Duane’s Story

Site created on April 29, 2019

Kelly and I greatly appreciate all the love, support, thoughts, and prayers being sent our way since my diagnosis of cancer. We receive a lot of messages from people checking in to see how I am doing. At times, things are rather hectic, and our friend Joelle Brouner suggested Caring Bridge as a simple way for us to post updates and for you to get a quick update or learn more about how my journey with cancer is going.  Our daughter Andrea set things up for us and will help us with updates.

 

A couple of months ago I was diagnosed with squamous cell cancer of the bladder. This is my second run-in with bladder cancer. About three years ago I had surgery to remove a tumor as well as a portion of my bladder.  After learning of this second diagnosis, my urologist explained that it was very fast-moving and deeply invasive and that squamous cell cancer cannot be treated with chemo or radiation. The biopsy of the tumor in my bladder was done in Olympia, and reviewed by a radiologist here.

 

I chose to go to the University of Washington Medical Center (UWMC) to receive the care and treatment needed.Fortunately, the doctors at UWMC felt they wanted their own radiology team to analyze a sample of the original specimen used for the biopsy. UWMC determined the original diagnosis was in error and that I actually had urethral carcinoma, a much more common type of bladder cancer that can be treated by chemotherapy. UWMC works together with the Seattle Cancer Care Alliance in their cancer care treatment to ensure they are bringing the best experts in the world into my treatment program. I have the utmost respect for everyone on my treatment team.

 

It was determined that I had Stage IV bladder cancer. Because the tumor was too large and cancer was also detected in the prostate and lymph, surgery was not likely to successfully remove all traces of the cancer.  So instead, I am starting my treatment with chemotherapy, with a goal of shrinking the presence of the cancer enough to surgically remove it. Chemotherapy is scheduled in 3 week rounds, and I will complete 6 rounds.  A cycle includes a treatment once a week for the first two weeks, with the third week off.  It will take 18 weeks or so, and I will get a CT scan halfway through to assess how well the treatment is working.

 

Presuming the chemotherapy does its job, I will need a pretty major surgery. The surgery to remove the bladder, prostate, and lymph, and do some reconstruction to deal with the loss of these organs is estimated to last around 6 to 7 hours. It poses plenty of risk, but we have the best team of physicians around and they are completely committed to a full recovery.

Newest Update

Journal entry by Andrea Moore

So, a lot has happened since we last spoke.  So much that this is the first time I have had the time and energy for an update.  Fortunately, that translates to Duane’s improving health after a really rough few weeks.  He’s not totally out of the woods, but he worked for several hours today and ate half a turkey and cheese sandwich for lunch and a good helping of Pad Thai and Fried Rice from Narai for dinner (many thanks to Rob and Shirley for the gift).  It really is the little things that matter now – eating, resting, eating, working a little, eating…you get the point.  Duane has really struggled to have an appetite after a long episode of dealing with one infection after another.

For those who want the bottom line…Duane’s chemotherapy has ended.  Chronic infections and the need for heavy duty antibiotics, in combination with chemotherapy, was just too much for Duane to tolerate and so his treatment was discontinued with one round left not done.  He is still scheduled for surgery on Sept. 4, and between now and then will get a number of tests to confirm it’s a “go.”  The surgery is to remove bladder and prostate, and to do some reconstruction.  I’m still a little sketchy on the exact nature of the reconstruction, but we have not had pre-surgery consults yet.  Duane’s main task is to rest, gain strength and gain weight.  Today was a good one that in all those regards.

For those who want the details…I’ll try to remember.  I must admit that you kind of go on auto-pilot to make it through the days and fall into bed, and looking back it’s blurry.  At the halfway point in treatment things looked good and CT scan showed good progress.  Near the end of Round 4 Duane got a UTI and had to go on IV antibiotics.  Antibiotics and chemotherapy is a nasty combination and Duane just did not feel well – and to make matters worse it was a two-week dose.  Duane even asked to skip a treatment around this time, but his oncologist advised him not to do that, but they did give him a blood transfusion as a bonus for effort.  Blood can help with feeling tired and weak.

Somewhere in Round 5, and before he had completed the IV antibiotic for a UTI, another infection was confirmed.  This one was an intestinal infection called c-Diff, which can be contracted from overuse of antibiotics.  Ironically, the treatment is another antibiotic. 

Duane started this antibiotic on the day of our annual Block Party.  He was able to make a brief  appearance at the party (which he largely organized with help from the neighbors).  Let’s just say he was not the life of the party and afterward he went to bed and stayed there for 5 days straight.   This infection was brutal, and Duane was too sick to even eat or drink much at all.  On Day 6 on the antibiotic he started coming around.  But by this point it was 2 days until his next treatment.  When he got his lab work it was clear that he was not having treatment.  He did, however, get another blood transfusion and an infusion of potassium.  Needless to say, chemotherapy is done at this point.

Over the last week, Duane’s been slowly but surely improving.  He still struggles with appetite, but he is eating and drinking enough to help him recover now.  He has a number of tests and procedures between now September 4, and our surgical consult is August 22.  We’ll meet with the amazing Dr. John Gore, Duane’s surgeon.  We consulted with him at the very beginning of the journey when Duane got his diagnosis, and we both felt completely confident in him after only a short consultation.  The UW surgeons and whole medical team are the best of the best.

Because Duane’s immune system is at a low point, we’ll be mostly laying low, resting, going to multiple medical appointments in Seattle, and getting ready for surgery.  Andrea and Eric will be coming up to be here and help during the week of surgery so we’re looking forward to having them home soon.

Duane has conquered one major milestone, and is preparing for what we hope will be the last.  Many thanks go out to all our neighbors, family  and friends for the love, support, soup, fresh veggies, and gifts of food.  We love you all!

Kelly and Duane

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