09/05/2023
Hi, I want to share an update about my dad. Sorry in advance as it is a long post, and I struggled to make sense of this situation so here it is..when someone asks, you know where we stand as of today. As you probably know, he was diagnosed earlier this year on Jan. 12th with a rare type of gastric cancer.
After his endoscopic ultrasound at Presby (Feb.22nd), we immediately knew that his cancer had already grown & spread since his previous and very first endoscopy and scan that was 6 weeks prior on January 9th. The GI doctor told us that the cancer had not only spread up into his esophagus but had also breeched and grown through his stomach wall and into nearby tissues such as his peritoneal lining & had definitely spread into at least 7 regional lymph nodes (and probably beyond) as they looked abnormal. Now we needed more testing to look at the extent of the spread.
So the technical staging at this point was Stage 3, grade 3, “poorly differentiated” which means high grade; aggressive growth. T3N3Mx, (T=Tumor, N= Nodes, and M= Metastasis) meaning his tumor was aggressive and of significant size, and the cancer had spread extensively into several regional lymph nodes & most likely beyond, and the metastasis was unknown. We were told that it could quickly differ with further testing.
The PET scan on February 10th did show uptake on an area of his back that was concerning, but we were all hopeful that it was not cancer as he had previous tumors on his cervical spine years prior that they ended up diagnosing as benign. After the visit to Presby on the 22nd, my dad completed the staging MRI which was scheduled on Feb. 27th with much persistence from me. I even got it moved ahead by a few weeks as I knew time is a crucial factor. The results were not what we wanted to hear. The cancer was indeed in the distal lymph nodes in his head, neck, chest, and arm region, along with the regional abdominal nodes, and the uptake was in fact metastases to his bones: T5/ right rib. So this changed the diagnosis to T4N3M1 meaning Stage 4 Advanced Gastric cancer w/ Mets. And in turn, they had to reevaluate and come up with a new treatment plan than we previously discussed.
The chemo regimen switched from FLOT to FOLFOX, and his first session was March 6th. He’d wear the portable pump for another two days after his infusion at the center and go back to get it removed. I lost track with all the cycles but believe he did ten (or 11?) until the third week of July. Now it was time to rescan to see how the cancer responded to his treatment thus far. I must say I sure was fooled. I convinced myself that we were going to receive positive news but unfortunately we did not. I was out of state with the girls when I spoke with him and heard the results. I was devastated all over again. It was the news that I had been fearing and wishing away. The chemo wasn’t working, and the cancer had progressed. It is so aggressive that it is still mutating and is resistant to the chemo. In this moment, what I read from my research and had heard directly from Dr. Duncan himself has now become the reality that I didn’t want to accept. I was floored that day we spoke with Dr. Duncan when we first heard a time frame regarding g life expectancy dealing with this cancer. To continue the appointment was difficult for both my dad and me to say the least. Even with the treatment, the cancer has grown bigger and spread into even more organs: now also his colon, his ribs- which have visibly fast-growing masses, and his right lung which has now begun accumulating fluid around it.
At this point, my dad’s regular oncologist at UPMC Hillman - Arnold Palmer Pavilion, has referred him to a doctor whom specializes in gastric cancer at Shadyside to see if she can offer any other options since he tried the standard treatment and it failed. She recommended trying second line defense: paclitaxel (a chemo) and ramucirumab (a targeted therapy approach with monoclonal antibodies). She wanted him on these ASAP and recommended I reach out so I called on our way home that very same day, Thursday (Aug. 24th), and once insurance authorized the treatment, he was able to begin this new combination on the 30th of August. We were informed that these are a bridge that will hopefully stop the cancer progression long enough to find a clinical trial for him to get accepted into as a patient that will produce positive results. The one she spoke to us about is supposed to open the second half of September 2023 sometime, but he can’t be screened until it is officially declared as open. There are two requirements and one must be met in order to qualify:
1. Must be under a certain age which he is not
2. Must be cod 205 positive which he will not be able to be screened until the official opening of the trial
So that’s where we are at. He will receive this 2nd line combo tomorrow 9/6 and the following week, 9/13, and then have an off week and visit with his local oncologist on the 18th. Next appointment at Shadyside is Sept. 28th in hopes of proceeding and entering a clinical trial in the near future if he qualifies. No guarantees 🙏🏼
As soon as we found out about his diagnosis, we said that it is in God’s hands. We both agreed to place it there and to try to find comfort & peace knowing that we did so. At that moment, I understood the importance of saying in time: "I love you, and to give our loved ones the time that they deserve. Nothing in life is more important than your family. Give them the time they deserve, because these things cannot be put off until some other time.”
As I came across this above message today, it inspired me and felt like it was time to finally write this. It is so true since tomorrow is never promised to any of us, but with God’s grace, eternal salvation, is ✝️ make today count.
We appreciate all of the thoughts and prayers that we have received along this journey so far. I still can’t believe we are here, and my heart goes out to all other cancer patients (past & present) and their loved ones as this is truly a trying time. I admire my dad as he has shown such strength and bravery throughout everything so far. We are genuinely blessed with each and every one of you who has positively touched our lives by simply being in it. Thank you 🙏🏼💞and God Bless.
