Sandi Sapp Sandi's Journey

First post: Jan 6, 2019 Latest post: Jul 16, 2020
Welcome to Sandi's CaringBridge website.  As she begins a journey of hope and healing, we wanted a way to keep family and friends updated along the way.  We appreciate your prayers, support and words of encouragement.  Thank you for visiting.
On December 10th, Sandi was diagnosed with lung cancer (unstaged at that point).  A little background leading up to her diagnosis... In April 2015, Sandi was diagnosed with stage 1 breast cancer in her right breast and underwent a lumpectomy and radiation therapy.  She has since had yearly follow ups with her oncologist without any concerns.  
This past November, Sandi was having soreness under her right breast and made an appointment to see her oncologist right away.  Her doctor wasn't convinced that it was breast related, but was concerned and ordered for her to have a PET scan done.  The results showed three questionable spots on her right lung and a very small spot on her left femur (thigh bone).  From there, Sandi had a biopsy of the area that had been the source of her discomfort.   This "mass" is located on the outside of her lung in her pleural space (between her lung and chest wall).  During our visit with the oncologist on December 10th, he informed us of the biopsy results, which was adenocarcinoma.  As you can imagine, this was extremely difficult news to take in.  Her doctor was optimistic regarding her treatment options, especially with the strides that have been taken with lung cancer treatment over the past few years and the fact that Sandi is otherwise in good health.  He was still left with questions at the appointment and was needing more test results before staging the cancer and discussing a treatment plan.  Lung cancer often travels to the brain, so he ordered an MRI of her brain for the following week and another appointment was made to see him in two weeks to discuss results.  Those weeks were very difficult for our family as the waiting for answers and fear of the unknown was starting to take over.  Thankfully, the results showed nothing in her brain!  
During those two weeks, Sandi's oncologist attended a conference with several other physicians (surgeons, pulmonologists, radiologists, etc.) where he presented her case.  The consensus from everyone was that she was not a surgical candidate - First, due to the location of the mass that had been biopsied, surgery would require removal of part of her chest wall.  Second, the location of the "2nd" mass is towards the top of her lung and too close to her heart to risk removing it (it is my understanding that this mass is also on the outside of the lung).  Lastly, the tiny spot that showed up on her femur during the PET scan didn't have everyone convinced that it could be cancer, but there's no way of knowing (there were no signs of bone breakdown, therefore no way of knowing where to biopsy the bone).  The physicians agreed to treat as if the area on her bone is cancer (this would mean staging the cancer at stage 4, which takes surgery off the table).  Stage 4 lung cancer means that the cancer as spread to another area of the body.  Again, we do not have a clear confirmation that this is the case with Sandi, but it is best to treat as stage 4.
Where do we go from here?  Now with a better understanding of what we are dealing with, we were able to discuss treatment options with the oncologist.  He first wanted to biopsy the second mass just to know for certain that it is the same cancer.  There hasn't been a lot of discussion about the third spot in her lung except that they are unable to biopsy it due to its location.  Sandi's treatment plan is as follows, a combination of chemotherapy and immunotherapy given through infusions every 3 weeks x 6 cycles.  After the 6 rounds, the chemo will be complete and the immunotherapy will continue as long as needed.  Immunotherapy is fairly new and has proven to be a great treatment option for cancer patients.  Unlike chemotherapy, where the drug looks for and attacks fast growing cells (cancer), immunotherapy boosts a person's immune system to make their body fight the cancer.  We hope to not see side effects from the immunotherapy, however, the immune system can become overactive and sometimes attack healthy cells, which could then manifest into illnesses like pneumonia or bowel problems.  Sandi will be monitored closely throughout the treatment process to try to avoid these complications.  Also, after the third round and after the sixth round of chemo, she will have scans to see if the cancer has decreased in size (this is obviously the goal).  If the doctor doesn't like what he sees, he will change the course of treatment. 
At the end of December, Sandi had the biopsy of the second mass done and received her port (access for chemotherapy/immunotherapy).  The results of the biopsy did come back as cancer, but there was some question with the pathologist as to whether her cancer could be related to her previous breast cancer.  I was not present during this discussion and am not certain what this fully means, but we will hopefully get more information at the next appointment with the oncologist.  The plan from there was to receive chemo education and begin treatment on January 4.  Sandi will also have blood drawn on a weekly basis, receive injections to strengthen her bones, and has been put on a few new medications (supplements, vitamins, and as needed antibiotics and nausea medication).  A common side effect of the treatment will be nausea and she will be more susceptible to infection, so she will need to be diligent with hand washing.
Sandi does plan to continue working (part time) and keep up her normal daily activity the best she can.  There's no way of knowing how she will feel until treatment is underway.  But she is very determined to not let this get her down! 
We all appreciate your love and support through Sandi's journey.  Those that have reached out and asked about how you can help or what you can do... we don't really know what is needed at this point.  I can tell you this...your prayers mean everything.  For her mind, body and faith to stay strong.  For her doctors and nurses to do what they do best.  For her body to respond well to the treatment.  For her to beat this.   

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