There is a light at the end of the tunnel (not an oncoming train )

Day 154 (5+ months) since Chemotherapy began.

I must apologize for the nearly 3-month hiatus from my blog. It’s not that I didn’t want you to know how I’m doing…It’s just that nothing extraordinary, or remarkable, or newsworthy seems to have occurred…besides my apparent success (so far) with the chemotherapy.

This side of expensive Computer Tomography (CT) scans or other equally expensive diagnostics, there aren’t reliable methods for assessing presence of cancer. The typical post-chemo assessment is a blood test called, “carcino-embryonic antigen” or simply CEA. This test measures the presence of cancer-fighting antibodies in the blood stream (or if I'm pregnant .)

My oncologist does not do CEA tests during chemotherapy since she believes the test gives too many “false-high” readings that may inappropriately disturb patients. My surgeon, however, wants CEA tests, if for nothing else, to create a baseline comparison that we can use after chemotherapy to note increases or decreases in the cancer-fighting antibodies. So, per my surgeon’s request, I got a CEA during my most recent blood draw. It was roughly what a non-cancerous subject would have (and much lower than the norms for a non-cancerous smoker).

My notable SEUSes (Side-Effects / Unusual Sensations) are still:

* the peripheral neuropathy which is now constant in my fingers and toes, making them feel frostbitten. It also prevents me from enjoying any cold drinks, which go down my throat like razor blades. The Internet says that the neuropathy should dissipate within 3-5 months following the end of my chemo.

* “Metal-paste” taste. Unless I am eating, I have a constant taste in my mouth as though someone has squirted aluminum paste there. The true taste of foods has nearly disappeared, as well.

* Energy deficiency/tiredness. Where I could stay up past midnight before all of this, my target bedtime is now 8:30 p.m.

A week from today (on October 2) is Chemo Round 12 of 13. My last round will be on my mom’s 86th birthday, October 16. So, we’ll celebrate that evening with a combination Birthday/End-of-Chemo party at Mom’s home in St. George, Utah.

And for those that have wondered about how this has affected my work...Including Surgery Day on March 25, 2009, I've taken 3 sick days.

Woo-Hoo!

My love and gratitude go to all of you who have been so supportive with your kind words, prayers, thoughtful gifts of time and service, and so many other gestures of goodwill and friendship.

Love and best regards,

Dave and Nancy Hunt

Chemotherapy – Day 70, one day after Chemo Round 6 (Today is Friday, July 3, 2009).

Wow ! Time has flown. It has been five weeks since my last blog update. I apologize for the delay (to those that have been checking in for updates). Round 6 marks my near mid-point in the 13 total rounds on my protocol, ending at the end of October.

The main reason for my not posting more regularly is that everything has been so…regular. My SEUSes (Side-Effects and Unusual Sensations) have been the same as earlier, with a couple of slight exceptions. Both news SEUSes occur within an hour after chemo, and they last for about a half an hour:

Additional SEUS #1: Visual “skewity”. If you can imagine what Marty Feldman’s vision must have been like, that's what I feel for a few minutes following my chemo.

Additional SEUS #2: Parkinson’s-like tremors. My muscles, especially in my hands, want to shake for about a half hour following the chemo.

The two worst/most annoying of the SEUSes, however, are still 1) horrendous hiccoughs on Days One and Two following chemo, and 2) the susceptibility to cold for about 7-10 days following the chemo…I cannot drink cold liquids during that time (I’m drinking a lot of hot chocolate), and if I must take anything out of the refrigerator, I must use oven mitts.

I spoke too soon about no shampooing for six months…I haven’t lost any more hair than any other guy in his fifties.

Nausea seems to be a bit cumulative during the chemo rounds: on the Mondays following chemo, I must make sure that I take my anti-nausea tablets, else I spend time over the toilet.

So, the chemo therapy issues are simply annoying. As I’ve said earlier, I’ve had more pain from hangnails than I’ve had with anything related to my surgery and the chemo.

I appreciate, so much, the continued good wishes, prayers, and support from you, my dear friends, co-workers, and family.

Best regards for the Fourth of July celebrations,

Dave and Nancy

Chemotherapy – Day 36, midway between Rounds 3 and 4 (Saturday, May 30)

Sorry for not being more diligent about blogging, but there just hasn’t been much newsworthy besides I’m feeling just fine.

• I still have not lost any hair (no more than normal, that is). Nancy gave me a fine haircut that makes me feel great to have once again left “The 1960’s” .

• I haven’t missed any days of work (besides surgery day on March 25 and that first Monday [due to nausea, et cetera] following Round 1 of chemo).

• I sorely dislike the sensitivity to cold temperatures, which prevents me from consuming anything refreshingly cold for about a week following each round of chemo.

• I equally dislike the hiccoughs that last from "Chemo Day Fridays" through the following Monday (when the hiccough-causing infused anti-emetic wears off). The peanut-butter remedy seems to have lost it efficacy, but I’ve found a better, virtually instant anti-hiccough remedy: I plug my ears and nose with my pointer and pinky fingers of each hand, then, through a straw, take a couple of gulps of liquid…Voilà…hiccoughs are gone!

• Strangely, where most people lose their appetites during chemo, I’ve had to go back to breakfast and supper, else I get nauseated. (Previously, when I dropped from 260 lbs. to 158 lbs. during Summer 2005 [and since then], I’ve usually limited myself to one light meal per day, supplemented with plenty of electrolyte supplements.) During my most recent bi-weekly visit to my oncologist, she looked at my weight gain on my chart from my previous visit and she poked me in the tummy, saying, “It looks like chemo has not dampened our appetite, has it?”

Last night, I was in charge of beaming the satellite broadcast of the “Youth Celebration” to our local chapel from the 21,000-seat LDS Conference Center in Downtown Salt Lake City. My grandson, Zack, was one of the over-7,000 performers in the youth celebration of the completions of the Draper and Oquirrh Mountain LDS Temples locally.

Tonight, I’m headed to Pleasant Grove, Utah, for a reunion of Pleasanton, California, friends. During the day today, I’m trying to phone hundreds of friends I know from the 1960s from Menlo Park, California. Every five years, I host a Menlo Park reunion here in Salt Lake City (since more Menlo Parkers from that era live outside of Menlo Park now than still live in Menlo Park). At our last Menlo Park reunion here in Salt Lake (on July 9, 2004), we had over 500 attendees. We hope for a similar attendance on Saturday, July 25 this year.

I’ve probably overtaxed your endurance for blog reading, so I’d better close with my continued appreciation for your continued thoughts, prayers, faith, support, encouragement…You really DO make a big difference in my well being !

Love, from Dave and Nancy

Chemotherapy – Day 14 and Chemo Infusion Round 2 (Friday, May 8, 2009)

Short story: As I begin Chemotherapy Round 2 today, I’m fine.

Long story: My apologies for my lack of postings here on the blog since my Chemo Day 1. I know that it is frustrating for those that navigate here to the blog, simply to find that I have not posted any new updates.

Because the chemotherapy has left me in relatively good physical condition, I have been working a full schedule back at work, which has occupied most of my time bandwidth. (Excuses, excuses.)

At the end of my previous post (Chemo Day 1), I mentioned that I was going to “hop back in my car and head home.” Actually, because I was feeling so well, I headed down the hill a few blocks, back to the office.

As is typical, I focused on my work tasks at my old desk at the North Office Building (NOB), and I lost track of the time. Compounding my focus was the fact that my desk phone extension was at my new office location at the Metro office building, and my cell phone battery had run down without warning me and it wouldn’t ring when people dialed my cell phone. As a result, my family was unable to reach me, and they became rather frantic.

At about 9:00 p.m. Friday evening, worried that I had keeled over somewhere as a result of the chemo, my daughters called my manager, Bill Johnson, and LDS Church Security responsible for the NOB. A few minutes later, a security officer approached me, asking my name. When I told him that I am Dave Hunt, he said, “Good…your family has been looking for you, worried that you were off the road in a ditch somewhere.”

I immediately called home and set everyone’s mind at ease. I also packed up and headed home.

The side effects of Round 1 of chemotherapy were nearly unnoticeable:

* Side Effect/Unusual Sensation (SEUS) #1 – Hyper-sensitivity to cold temperatures: After I returned home and had a bite of dinner, I finished my meal with a glass of cold milk. I thought that the refrigerator had been on too high since the milk went down my throat feeling like there was a layer of sharp ice crystals scraping their way down. I looked in the glass and saw no ice. Then I realized that, as advertised by my oncologist, I would have “peripheral neuropathy” caused by cold temperatures.

* SEUS #2 – Hiccoughs: At about 4:00 a.m., I awoke to an annoying case of hiccoughs. (I rarely get hiccoughs.) The only way I could get rid of them (and go back to sleep) was to get a plastic shopping bag and re-breathe my own carbon dioxide until the hiccoughs disappeared (after about 45 seconds of re-breathing). I had to use this “home-brew CO2” remedy every half-hour or so all day (and night) Saturday and Sunday until the offending medication (Decadron/Dexamethazone anti-emetic) had worn off.

* SEUS #3 – Nausea and Vomiting: Once the anti-emetic wore off, I then had the pleasure of nausea and vomiting on Monday. Because I was naïve about my side effects (having a false sense of security from my being relatively unscathed to this point), I had not filled the prescription for post-infusion anti-nausea medicine. So after having to miss work on Monday due to this SEUS, my daughter, Kristie, kindly filled my anti-emetic Phenergan prescription. Once I started with this Rx, SEUS #3 disappeared.

* SEUS #4 – Energy Deficit: accompanying SEUS #3 on Monday was a day of malaise and no energy. It only lasted through Monday. (Now that I’m aware of that SEUS, I can anticipate it and adjust my workload appropriately, so, hopefully, no need to miss work.)

After making it past Monday’s (April 27) SEUSes, it has been clear sailing through today (Friday, May 8), as I sit through my second round of chemo here at Intermountain Medical Center (IMC) in Murray, Utah. The cold sensitivity disappeared completely by Thursday, April 30, so I could go back to enjoying my cold glasses of water and milk.

I still haven’t lost any hair yet. I need a haircut rather badly…I’m pretty shaggy in back (although I’d never allow myself to appear “mulletty”). I figured why get a haircut if I’m going to shave my head at the first sign of “hair loss by the handsful” . My Aunt Elaine never did lose any hair during her chemotherapy treatments, so if I haven’t lost any hair by Round 3, I’ll give in and get a decent haircut.

At this point in my Round 2 treatment today, I’m done with the in-hospital part of my infusion, but we’re waiting for the arrival of my “GameBoy” infuser, which accidently ended up at the LDS Hospital Infusion Clinic instead of here at IMC’s infusion unit.

On the HomeFront, dear friends, family, and professionals finished the laying of laminate flooring in our kitchen, dining room, and front entry way, along with carpeting in the living room, library, hallway, stairway, and back bedroom. Two-tone painting is complete in the living room, library, front entry, and back bedroom, with finishing coat in the hallway. We still need to do base boards and moulding between the two tones in the living room and replace the banister on the staircase.

As an added “touch”, Kevin and Kristie decided that during the next couple of weeks (under the professional direction of friend and neighbor plumbing contractor, Brad Zarbock), the main bathroom needed redoing, as well: replacing the bath/shower tile, flooring, toilet, vanity, and water fixtures. They certainly have more energy than Nancy and I ! (Thanks, you guys, for this added flourish.)

So, until next update, thanks for all of the wonderful thoughts, prayers, faith, support, encouragement, and success stories of friends and loved ones.

Love and Happy Mothers’ Day to all of you Moms and to those of you who have Moms.

Dave and Nancy

Chemotheraphy – Day 1 (Friday, April 24, 2009)

(Note: I posted three different blog entries here today. These postings will make the most sense if your read them in chronological order. To do that, please scroll down and read them in this sequence:

....* Last Pre-Chemotherapy visit… (Monday, April 20, 2009)

....* Chemotheraphy Day Minus 1 (Thursday, April 23, 2009)

....* Chemotheraphy – Day 1 (Friday, April 24, 2009)…This posting

Short story...

I went to work, then started my chemotherapy today...No pain, No side-effects, No unusual sensations yet. I couldn't ask for a better start to all of this !

Long story...

I arrived at work at about 7:15 this morning to complete a database-architecture deliverable and to attend our daily team briefing at 9:00 a.m. Following the team meeting, I drove from my office the few blocks to LDS Hospital for my chemo therapy appointment at 10:30.

When I arrived at LDS Hospital’s Infusion Therapy Department on the Seventh Floor, I heard this lovely, familiar voice say, “Dave Hunt ! I can’t believe you are here at the same time that I’m here.” The wonderful greeting was from my next-door neighbor, Linda Black, who has been valiantly winning her battle over Stage 4 (Metastatic) cancer. She has had several affected organs either partially or completely removed during her fight. She has completed her chemo (and other) protocols, and was here receiving IV infusions of nutrients because she has had a difficult time gaining, or sustaining, weight because of the radical removal/re-section of abdominal and other gastric organs. She began her battle at a healthy-looking 130 pounds. She is now 105 pounds. Although Linda retains her beautiful facial features, she could benefit from her having additional weight back on, mainly for her health’s sake. (She has been staying with her wonderful care-giving sister in another neighborhood, but hopes to return soon to her place next door to us.)

Linda and I had a lovely visit for a few minutes before our respective infusions began. Our congregation’s Relief Society President, Nancy Tillotson, brought Linda to this appointment, and when Nancy returned at the end of Linda’s infusion, Nancy and I had a great visit, as well, as I updated her on my health developments, and she updated me on the continuing support for our family that Relief Society members have completed and have planned.

By 10:45, my infusion began:


.... * Hooking up my IV Port and administering the in-hospital chemotherapy:
........ - Anti-nausea medications, “Zofran” and “Dexamethasone”.
........ - Next, “Oxaliplatin” and “Leucovorin” anti-cancer medications in saline solutions. This infusion took about three hours.
........ - Flushing the line with a glucose solution (since the next medication is incompatible with saline).
........ - Administration of Fluorouracil (also known as 5-FU, for short). This infusion was a “power burst” (a “bolus”) of 800 ML (nearly a quart) of this medication over a 15-minute period.
Another line flush.

.... * Hooking up, and starting, a “portable infusion unit” to dispense to me 5-FU over the next 46 hours. This last step of my infusion session today is to unhook the hospital-based IV bags of chemo therapy and replace them with a battery-operated, portable infusion device. This clever piece of machinery looks like a “Game Boy with tentacles”. The “tentacles” are IV tubes that hook right up to my IV Port in my chest. The “Game Boy portion delivers the prescribed 5 ML per hour of 5-FU for 46 hours. To carry the Game Boy, Infusion Services gave me a -- (UK term:) “Bum-Bag”; (US term:) “Fanny Pack”…sorry UK folks, I know that “fanny” in the UK is something totally different from the American meaning of “rear end”. The delivery tubes then lead unobtrusively from the Game Boy under my shirt to the IV Port to deliver the 5-FU. At the end of 46 hours, I return to IMC Infusion Therapy Department to have them unhook the Game Boy and the tentacles, which marks the end of this first round of chemotherapy.

The infusion team then gave me the go-ahead to leave, so I hopped back in my car and headed for my office to continue work on my current work assignment. After finishing my work for the day, I posted this blog to you.

At this point (a few hours following Round 1 of my chemotherapy), I know that it is too soon to “expect” any side effects, or other physiological responses, or other sensations from the chemotherapy, but so far, several hours after this session, “It’s all good” – No pain, No nausea, No discomfort, No unusual sensations whatsoever. So, I believe that I’ll hop back in my car and head home to my lovely wife, kids, grandkids, friends, and neighbors who are working valiantly on “face lifting” our home.

For those that are interested in my day-by-day, blow-by-blow account of what happens now that I’ve begun the chemo, I’ll try to post brief updates each day, of what I encounter.

Thanks so much for the good thoughts, love, prayers, faith, acts of kindness and support. As I've said before, with that kind of support, the outcome cannot help but be excellent !

Love and best wishes to you all,

Dave

Chemotheraphy Day Minus 1 (Thursday, April 23, 2009)

(I composed and posted this entry following chemotherapy on Friday, April 24, ,2009).

Short story...

They fixed me up with my six-month Intervenous (IV) spot on my body. I have marvelous family, friends, and neighbors.

Long story...

Today (Thursday, April 23), my son-in-law, Kevin Moreton, drove me to my 10:00 a.m. appointment at the Intermountain Medical Center (IMC) in Murray, Utah, so that I could receive the intravenous line necessary for tomorrow’s chemotherapy infusion. The plan was that following my receiving the IV line, I would head north at about noon on TRAX (Salt Lake Valley’s light-rail system) to my office in downtown Salt Lake City, then work until the end of the day, and head back home on TRAX.

As I mentioned earlier, I had previously selected the PICC line for infusion, mainly because it seemed that it would be less expensive by avoiding an additional surgery. During my pre-procedure interview with the technicians that were to place my PICC line, they asked my occupation. When I indicated that I was a database engineer for the LDS Church, one of the professionals suggested that instead of the PICC line through my arm, that the IV Port would be far less intrusive to my keyboard-intensive work. She asked why I chose the PICC over the Port. I suggested that I wanted to save my employer the additional costs of the Port.

She explained that if I figure in the costs of weekly dressing changes for the next 25 weeks, which the PICC would require, and the time away from work for each of those 25 weeks, just for the dressing changes, then I am miles and dollars ahead by having the Port, instead.

My only remaining concern, I told them, was, if, as a Latter-day Saint, would having a “Port” be frowned upon in the same way as having a “Chardonnay”, a “Pinot Noir”, or a “Cabernet Sauvignon”. They giggled and assured me that I would be okay from a religious standpoint. With these additional reassurances, I agreed that an IV Port would be both economically superior and certainly of greater convenience to me than the PICC.

So, the great folks at IMC’s Infusion Services somehow performed the miracle of arranging an operating room and the medical staff to install my IV Port with only a couple of hours’ notice.

I got plenty of work done on my computer while I waited for the implantation surgery to occur, and afterward while I was waiting to be released. (Getting my computer work done is, frankly, very relaxing and puts my mind on more creative endeavors.)

The Port-implant team, as with all the other medical staff providing my care so far, performed highly professionally. They took the time to explain exactly how the port looks, works, and feels, along with how the implantation procedure would proceed.

They administered Lidocaine at the implant site, and I was fully awake during the surgery. I had to turn my head to the left as far as possible to give the team the best access to my right-side clavicle.

Once they cut a slit in my upper chest, they inserted the narrow-gauge tubing into my jugular vein, worming the tubing down to my superior vena cava. Once that was done, the port fit nicely in a little pouch they fashioned under my skin. They stitched the subcutaneous closed over the port, and closed the epidermis with “medical Super-Glue”, which sloughs off after several days. All of this occurred without a single sensation of pain ! Amazing ! From the first incision until they were done, it took only about 20 minutes.

Because of the later-scheduled surgical procedure, the additional time for the implant, and the requisite recovery time, it left me no time to take TRAX to the office before the end of the work day. Kevin, Kristie, Aubree (age 4) and Emily (age 10), kindly came to IMC to pick me up and take me home.

Great Gifts from the Heart

As a wonderful gift from the heart to me and Nancy, dear friends, neighbors, and family have all pitched in to re-decorate our home to give a fresh (hypoallergenic, and bacteria-free) face to the house during my chemotherapy treatments:

* Dear friends from church are underwriting material costs of replacing our carpeting.

* Kevin and Kristie are providing very capable project management and, along with their children, and my other children and their spouses, late-into-the-wee-hours-of-the-morning labor to complete the wall and trim painting and laminate-floor installation.

* Other dear friends from church (and their friends from as far away as Texas and Louisiana) have been providing painting labor, flooring advice and labor, and strong backs to load into a moving van most of our belongings, destined for a storage unit until the project is completed.

* Families from church have kindly brought by tasty dinners each evening this week so that we don’t need to stop to prepare meals.

With Kevin and Kristie’s excellent project management skills and labor, and the unselfish help and provisioning from all of the above participants, Kristie and Kevin expect the project to be done sometime next week – elapsed time, start to finish: two weeks. Wow!

Thanks to all who contributed, and will contribute, to these selfless acts of love and support.

Last Pre-Chemotherapy visit to the Oncologist and a post-operative visit to the Surgeon – Monday, April 20, 2009

(I composed and posted this entry following chemotherapy on Friday, April 24, ,2009).

Short Story...

I went to my doctors.

Long Story...

My wife, Nancy, and I headed out to the oncologist’s office for last-minute briefings and health checks prior to my chemotherapy on Friday. (On the way out the door, one of my grandkids asked where I was going. I explained that we were going to my oncologist. They asked, “What’s a ‘honkologist’.” Luckily, we had enough time to compare and contrast a “honkologist” with an “oncologist”.)

My oncologist, Dr. Legant, answered our pre-infusion questions, checked my overall health, then we discussed my two options for chemotherapy-infusion methods:

1) Peripherally Inserted Central Catheter (PICC) line: an intravenous line, inserted at the inside of the elbow, with a thin, 12” tube that runs up the main artery in the arm, then connecting to the superior vena cava, which is the main coronary artery.

2) IV Port: an inch-diameter device surgically implanted under my skin, just below the right clavicle, with a thin tube that inserts through my jugular vein, then continues on to my superior vena cava (the heart’s largest blood-supplying vein). The port has a thin rubber membrane covering the center of the outer surface through which an infusion technician can insert a special “Huber” needle for the chemotherapy delivery.

I chose Option 1 (the PICC line) since did not require surgery, and thus, seemed less expensive. The PICC’s downsides, however, are that it requires weekly dressing changes by hospital personnel, it is more susceptible to infection since it extends outside the skin, and it requires a special cover while showering. None of those disadvantages exist for the IV Port, but I did want to save insurance expenditures for my employer wherever possible.

Next stop was to Dr. Murday, my sigmoid-colectomy surgeon. She declared my surgery incision well healed and indicated that Nancy and I need not worry any longer about any bandages for the incision. Next visit with Dr. Murday is a post-surgical re-check in July.

...Successful visits to my "honkologist" and my "sturgeon" (...Hmmm...there something "fishy" about that.)

Happy Easter !!!

Our dear friend, Kendra Peterson, pointed out that “No news is NOT good news when you are waiting for word on how things are going”…Sorry for the delay in updating the blog.

I had my first meeting on Friday, April 3, with oncologist, Dr. Patricia Legant. She indicated that we will probably begin my chemotherapy on Friday, April 24. That puts a month between my sigmoid colectomy, which occurred on March 25 and the start of the six-month protocol of chemotherapy.

Dr. Legant proposed the bi-weekly chemo administrations occur on Fridays so that I will have Saturdays and part of Sundays to bounce back and to reduce the potential impact on my work schedule.

My cousin, Kathy Crawford Carter, who has successfully survived her own battles with cancer from five years ago, gave me some great insight: “Lots of people will tell you how chemotherapy affected them or their friends or family. The one common thread that you can depend on is that chemotherapy affects everyone differently.”

I look forward to getting started, and getting done, with my treatment. So far, the surgery has been uneventful and relatively painless. I’m hoping that my otherwise good health and fortitude will bring me through the chemo protocol relatively unscathed, as well.

It’s been delightful to visit and play with all of my ten grandkids over the past few days. Nancy and I traveled down to Gunnison, Utah, on Friday for an overnight visit with our daughter, Sarah; her husband, Tyler Donaldson; and their two lovely daughters, Carolyn (age 9) and Julia (age 10 months).

I was honored to sing in our ward choir for our Easter program on Sunday. The good wishes, faith, and prayers from you, dear friends, family, and co-workers, are very generous and reassuring. My outcomes cannot help but be positive with that kind of wonderful support.

Love and best wishes to you all,

Dave and Nancy

Woo-Hoo !!! No Shampoo-ing for Six Months !

Short Story (Part II):

I’ll have chemotherapy beginning about the end of April…No shampoo-ing needed for a while . I’ll be fine.

Long Story (Part II):

Many people suggest that I have rugged, Vin-Diesel looks (http://www.imdb.com/name/nm0004874/), but unfortunately, I probably will look more like Michael Chiklis (http://www.imdb.com/name/nm0004821/) starting around May 1, when my chemo starts into full flourish.

I’m a “T3, N2, M0”

My surgeon, Dr. Murday, advised me today that my status is “T3, N2, M0”. Of course, I had no clue what that meant, so I requested enlightenment. She explained:

* “T” describes how far the main (primary) tumor has grown into the wall of the intestine and whether it has grown into nearby areas.

* “N” describes the extent of spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections.

* “M” indicates whether the cancer has spread (metastasized) to other organs of the body. (While colorectal cancer can spread almost anywhere in the body, the most common sites of spread are the liver and lungs.)

Numbers appear after T, N, and M to provide more details about each of these factors. Numbers that increase from zero indicate increasing severity.

“Tumor – T” Values:

T1: The cancer has grown through the muscularis mucosa (inner lining of organ) and extends into the submucosa (second layer of tissue).

T2: The cancer has grown through the submucosa (second layer of tissue) and extends into the muscularis propria (outer muscle layer).

T3: The cancer has grown through the muscularis propria and into the subserosa (organ’s outer fat layer) but not to any neighboring organs or tissues.

T4: The cancer has grown through the wall of the colon or rectum and into nearby tissues or organs.

My “T” value (which we knew prior to surgery) was “T3”.

“Lymph Nodes – N” Values:

N0: No lymph node involvement is found.

N1: Cancer cells found in 1 to 3 nearby lymph nodes.

N2: Cancer cells found in 4 or more nearby lymph nodes.

The lab results from my surgery indicated that of the 30 lymph nodes that Dr. Murday removed, 10 of the lymph nodes contained cancer cells. Therefore, my “N” value is “N2”.

“Metastasis – M” Values:

M0: No distant spread is seen.

M1: Distant spread is present.

We knew prior to surgery that I had no spread outside the colon, so I am “M0”.

Without my boring you with all the grading classifications, my specific classification is “3C”, which means primarily that my lab work turned up involvement of more than four lymph nodes, but without metastasis.

If you are interested in more details, you can navigate to http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp

Tomorrow, I go to my oncologist, Dr. Patricia Legant, for my first visit with her. We’ll find out all the “newspaper” answers (i.e., Who, What, When, Where, [we know Why], and How) for what’s ahead.

BTW, I feel GREAT ! The only pain I have feels like a minor sunburn near my incision. Onward and Upward !

Thanks for all your continued support !

Dave

"Home is Where the Heart Is"

(Kristina, thanks for holding up the blog postings since my last post here !)

Everyone, I’m sorry for being so lazy about posting here lately…I’ve been holding out for some tangible medical findings from the lab that tells us whether or not there is chemo in my future. But, after coming up empty with the surgeon’s office daily on the topic of lab results, I decided that I’ll just update the blog again when those results materialize.

In the meantime, as Kristie mentioned already, I came home from the hospital on Sunday, changed into church clothes and went to church. (The doctor said that I could go “home”, and since “Home is where the Heart is”, and since my heart was at church on Sunday, I figured that is where I should be.)

I’ve had hangnails that were more painful than the post-surgery pain I’ve experienced, and that’s without any pain meds. (I figured why pay for Ibuprofen if I have no pain.)

I’ve been doing a bit of work daily for my job at the LDS Church, and attending, via conference call, my morning briefings with my co-workers that are building the Church Unit Banking System (CUBS) application.

My daughter, Kate, is just leaving our house after having delivered my favorite meal, Beef Stroganoff. (Thanks, Kate…you made my day!) Dottie Jerman brought over a loaf of “Extreme Cinnamon Swirl” bread. Several of you have sent along greetings through the mail, over e-mail, and over the phone, all of which have brightened my day.

My next scheduled visit with my surgeon, Dr. Murday, is Thursday. She’ll “unstaple” me and see if everything holds.

Until then, thanks, all, for your kind support and best wishes,

Dave “Semicolon” Hunt

HE'S HOME!

More great news! My Dad came home from the hospital today! He is a little sore and a little tired but first thing he did when he came home is get dressed and go to church! What a guy! (I made sure he was only at church for an hour. I promise.) We are all very happy that he is home. We still do not have any news about the pathology but we are expecting to hear from Dr. Murday tomorrow. I am sure my Dad will post his own update and color commentary very soon. Thanks again for all of the well wishes and prayers -- (so far)THEY WORKED!

"When can I get out of here?????"

My Dad is still doing great! He is annoyed that the nurses come in his room "every 10 minutes" during the night to check his vitals and make sure his "output levels" are what they need to be. He wants to know when he can go home. My Dad has felt all of the love, support and prayers for him. He has enjoyed the cards, calls and visits. Thank you. I will post more information as it comes available.

Love to all,

Kristie

UPDATE!

Well I am happy to report --- Houston we have NO problems!

My Dad's surgery went very well. The surgery started a little later than expected but my Dad was headed to the recovery room at 2:00 PM. Dr. Murday said the surgery went as expected. She said there were no surprises or anything that was cause for concern. Dr. Murday took out the section with the growth and took the surrounding lymph nodes as well. We will not know the pathology until Saturday so we aren't sure if we are totally out of the woods yet but so far so good! Since this is my Dad's first experience with surgery we were all anxious to see him and confirm that he is okay. At around 4:00 PM the "transporter" wheeled him into his room and my Dad was very very sleepy. He fluttered his eyes open long enough to say "hi" then he was out again. His vital signs are strong and I am sure he will be up and looking for his computer in no time! I will post pictures as soon as I download them from my phone. Thank you for all your prayers and thoughts. I will keep you posted.

Love to all,

Kristie

Day-Before-Surgery Update…

I lied about, “Next installment…Surgery and post-operative outcomes.”…I’m slipping in this update before I show up for surgery tomorrow.

Today (Tuesday, March 24…the day before surgery) I went to St. Mark’s Hospital for “day-before details”: pre-registration, blood tests, and EKG. The surgery-scheduling office said that I must be to the hospital in the morning by 8:30 a.m., with “wheel in” to the OR at 9:30 a.m., surgery at 10:00 a.m., “wheel out” at 12:30 p.m. (and that’s if there are no hitches with whoever is in the OR ahead of me).

No food today…Only clear liquids…Nothing after midnight…No big deal – I’ve done that twice already this month for the other, previous diagnostic procedures. (And those of you who knew me when I was 260 lbs. know that I am fine with just ZipFizz for an indefinite period of time. )

Thanks to all those phoning up to extend good wishes !

Still having no worries or anxieties…Not my style to worry...

Next update here will probably be from my eldest daughter, Kristie, posting the post-surgery outcomes.

BTW, I understand that if you click to be a “Follower” of this blog (as my childhood buddy, Ginger, and my daughter, Lisa, have done), you receive automatic e-mail notices when we update this blog.

Best thoughts and wishes to all of you.

Dave

The "Adventure" Begins

Short story…

I have colon cancer…Surgeons remove the cancer on Wednesday, March 25, 2009…I’ll be fine !

Long story…

On Thursday, March 5, I went in for my triennial colonoscopy screening appointment with Dr. Peter Fenton, gastroenterologist. Following the procedure, Dr. Fenton came into my post-procedure cubicle at Intermountain Medical Center in Murray, Utah, to debrief the outcome.

Dr. Fenton explained (with a hint of his native Jamaican accent), “Mistah Hunt, the results of your colonoscopy concern me. We found a 2 centimeter by 4 centimeter lesion in your lower colon. We’ll have you in for a CAT scan today as soon as they can work you in. The CAT scan will tell us if the lesion has gone beyond the colon to other organs, including the liver.”

The look on Dr. Fenton’s face was rather grave, but I told him that the news did not worry me, and even if I keeled over tomorrow, I would go a very happy man, having done everything that my Father in Heaven and I had planned for my life. I explained that since both my father and grandfather died at age 52 from heart failures, that every day I survive beyond age 52, I consider to be “bonus days” in my life. So, I don’t worry about anything, no matter what the outcome of the investigations.

By late afternoon, the CAT scan was complete and my daughter and son-in-law, Kristie and Kevin Moreton drove me home.

Later that evening, Dr. Fenton called me at home, greeting me in his Jamaican accent with, “Mistah Hunt, I have ‘grrreat’ news and I have ‘fnntastic’ news for you…Which would you like to heah fuhst?”

I said, “Well, it already sounds wonderful…go ahead and surprise me.”

“The great news is that the lesion has not affected any organs outside the colon, including the liver. The fnntastic news is that you ah going to live happily for the next thihty to fohty yeahs.

“I’ve made an appointment for you to have an ultrasound this coming Tuesday, March 10th, with one of the two specialists in Utah that do that procedure on the colon. That test will show us how many layers of the colon the lesion has affected. I’ll also make appointments with a grrreat surgeon and an oncologist.”

Tuesday’s ultrasound at LDS Hospital with Dr. Oscar Batista indicated that the lesion had affected all layers of the colon and involved the fat layer just outside the colon. This indicates at least a Stage Two lesion. (We won’t know if the lesion is Stage Three until pathology results of the lymph nodes return following surgical removal of the affected area and the associated lymph nodes.)

A Visit With the Surgeon

On Thursday, March 12, I met with the gastrointestinal surgeon, Dr. Michelle Murday. Dr. Fenton says that he has known Dr. Murday for many years and has total confidence in her abilities. My visit with Dr. Murday reinforced Dr. Fenton’s assessment. She is very professional and took the time to answer all of my questions.

She indicated that the colonoscopy and ultrasound results indicate removal of about a foot of lower colon (sigmoid colon) and the attached lymph nodes to ensure removal of the malignant tissues. Pathology on the lymph nodes will indicate whether or not I will need chemotherapy following ablation of the affected area.

I had several questions that Dr. Murday answered to my complete satisfaction:

Q. What protocol does my case indicate?
A. The protocol, in chronological order includes:
Laparoscopic ablation (surgical removal) of the section of the colon for several centimeters above and below the lesion, including the attached lymph nodes.
Biopsy of the lymph nodes to determine if any malignancy has traveled beyond the colon (Stage 3).
Chemotherapy if the lymph nodes show any malignancy.

Q. Who, among my immediate family members, should have screening for this same issue?
A. Siblings and children should have screenings at least every five years, beginning at age 40.

Q. What is my prognosis?
A. Stage 2 statistics show better than 80% survival beyond five years; Stage 3 survival is 60%-80% beyond five years. (If I had a 60% chance of winning the lottery, I’d certainly buy a ticket. ) Dr. Murday confirmed that my prognosis is excellent.

Q. Since I have no direct-line family history of cancer of any kind, how did I end up with this challenge?
A. Cancer results from some variety of cellular mutation. There is a specific genetic defect called KRAS. If you had that particular gene, then you and your children would have a 100% chance of developing colon cancer by age 40. Since you did not develop this lesion by age 40, then we can rule out that specific genetic defect.

If the mutation is not genetic, then the mutation is environmental. We are finding that typical causes of environment cell mutation seems to occur with incidence of animal protein consumption and not enough consumption of dietary fiber, fruits, and vegetables.

Q. What should I expect immediately following surgery?
A. Perhaps 5 days in the hospital, then a month of home recovery prior to return to work.

Q. What follow-up procedures can I expect?
A. CEA (CarcinoEmbryonic Antigen) blood tests each quarter for two years; semi-annually for the next 3-5 years, then annually after five years. Also, regular colonoscopies are in order.

Q. When and where is my surgery?
A. Surgery is Wednesday, March 25, at St. Mark’s Hospital (1220 E. 3900 South, Salt Lake City).

My Thoughts About this Adventure

First, I have spent not even one moment worrying about these procedures and my future…Worry doesn’t solve a thing, and it can actually have a negative effect on medical outcomes. Wonderful professionals are treating me, and I have total confidence in their skills.

Nearly immediately following the initial findings, I spoke with my MD uncle, Dr. A. Hamer Reiser, Jr. He properly advised me that my first medical procedure should be a Priesthood Blessing from Melchizedek Priesthood holders. I was honored and blessed to have that procedure from dear friends very early on. Participants in that blessing received confirmations of the efficacy of that blessing for my full recovery.

Frankly, my major concern at this point is for the health of my contemporaries. At the time we received this diagnosis, I had no symptoms and there is no direct-line family history of any cancer. We discovered this challenge because I have received regular screenings that people should have at specific ages.

My dear friends and family, have age- and gender-appropriate cancer screenings! Please e-mail me, or call me, if you have any questions or concerns regarding your own screening.

Where We Go From Here…

If you have questions, please feel free to contact me at my e-mail address.

Next installment…Surgery and post-operative outcomes.