Thursday, March 29, 2007

ACS Releases New Breast Cancer Screening Guidelines

Yesterday, the American Cancer Society (ACS) released new Breast Cancer screening guidelines for women who have a higher risk to develop the disease. Click HERE to read them. Why did they do this you may ask? In the adjacent picture you can see the mammogram on the left and an MRI on the right of the same patient. Obviously there is much better detail on the MRI. MRI is not being recommended to replace mammograms but rather to complement them. For example, calcifications will show on a mammogram but might not on an MRI. Often calcifications are indicative of a possible cancer. MRI's also have built in software programs that use sophisticated algorithms to detect probabilities of cancer in lesions identified.

I may have told this story before so if I have please forgive me. When Patty had a biopsy of an area in March at my urging, the doctor had said it wasn't necessary, there was a another very small area that was seen. It did not look like a breast cancer. It instead looked like a benign lymph node. It was also in a difficult location to biopsy without causing a lot of pain and misery (This is not the area where a cancer ultimately developed). The Radiologist said we could get an MRI but he didn't think it was necessary. Patty had just had two biopsies and didn't want to have to go through another procedure. My instinct and experience was to disagree and strongly suggest that it be done but, I was persuaded by her weariness and his experience. And, her risk over the next 5 years of developing breast cancer according to several risk assessment tools was ONLY 2%.

Worst mistake I've ever made. I regret not following my initial instinct and knowledge EVERY day and will for the rest of my life. If we had proceeded, the MRI would have most likely discovered both areas in their earliest stages.

I said all that to say, for the current time it is still going to be difficult to obtain a Breast MRI unless you meet certain criteria. See the criteria below:
  • have a BRCA1 or BRCA2 mutation
  • have a first-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation, even if they have yet to be tested themselves
  • lifetime risk of breast cancer has been scored at 20%-25% or greater, based on one of several accepted risk assessment tools that look at family history and other factors
  • had radiation to the chest between the ages of 10 and 30
  • have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or may have one of these syndromes based on a history in a first-degree relative
This is due to the cost of the exam. Mammograms are relatively cheap in the health care arena. MRI's are not. These new guidelines may or may not be followed by your insurance company. There is a risk calculator that will be used to help see if you qualify for a Breast MRI. I strongly urge every female reading this to click HERE and assess your risk. Men, have your wives assess their risk.

One thing to keep in mind is this. If you don't meet the criteria but your intuition gives you concern or the physician wants you to return in six months for a follow-up exam, insist on having a breast MRI even if your risk factors do not meet the requirements (see above). You may have to even pay for it yourself. At that point you'll have to ask yourself, how much is your health worth or your peace of mind? Tough question.

Tuesday, March 27, 2007

March 22nd Spurgeon Prayer Link Corrected

I found out the link I provide to the Spurgeon devotional on prayer was not the right link. For those of you who attempted to read it I have updated it to reflect the correct link. It is HERE as well.

Final Setup Today

Patty comes in today for her final setup to begin her radiation treatments.

To explain, most patients come for an initial CT scan through their area of treatment so that we can then develop the most optimal treatment plan to treat them with. Once that is complete, we then bring them back in to "confirm" that the treatment plan is indeed most optimal. Once this is complete and approved by the physician, we can then begin their treatments. Once treatments are started, we image the patients daily to assure that we are indeed delivering the plan that was created. Got it? I thought so, lol...

Please continue your prayers for us throughout this process. Specifically that Patty doesn't have any unfavorable skin reactions to the radiation and for us as a whole. Trust me, we need them.

Spring Break

We didn't do much over Spring Break. I took Monday through Wednesday off and we traveled down to Chattanooga to visit with some good friends of ours that used to live here in Knoxville. Some of you know them as Earl Marcey.

We went down Monday afternoon and the next morning we headed off to the Georgia Aquarium. Self-purportedly the "World's Largest and Most Engaging Aquarium." Do you feel a review coming on? Good.

It was relatively easy to get to and the line wasn't long to enter except for the security. We had purchased tickets ahead of time online of which I definitely recommend. Be sure to print out the tickets they email you before you come though. One small step I seemed to miss. Alas, it wasn't a big issue as the will call line wasn't long and we traversed right on into the Aquarium. The design is well thought out as it is a pod design where there is a central Atrium/Lobby that is surrounded by 5 pods appropriately separated by aquatic life (river, ocean, etc.). With this design your not in one continuous line and you can enter whichever one looks the least crowded. It took us about two hours to tour the whole facility.

They do have some aquatic life that I had not seen before. I've been to several aquariums (Monterey, Newport, Ripley's, and Chattanooga) and hadn't seen a Whale Shark

or a Beluga Whale.

Both of these were pretty impressive. As far as being the largest aquarium in the world, well, it didn't seen any bigger than other aquariums I've seen. But, maybe that's just my revisionist memory, lol... It is definitely worth the trip to see it as least once.

We left and headed back to Chattanooga where we spent the night again with Earl Marcey. We got up and headed back the next morning. Below is a pic of the kids along with Earl Marcey's kids Alex and Eliza.

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Thursday, March 22, 2007

Phase 3 Begins (LINK UPDATED)

Patty is here today to begin the first procedure of what will be a 7-8 week process; Radiation Therapy. Once again refreshing in my mind how surreal this whole process has been and still is. I still find it hard to believe that my wife is here at my work for treatment. I never visioned such a scenario. Sometimes there are snippets of time where we can get away from this whole thing but today is not one of them. I was feeling
kind of down this morning as the reality set in that she was coming
today. I needed some encouragement so I turned to Spurgeon's daily devotional and found this,

“And he went a little farther, and fell on his face, and prayed.”

Matthew 26:39

Ok, that seemed to be a rather timely message to read. So, I sat down and did as such. I then read the rest of the devotional and it is another of his gems that can be treasured to read over and over again. Thus, I'm going to provide the link below to the whole devotional. Click HERE to read.

I then begin to wonder what Patty thinks about having to come here for treatment? I'm sure its surreal for her as well. Maybe I'll ask her to post here what it is like. I guess she'll get to know many of my co-workers well.

The day didn't start off well for her. She went this morning for her Herceptin infusion. It didn't go as well as usual. They had to stick her 5 times before they finally got access to her port to do the infusion. Not to mention the pain of being stuck but the bruising will probably be bad as well. Hopefully she'll have a better afternoon. I think her and some other friends are going to go to lunch and take the kids to the park.

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Friday, March 16, 2007

Stepping Out

I apologize for not posting as of late. Katie developed the flu and its made it for a more strenuous week. Today is her first day back to school. Luckily, nobody else has developed it, especially Patty because this week her counts from the last chemo treatment or the lowest.

Last night, Patty spoke for the first time about this ordeal she/we have been traversing. The group she spoke to was the ladies' group from our church. They meet once a month on a Thursday night for a time of discussion and fellowship. There is always a guest speaker and so last night Patty played the part. She said there were approximately 30 ladies in attendance. I asked her how she did and she said, "good." I could infer from her voice it indeed went well. Funny thing how you can infer the real meaning of a spoken word just by the tone. She had practiced it for me the night before and I was soundly impressed. She said she had been practicing ;). Patty's has always been lacking in the self confidence category. Unduly so, as everything she puts her mind to she does it with excellence.

Anybody have any good ideas for a quick Spring Break trip?

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Friday, March 09, 2007

What Come of This?

Patty received her weekly Herceptin infusion yesterday without any issues. She is still feeling a lack of energy from the chemo treatment last week. Chemotherapy is cumulative so its probably the culmination of all the treatments as well as the shots to boost her red and white blood cell counts.

She has started an exercise program we offer at our Fitness Center that is designed with cancer patients in mind. She has already jumped right into the program. Yesterday she said she rode 3 miles on the bicycle and walked another 1.5 miles. Studies have shown that a moderate exercise program while under treatment will improve fatigue levels.

Changing gears, you wonder what God has in store for you on the other side of tragedies such as this. I've wondered that a lot actually. Last night, I met a wonderful lady who had recently underwent a mastectomy for breast cancer. When she learned my profession she had lots of questions about breast cancer of which I was able to help her better understand it and her situation. I was sort of taken back about how thankful she and husband were afterward.

Even though I was in the field before this I didn't know a quarter of what I've learned about breast cancer since. What was ironic about this encounter was I had just spoke to old friend earlier in the day, who through describing a trial of his own, spoke about how God uses events such as this to prepare us for his work and will. On the way home last night I recalled that conversation and wondered if being a resource for others facing this is meant for me. If that is the case, I'm ready to help as many that face this issue as humanly possible.

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Tuesday, March 06, 2007

The Next Step

Well, Patty showed up at my work today and it wasn't to see me. Today was her initial consult with our Radiation Oncologist. There was some debate about whether or not she should receive radiation therapy or not but after pouring over the latest clinical trial and study results it looks as if there is some benefit to be gained by having the radiation. Small but albeit there. Additionally, it appears that if she opts for reconstruction it is advantageous to perform the radiation before any type of reconstruction. She's going to wait until after Spring Break to get started so that she can recover fully from the chemo and not have to drag all four kids to the treatments.

She looks as if she is on the upswing she is still having some significant back pain but it is bearable if she is on the meds. Having injections to improve both her white and red blood cell counts is definitely a longer recover period for her.

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Monday, March 05, 2007

Doing Better Today

Patty has done much better today. Holly watched the boys for her so she was able to get some good rest. Her back has started to feel better but still is bothering her some.

I took Kendall for her annual eye appointment today. She received a good report on her Amblyopia. We were a little early so I stopped at my "local watering hole," Starbucks, and got her a hot chocolate. She was stoked that she got to sit in the parking lot with me in the front seat and drink her hot chocolate. It took her all of about 3 gulps to finish it.

Katie finally let me pull a loose tooth today. Oh, the horror!

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A Summary of the Latest in Breast Cancer Treatment

Click HERE for a link to a summary of the latest in breast cancer treatment from the 29th Annual San Antonio Breast Cancer Symposium. The preeminent cancer conference in the world. It will be a difficult read for those not in the medical field. Patients who have educated themselves will be able to understand much of it.

The synopsis; the state of breast cancer treatment is improving one small step at a time. There is no single magic bullet. The article predicts that overall deaths from breast cancer will be HALF of what they were in 1990. An amazing stat for a twenty year time period. Thanks to all the researchers who have made this a possibility.

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Weekend Update

Patty did ok on Saturday. She was really sleepy due to the pain meds but we actually got out that evening. Today was a different story. She was pretty much wiped out all day. Her red blood cell count was borderline low on Thursday and probably lower after she got the chemo. When that is low it causes you to feel as if you have no energy. That along with the pain meds to combat the Neulasta shot combined for a recipe of grogginess and sleep.

I took the kids on to church so she could get some "quiet" rest. It was a great service. We had 10 people baptized. I have never seen that many at one service. Our worship pastor, Mark preached the sermon. I really enjoy his sermons. He never skirts around the truth. The reason he was preaching was our pastor, Scott, was a feeling a little under the weather because he had donated his bone marrow earlier in the week. He was a match for a leukemia patient on a bone marrow registry he signed up for many years ago. Shane, our children's minister led worship. It was awesome as well. He is definitely talented.

Hopefully, Patty will be on the upswing tomorrow.

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Friday, March 02, 2007

Post Treatment Update

Patty had her last major chemo treatment yesterday. It went as well as it could, no reactions or illness. She also had to get another shot to boost her red blood cell count, Aranesp and she will get the Neulasta for the white blood cell count today. The double shot expresso, chemo style.

She made it all the way through without having to enter the hospital with low blood counts which is a great thing. Many have to delay their treatment until their blood counts increase. Some even have to go into the hospital to have IV antibiotics because they developed an infection that normally wouldn't bother you but do to their white blood cell count being so low it can be extremely harmful. Hopefully, the Neulasta will not wipe her out for 3 days as it has done in the past. Last time it wasn't as bad as the others so keep praying.

Two major hurdles down, surgery and major chemo, one more major to go, radiation, and many minors from here to eternity. The journey now has been almost 7 months. It seems much, much longer.

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