Cyndi Duprey

In December of 2015, I developed hematuria (blood in my urine).  I initially had some urinary discomfort, and started an antibiotic. When it did not clear after a few days, I approached my doctor (employer, co-worker, and friend) who suggested a CT scan. Well sure enough, on 12/22/2015 a scan revealed a mass on my right kidney. I went to a surgeon who suspected urothelial cancer. This is a cancer arising from urothelial cells which line the bladder, ureters and into the kidney. So, on January 26, 2015, I had my kidney, ureter and a small part of my bladder removed. I thought initially that would be the end of it, but pathology showed some invasion into the renal parenchyma.. My tumor, which I hoped was a Stage I or II, was now a Stage III. Fortunately, I work in oncology with many wonderful doctors. After much discussion and conversation with a doctor at Duke, we decided to proceed with chemotherapy. You see, this type of cancer in the upper tract is generally high grade  and has a high risk for recurrence. It is also poorly studied so it is treated like bladder cancer even though it is more aggressive. Although protocol still dictates a watch and wait approach, my age and relatively good health prompted us to go forward with 4 months of chemo to increase my overall outlook. I won"t go into too many details about chemo as anyone who has it knows how difficult it can be. But I made it through. Lots of nausea and lost most of my hair But hair grows back. And it did. Curly and gray! Chemo finished in June 2016, and  excited that this would be behind me, I returned to work as an Oncology NP. Work can sometimes be the best medicine. Not only do I love my job and what I do, but I absolutely love the office where I work. I am blessed to have so many caring  people in my life!


In September, my first surveillence scans were clear. No evidence of a recurrence. Yay! Mark and I went on a fabulous trip with fabulous friends to Boston and Maine. I was feeling good. My energy level was improving, my hair was growing and I had adopted  a mostly vegetarian diet to keep myself healthy. Unfortunately, my next set of scans, January 3, showed a new soft tissue density where the kidney used to be. A PET scan was ordered which confirmed this to be  most likely a malignancy. If you aren't familiar with PET scans, they basically "light up" areas of hypermetabolic activity, like cancer which grows rapidly. Well, it lit up. After more discussion with what I call the dream team, my oncologist and the 2 wonderful docs I work with, I was set up with a surgeon at Emory to evaluate if the tumor could be surgically removed. I met with him today and he described how big the surgery would be with lots of down time. He also wanted to wait to see if the new drug I started last week would prevent any further progression. I started on atezolizumab last week. It is immunotherapy, specifically a PDL-1 inhibitor, which will allow my own immune system to fight the cancer. It is given every 3 weeks intravenously. Fortunately, there are few side effects with the biggest one being fatigue.  So that's that. 
 
i'm not sure how to eloquently say how much this sucks! Or how I feel my body has betrayed me. I think I have earned the right to be a little mad about it and even a little sad. But those of you who know me, know that won't last long. I will continue to smile.  I will keep on fighting it. I will do as I am told. I will take my medicine. I will continue to eat clean (except for wine, let's be real). There may be surgery or chemo in my future. but for now, I will continue living. I will work and spend precious time with my family and friends. I will keep you posted.