain, diarrhea, fever, and blood in her stool. She dehydrated and was anemic, too. I rushed her to the local ER. She was admitted and spent four very uncomfortable days in a hospital bed. She was discharged just in time for the holidays: diagnosis unknown.
2009: The year 2009 was like 2008. It started off with a recurrence. Scans in late February showed yet a new lesion, again in her liver. Chemo restarted in January. She couldn’t get out of bed for several days after each session. There was metabolic activity near her right lung also. She refused to stop chemo at this time saying she wanted this disease “out of my body”. Irene had to be wheeled to the infusion room she was so weak. She received that session in one of the “penthouses”.
Regular chemotherapy, FOLFIRI plus Avastin, resumed in August and continued through December. Irene suffered serious side effects and the liver tumor still increased in size.
During this period, at home after each infusion at Moffitt, the visiting nurse removed the 5-FU dispenser bag, drew blood and flushed the port lead. I injected the blood thinner shots 24 hours after the portable bag removal. The pain in Irene’s stomach was very sharp and Irene’s hair was falling out again. Infusions restarted in June, adding nine or ten more chemo sessions bringing the total to around 127, again conservatively speaking.
In December, after diagnostic scans, the FOLFIRI part of the cocktail was stopped as not being effective anymore in addition to the side effects being too debilitating for Irene. She continued to be infused with Avastin only. Irene needed a rest over the holidays. The oncologist gave her a two month break to recuperate.
A positive decision by the Tumor Board, however, opened the pathway to try radio-embolization—theraspheres. It had recently been approved for colon cancer if metastasis was only to the liver and not more widespread. We scheduled the procedure for the spring of 2010 after extensive preparatory mapping exams and tests.
The foregoing summary through 2009 contains the essentials of the first 6½ years of Irene’s treatments. It includes her major surgeries: 18 inches of her colon removed; right lobe of her liver removed; and, the resection of her lower right lung. The remaining treatments, including the upcoming liver and related surgery, from 2010 to Irene’s passing, are more complicated and detailed, believe it or not.
Before I describe those years of 2010, 2011 and 2012, I wanted the reader to appreciate what Irene had endured to this point so going forward, her struggles would be fresher in your memory.
Hopefully, you can keep in mind all the pain and discomfort that she braved while you read the description of her battle and the extraordinary stamina required to deal with her situation from this point forward. For example, ask any one you know who has received chemotherapy, just how many hours-long infusions they withstood. The total number probably reaches nowhere near Irene’s total. I don’t have any idea what the record is but, Irene is surely in the running for the most ever. Consider all those associated side effects, too, including the emotional ones.
I noticed Irene was gradually weakening. I reminded her the Tumor Board approved her for radio-embolization.
“Tom, I’m getting really tired. Do you think this new procedure will work?”
“Yes, honey. Think about it when it does work. This could be the end of your cancer if they’re able to destroy that one last nodule in the liver. The doctors are even excited for you. The chances are in our favor. We could have many more years together. It’ll be a good time for us, honey, free of this disease. It could release us to be finally done with chemos, scans and the whole world we’ve been living in. We could have the longest treatment break ever.”
Irene reached for me with her arms extended. She beckoned with her hands.
“Please, gimme a big hug, handsome. I hope and pray you’re right.”
“Don’t worry, honey. We’re together.”
“I love you.”
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