February 8, 2011

Light at the End of the Tunnel

Sue, sister-in-law of Dennis, sending an update from Irvine

Friday morning I accompanied Dennis & Lieska for his weekly visit to the social worker, N, at the Hoag Cancer Center who has served as an invaluable counselor and advocate throughout his treatment. The antibiotics had started working so he was feeling better physically than he had earlier in the week. However, he was at a low point emotionally, and he was very unhappy with certain radiation treatment logistics. I listened with a sinking heart as he told N that he was ready to quit treatment altogether if certain things could not be arranged to his satisfaction. He was so fed up that he felt ready to walk away and just let things run their course.

My observation: Dennis had been hanging in there while treatments went as scheduled, even though they were brutal. But when the infection derailed the plan he felt he had lost control of things and he went into a downward spiral in attitude.

N volunteered to contact the radiologist about his concerns. Then she reminded him of something we all “know” but often don’t fully comprehend – namely that the only thing in life we can actually control is our response to things. She challenged him to spend time over the weekend relaxing, enjoying the break from treatment, and contemplating his responses to the uncontrollable events swirling around him. N gave him a way to reevaluate and gently “whupped his ass.” (I’m quoting Dennis here…) He needed it.

Dennis had a quiet weekend. No doctor appointments, not even hydration, so he had plenty of time to rest and think. And the antibiotics continued working…so he continued to feel better.
Monday morning was an appointment with Dr. Q, his oncologist. She looked him over and asked some questions about how he was feeling physically, and she literally danced a little jig to express how pleased she was with his state of health at this point. The infection was really cleared up, and she recommended restarting radiation immediately, as in that afternoon directly after hydration. She stated that she would schedule his final chemotherapy session for Thursday. Dennis looked to me to ask the questions we had written down (although he can speak sometimes, it is a great effort and he pays a price).
  • Can this radiation logistic be arranged to fit my needs?
  • Can the final chemo be eliminated or done at a reduced dosage?
  • If I choose to discontinue treatment at this time, how will that affect my prognosis?

Dr. Q left the room to call radiology personally to verify logistics. She said Dennis was in charge of deciding to have the final chemo or not, explaining that its purpose is not to kill the cancer cells directly. If you recall, after radiation began, the chemo treatments changed from three drugs to one. This single drug works to radio-sensitize the cancer cells so that the radiation targets them and kills them more efficiently. She advised that for the best result he should have the final chemo, but that it would be OK to reduce the dosage. I held my breath waiting for his answer: “OK, let’s do it.”

Lieska stayed with Dennis during hydration (which included the final dose of antibiotics as well as an antiviral to help with mouth and tongue sores) while I drove home to pick up his anxiety medication to help him tolerate the radiation. We made the drive from the doctor’s office to Hoag Cancer Center with no time to spare.

Enroute my daughter called to see how things were going. She was surprised and delighted to hear that he was going to have a radiation session in about five minutes. I’m sure you all join in her message: “Go kick some cancer booty, Uncle Dennis!”

And now just 8 more radiation treatments to go…