Saturday, January 21, 2012

Headed Home Today

Doctors just made rounds. Memories of being a medical student and intern again. Good news though. Kay, after a tough night with nausea post op, is doing fine and is going to be discharged about noon today. Hooray!

Friday, January 20, 2012

Surgical Results Promising

When we entered the preoperative ward today we looked up and saw that Kay's stall was stall "K", and took that as a very good omen. It may have been as Dr. Swisher just came out to talk with Jean, Brett and me and she gave us very good news. Kay had a 2-3 hour robotic surgery and in Dr. Swisher's words everything went just like we had been hoping. On examining Kay's abdominal cavity there was no visible cancer at all, and no adhesions or scarring to make the surgery difficult. They removed the cervix easily, and were able to locate the lymph node noted on the CT scans and remove that also, even though it was lying right on top of the inferior vena cava (the big vein returning all the blood from the lower body to the heart) they removed it without bleeding or complications.

The plan was to place an intraperitoneal port if there was no remaining visible disease, and so they did that too. This port will be used to give Kay chemotherapy directly into the peritoneal cavity in hopes of killing off any microscopic disease that remains more effectively than they can with intravenous chemotherapy.

We will be seeing Dr. Swisher again in 2 weeks and making sure Kay is healing well, and if so begin a course of chemo, likely Taxotere IV on day 1, carboplatinin on day 2 of each 3 week cycle for a total of 6 cycles. Taxotere is similar to Taxol, but may cause less progression of Kay's peripheral neuropathy. Unfortunately it will be back to wigs and caps again as she will lose her hair in all likelihood.

We are very thankful that the findings at surgery and the surgery itself were so positive, and are now praying for an uneventful recovery and a long remission from the upcoming chemotherapy. Thanks for all of your prayers. If the night goes well Kay will be coming home tomorrow.

Love to all.


Thursday, January 19, 2012

Beating the Ice Storm

Kay and I decided to come to Seattle early, and are safely here and checked into the Collegiana Hospitality House, a UW hospital place for patients and families. Dorm style but comfortable with easy walk to the hospital and a shuttle. We were anxious about weather tomorrow making a nervous drive up in the morning. Back in Puyallup our yard looks like a tornado hit, with limbs and trees down everywhere. Planning to go to a sports bar to watch the UW-Cal basketball game soon.

Check in time tomorrow at the hospital is 9:45 AM so I'm expecting surgery late morning or early afternoon. I'll post then as soon as I have any news. Thanks for all the prayers.


Sunday, January 8, 2012

Back On the Offensive

2011 was a very good year for Kay and the Pullen family. Kay finished her last course of chemotherapy about March, and took a few months more of the PARP inhibitor, but has mostly felt great and we have taken lots of vacation, played hard, and had lots of fun. Starting about September it was clear that Kay's CA-125 was creeping up steadily, and so we stopped the PARP inhibitor treatments. After consultation with Kay's oncologist here in Puyallup Rob McCroskey as well as Dr. Swisher at the Seattle Cancer Care Alliance we all agreed that taking a 3 month break from checking lab tests and going to doctor's appointments was the approach to take. We planned to wait until Kay either felt sick or had evidence of cancer recurrence to resume treatments.

We made the most of this break, and visited Belize and Guatemala. To visit Tikal was a bucket list item for Kay. We visited California for Keith and Ken's 60th birthday, and went to Mexico enjoying the break.

Our children continue to do exceptionally well. Jean is at Ernest and Young in Seattle, and Brett who has finished his studies at Seattle University has embarked on a career as an internet entrepreneur starting Colmar Enterprises, a company of web assets where he is working hard and having success at developing.

We were really pleased and surprised that after 3 months in November Kay's CA-125 had not increased very much, and although a potentially worrisome lymph node showed up on a CT scan everyone was pleased. We planned to wait another three months and check again.
Our plans changed when Kay started to have symptoms that led to discovering that the cancer had recurred in her cervix. You may recall that at the time of her original surgery the surgeon was not able to remove the cervix because of too much cancer in the area. It looks like some remnant of that cancer has started to progress, and is lurking in Kay's cervix. This was confirmed with an ultrasound and an MRI.

Since this was discovered we've been agressively looking at Kay's options for treatment. We've decided to have Dr. Swisher, the SSCA GYN oncologist, do a robotic laparoscopic surgery to remove the cervix to manage the locally symptomatic disease, see if she can also remove the retroperitoneal lymph node, and explore the abdominal cavity to assess how much cancer is apparent.

The date for this is set for Jan 20, so keep Kay in your prayers that day. The surgery should be "minimally invasive" and we hope for an overnight hospital stay and to go home the next day or in 2 days maximum. Kay has a track record of great recoveries, so I'm optimistic this will be the case.

If at the time of surgery there is very little residual cancer found the plan is to go through an agressive course of chemo, similar to the first course except probably using intraperitoneal carboplatinin instead of IV infusion with this drug. This will involve an IV infusion of Taxotere on one day, a day in the hospital the next to get the intraperitoneal infusion, and to repeat this every 3 weeks for 6 cycles. We anticipate the same hair loss as the first time which Kay is really dreading, but hope for a long remission when this is completed.

If at the time of surgery it appears that there is a considerable amount of tumor apparent then the plan is to go on a less toxic regimen of therapy with weekly Taxol and possibly adjuvant Aromatase Kinase Inhibitor treatment as a part of a clinical trial at the SSCA. The logic behind having two options depending on the findings at surgery is that if there is little tumor apparent agressive therapy may give a long remission, whereas if there is a lot of tumor apparent the chances of a long remission are slight, and less toxic treatment is a better option.

Kay wants everyone to know that the time off treatment has been a real blessing, and to thank everyone for their support. Whatever is found at the time of surgery Kay is going to continue to fight hard, live every day fully, and need all of your prayers. We both want to thank everyone for their support and wish you all a very happy New Year.