Oct 1, 2009: Bill's treatment plan

Again, thank you with all our hearts for caring enough to check here! We are so touched that you care.

We got home this afternoon from the big meeting with our Urological Oncologist Dr. Walther at Duke University. We got the results from the transurethral bladder tumor resection and the pathology report, from last weeks' surgery. We are very happy with the speed at which Dr. Walthers has kept things moving.

Okay, so...

Bill has the most invasive and the most aggressive form of transitional cell carcinoma and carcinoma in situ--all highly aggressive/invasive, and many of them all over his bladder. "Life threatening, high potential of having spread as micrometastasis (metastasis which doesn't show up right away on x-ray), not a trivial situation," said Dr. Walther, according to my notes.

He will have to have FOUR MONTHS of chemotherapy in Boone before they will even do the surgery to take out his bladder. Click this different-colored text if you want to see a page that carefully explains what his chemo will be like.

The schedule is tentatively something like this: starting as soon as humanly possible, like next week, Bill begins 4 one-month chemotherapy sessions. Between each session, they test him until his blood returns to normal, then begin the next session. This could cause delays.

After the four-or-so months, he gets one month of rest, to strengthen his body for surgery.

Then sometime in March or thereafter, whenever his body is ready, he gets the whole shebang's worth of tests again to see if any cancer is still in there, then he goes into surgery for a "radical cystectomy."

That surgery takes EIGHT HOURS, [Hep me, Jeeeesus!]and comes with many potential complications. He will be in the hospital at Duke about 2 weeks, and cannot return to normal activity for two to three MONTHS! OMG!

That surgery will occur at Duke in the hands of Dr. Walther, next spring.

If, during that surgery, they find any new pop-ups of cancer, he will have MORE chemotherapy, after he recovers from surgery, and that chemo will occur, presumably, in Boone.

He will not be having radiation. Dr. Walther feels that radiation has such drastic effects on that part of the body that it renders surgery extremely difficult.

For those of you who google or follow chemo drugs, Bill will be getting Gemcitabane and Cisplatin.

Bill's number one thought is that he so desperately wants to continue teaching at Appalachian. He loves it so much, he said. He is trying to work out a chemo schedule that will allow him to finish this semester normally at Appalachian, while getting his chemo on Thursdays, allowing recovery time until his Monday classes. He knows that the spring semester of 2010 is impossible, but hopes to return, completely cured, in the fall of 2010.

That's pretty much the summary. If any of you want details, do feel free to email me! At this point, I'm pretty much not doing anything but taking care of Bill, and making all this stuff happen, with him.

Bill's attitude is pretty good. He was kind of stunned today, as was I. Neither of us expected to hear about chemo. We thought he would almost certainly get a cystectomy next week (bladder out), so this is all kind of a stunner.

I didn't know to be googling about chemotherapy, so I only made myself an armchair expert on bladder cancer, alone. But by this time, next week, I'm going to know a lot more about the chemo--God willing and the creek don't rise, as they say down here.

Thank you, thank you, thank you for your love and prayers and light and thoughts and good wishes. Hugest, most profound gratitude.

God is good.

Love,
Beth