Creatures of Habit

Kevin went in for scans again this past week. It’s been two months without any treatment and three months since his last scans so we were kind of prepared for anything.

The appt with the Orthopedic Surgeon went very well. The hip area has healed great – actually much better than anyone could have predicted. Kev’s mobility is still pretty limited though and the surgeon recommended some physical therapy to strengthen the joint. I think his fatigue and neuropathy problems have lead to a fairly sedentary lifestyle and without exercise he has never re-strengthened his hip joint. So hopefully he follows up with that.

The meeting with the Oncologist went equally well. The CT scans indicate most tumors have remained stable, a few actually decreased in size and a couple grew. This is pretty consistent with his last few scans. Maybe there is some residual effect of the treatment (Abraxane/Nexavar) still helping. …None the less, we are off on a new path…The oncologist is recommending a new treatment – Ipilimumab. It works on a new premise – It’s designed to block the activity of cells that decrease the immune system’s ability to fight cancer. In other words, it is hoped that this will help Kev’s own immune system to search out destroy the cancer cells. It is an experimental treatment targeted at specifically Stage IV unresectable Melanoma patients and there is a series of screening tests that must first be passed, but at this point it is expected he should qualify. Of course, the new treatment comes with the usual of side effects…

The Neurosurgeon delivered some unpleasant news. The MRI shows a new wedge-shaped tumor and an accumulation of blood products in the right inferior frontal lobe (forehead area above right eye) of his brain. This is the same area that was “zapped” last year, so either the laser treatment didn’t work as well as we all thought or coincidently a new mass is growing near where the other was. The blood products are consistent with melanoma. It was agreed that the tumor should be removed as quickly as possible and so Kevin is scheduled for surgery on Wed Mar 5. We’re told they have to cut through the skull again, but this time instead of a nice scar hidden on the side of his head, it will go across his forehead – Frankenstein style or maybe a more stylish Harry Potter fashion…

People say you can get accustomed to just about anything. Habits are habits and repetition makes even the most extraordinary events seem ordinary. When you are first thrown into the world of cancer what follows is nothing short of chaos. Everything is strange and unknown and then there is always the looming threat of death around every corner. But you soon realize that you can not survive living like that day-in and day-out, year after year and somehow you adapt. A new nominal is derived and you soon forget about the other side. The scans, appointments, treatments, and surgeries all become commonplace events. Part of it also may be that it is not so unknown anymore. MDAnderson is dedicated to cancer research and treatment. They’ll care for 80,000 people this year. At each appointment we are entirely surrounded people treating or being treated for cancer. We know all Kev’s Drs. and nurses very well. We know about their families and their hobbies, as they know ours. We know the routine – the 5 am arrival for surgeries, the appointments with the anesthesiologist the day before, the special anti-nausea cocktail to counter the effects of the anesthesia, the pre-op procedures, the special waiting room for the more complex surgeries, the post-op procedures, and the likely transfer to the Critical Care Unit for observations “just in case”. It’s all very routine now.