First of all, Joe was diagnosed with bladder cancer back in 2009. Dr. Eyer (?) was able to remove the cancer (I believe this was done via cystoscopy) and Joe followed up with 6 weeks of a chemotherapy treatment that was injected into the the bladder. He has had regular check ups with the doctor with the most recent being this past July and everything is clean.
On July 28th, Joe had an appointment with Dr. Zito because he was having some difficulty breathing, he was getting dizzy, and was losing weight. He did not "feel" right. An X-Ray was done which showed a shadow in the chest area.
July 31 a CAT Scan was done at Faulkner which showed a large mass on the aorta, esophagus, lung and left artery.
August 1st an MRI was done at Faulkner.
August 3 a breathing test was done at Faulkner.
August 4 a Consult with Dr. LaHive regarding a Bronchoscopy at Faulkner
August 5 an appointment with Dr. Belkin, a vascular surgeon, at B&W and results were fine.
August 7 a PET Scan was done (head to thigh).
August 11 Bronchoscopy was complete at Faulkner by Dr. LaHive that was inconclusive. She tried to get some samples, wasn't good enough.
August 17 Ultrasound was done at B&W on legs and neck and everything was ok.
August 18 another breathing test at Faulkner without oxygen (?) which allowed a script to be done for Joe to get oxygen at home.
August 25 appointment at B&W with a Thoracic Surgeon, Dr. Weiner. At this point, Joe has lost about 40 lbs since May and is having difficulty breathing and is in pain, particularly in the morning. There was a rehashing of how this all started, and a review of the tests as well as reviewing how Joe was feeling at that time, Dr. Weiner indicated he was pretty confident its cancer, presumably lung cancer. His concern was on the PET scan as it appeared there was something on the adrenal gland. Recommended a biopsy, and if it comes back as cancerous, then it's stage 4 lung cancer. A biopsy was scheduled, a script was created for pain medication and a consult appointment was scheduled at Dana Farber.
Sept 3 the biopsy was done at B&W with CT imaging. Thought Joe would be knocked, but he wasn't. Very painful and had to stay in recovery for 4 hours. It got pretty bad and he needed pain meds and oxygen. The Doctor who performed the biopsy indicated they got 6 good samples and it would take 5-7 days for pathology results.
Sept 8 consult at Dana Farber. Dr. Braun came in to make sure he had all the correct info and we walked through the whole process again (from Jul 31 through today) as well as Joe's history (family, COPD, emphysema, peripheral artery disease, bladder cancer, etc.). Talked about the current symptoms of breathing difficulty, pain, coughing, phlegm and difficulty eating. Doctor suggested taking the pain medications now - don't know how much pain you're really in until you are not in pain. Take the Boost 3 times a day and get as many calories as possible (mac & cheese, ice cream, soup, etc.). And no results yet on the adrenal gland which is critical. The pathology does show cancer cells, but they have to "stain" them in order to determine the type of cancer. Dr.Braun left to consult with the medical oncologist Dr. Jackman. Dr. Weiner came in to say no results on biopsy although, again, fairly confident it's lung cancer. Asked if this could have come form the bladder cancer, he said probably not, he's never seen it behave that way. Typically, lung cancer goes to the liver, adrenal, and brain. He encouraged, strongly, taking the pain medication. Reducing the pain will, hopefully, provide more energy to move around. Dr. Weiner said he is handing the case over to Dr. Jackman. Dr. Weiner will be involved if any surgery is required. Dr. Jackman and Dr. Braun came in. They explained that the goal is to now help Joe feel better and live longer. Given what they know now, they feel it's cancer and it's advanced and most likely it is lung cancer. Need to know from the biopsy if it's Non Small Cell Lung Cancer or Small Cell Lung Cancer. Both grow differently and would require different treatment. They are very concerned about whether Joe is strong enough for any treatment. At this visit, he needed another Tylenol and oxygen. He gets very "stressed" when he has to talk too long, particularly when he's trying to make sure he is communicating what is important. Can't get rid of the cancer, but will try to make him feel better. They believe it started in the lung and went to adrenal. A CT Scan was scheduled at Faulkner for next day to check on the lung, make sure there isn't a blood clot, and check out any other areas. An appointment for another consult is scheduled for next Tuesday at Dana Farber. Once again, encouraged taking the pain medication.
Sept 9 - Joe took the Oxy last night and slept better. Joan is getting him out today to move around. Roche Brothers has tables and chairs. Joan is also looking into getting portable oxygen so he can move around easier. She is making him eat!
Sept 9 CT at Faulkner. Dr. Braun called with results of CT. No blood clot(s) in lung. The mass is slightly bigger which is to be expected since the last CT was a month ago. Gives them a frame of reference when treatment is started as to how much the mass may go down. No biopsy results yet.
Next appointment is Tuesday morning at Dana Farber with Dr. Jackman to get the results on the biopsy and find out what type of lung cancer it is, and next steps.