Thursday, October 22, 2009

Two weeks into treatment

Since my last entry, I got my MRI results, which the doctor says are "inconclusive." The multiple lesions on my liver are between 2mm - 5mm in size, which is smaller than a 6 mm pencil eraser. No cancer lit up in them even with the MRI. But due to the small size, the doctor won't rule out cancer within them. The only way they will know for sure if the lesions aren't cancerous is if they react to my chemotherapy. So they will watch for a reaction. If they don't change, then they are benign. They might either be from a past infection I may have had, or from a hereditary condition that causes such lesions. I am hopeful that either of these are the case, and that the only cancer in my liver is in the right lobe where they found the metastasized tumor.

I also found out who my surgeon will be at UNC, and I got my first choice, Dr. Benjamin Calvo. My initial visit with him is scheduled for November 30th. And I'm certainly looking forward to getting his opinion on how my treatment has been administered thus far and if he suggests any adjustments.

The chemo and radiation treatments so far have been extremely time consuming and I am starting to feel side effects of nausea, heartburn, sore throat, skin irritation, but I also can tell that the rectal tumor is shrinking, and the bleeding has almost subsided. Most of all, the pain caused by the rectal tumor has been significantly reduced.

And finally this past week I have been so touched by all your emails and the special ways that some of you have reached out to me. I wish I had time to answer each email personally, but there just isn't. But know that each comment and email gets read, and that they certainly lift my spirits. Please keep them coming.

Thursday, October 8, 2009

1st day behind me...

Today started at 8 am with an MRI, ended with 3 minutes of concentrated radiation on my rectal tumor, and large doses of chemotherapy between them. I got home about 4:30p, exhausted. So I took a nap with my new friend, this chemo drip device that is operating on me 24/7. Fortunately, I return it on Fridays, getting the weekends off. So I can go to my nieces wedding on Sat device free.

Feeling no sickness yet. A little queasy, but not bad. I get the MRI results by Wed. It'll tell if I have any cancer in the left lobe of my liver that was too small to see on the other scans. Currently, we know I have a 3cm tumor in the right lobe of my liver. If it's already spread to my left lobe, that would be very bad news for my prognosis. Best case, it hasn't gone to the left lobe yet, and my chemo treatments keep what is there at bay until surgery.

Wednesday, October 7, 2009

How Did I Get to Stage 4 Rectal Cancer without Knowing I Had Cancer Sooner? ....A Warning About Hemorrhoids

My name is Stacy Kagawa. I am 41 years old and about 6 weeks ago, I was told for the first time that I have rectal cancer. What's more, I soon learned that my tumor had been there for years, and it was at stage 4, meaning that it had spread, and I now have two tumors. The second is in my liver.

Tomorrow I begin my chemo therapy and radiation treatments. I have set up this blog so that I can share my story with my friends around the nation, and keep them updated on my progress. But I also want to share my story with others, as they might learn from it. I was misdiagnosed, having been told for years that I have internal and external hemorrhoids. As it turns out, it seems that my internal hemorrhoid was actually a cancerous tumor. Here I willingly share the gory details of my doctor visits. Hopefully, I save someone from the misdiagnosis that I experienced. Certainly, if my cancer were caught sooner, I probably would not have it in my liver today.

I gave birth 4 1/2 years ago. A common side effect of giving birth is hemorrhoids. I had hemorrhoid like symptoms (emphasis on the word symptoms) after giving birth, and did my best to treat them. About 5 months after child birth, the pain was unbearable, so my primary care physician referred me to general surgery to have a look. It only took a moment for the general surgeon to take off his gloves and say, "We're done here." He could not follow through with the examination as I had developed a fissure. A fissure is a nasty repercussion of anal pain. It is a tear in the anus. (Here come the gory details). When pain occurs in the anal cavity during a bowel movement, the sphincter muscle can react by tensing up. The rectum responds to excavate the bowel movement. In essence, the two muscles go to war. And the rectum always wins in the end. Over time, a fissure is inevitable if the pain is not put under control. Once a fissure occurs, a doctor generally will not perform any anal scope, as they do not want to tear the anus any further. My fissure was moderate in size, and took approximately 6 months to fully heal, as they do not heal readily. Botox injections were used to relax the sphincter muscle. Multiple baths were taken daily. And passing a bowel movement felt like passing glass. It was no joy ride.

I was 37, almost 38 years old at the time. Because of my age, the doctors seemingly never considered that I might have a rectal tumor, which in hindsight is probably what was causing all that pain. And the external hemorrhoids that I did have, along with my age, served as a smoke screen to the fact. The doctors told me that my external hemorrhoids were the source of my pain, and that internal hemorrhoids generally do not cause pain. Having just given birth, this all seemed reasonable to me. After several follow-up visits, I eventually was told that the fissure was healed. I was told to be diligent about treating my hemorrhoids, given instructions on how to do so, and was discharged from care. As my external hemorrhoids and fissure were deemed the source of pain, the doctor never scoped me internally. If I could go back in time, I would make sure that the doctor looked at the internal hemorrhoid(s) too. Here comes the moral of this story, if you are diagnosed with internal hemorrhoids, insist that your doctor perform an internal scope.

Four years and five doctors later, a doctor finally had enough precaution to perform an internal scope. He didn't have to even use a device. He simply touched it and immediately knew it was a tumor. Knowing that I was under the impression that he was inspecting a hemorrhoid, the doctor put it as tactfully as he could. "If you were 10 years older," he said, "I would tell you that you probably might have cancer. We need to schedule a biopsy." I was too stunned to reply. I thought, "Did he just tell me that I have cancer?" The biopsy confirmed it. Several tests later, I underwent a second biopsy, this time of my liver. And tomorrow, I start the fight.

For those of you who know me, let me fill you in on the surgery details, as I know some have questions about that. One week ago, I was told that I had to choose a new surgical oncologist. Since the cancer had spread to my liver, my hospital has no surgeon qualified to handle my case. I was told that I could go anywhere. I decided to go with the team of doctors at UNC. Mostly because they are certainly qualified and furthermore, they have an established a relationship with my current hospital. Thus, the protocol and communication is already set-up. I feel that time is of the essence for me at this point. If I had decided to choose Dana Farber in Boston, which I had strongly considered so that I could be nearer to my family and old friends, then I might loose precious time on treatment. Time is something I just can not afford. For those of you who are die-hard Dana Farber advocates and feel that I should go nowhere else, I'll provide a link for UNC, and leave you with this. John Edwards' wife is being treated at UNC. It is one of the best places to go.

So please keep me and my family in your prayers. Studies have proved that cancer patients with a strong faith have better odds at winning their battle. So pray for my faith as well, as I haven't been as close to God as I once was in the past. These events should correct that. Also know that I am determined to win this battle.

Check back to my blog from time to time. I hope to include some interesting links, as well as update my progress.

Warm Regards,