PET Scan Results

I just got the results from the PET scan from this morning. The tumors in his lungs are slightly larger and a little more active. There are also some additional very small tumors showing on the scan as well. His primary tumor is slightly more active as well. There are no other new tumors shown. We meet with the doctor on Wednesday to discuss a possible change in his chemotherapy and or possibly radiation therapy to his lungs or heat/cold therapy. I will update again after we meet with the oncologist.

Scheduled PET Scan

Curtis has another PET scan scheduled for Friday 12/28/11. He is having some symptoms of a kidney stone or urinary tract infection. They should be able to see any stones with the CT part of the PET scan on Friday. He is off the TPN now which was providing him additional nutrition for 12 hours every night. He has lost some weight since stopping the TPN but we are hoping he will be able to gain some and not have to go back on it. We had a wonderful Christmas with Tavner and our families. I should get the report Friday so I will update this weekend of the results.

Happy Holidays! (Here is a picture of Curtis taking a cat nap with our niece Zoie)

PET Scan Results

Curtis had a PET scan, I guess it's been about a month now.. Looks like he is responding to treatment. He has 3 small tumors in his lungs still that are actually getting bigger but they are less active. The doctors are not sure if these are actually tumors or if they are pneumonitis which is a nodule that is a side effect of the study medication he is on. The other tumors are no longer detected on the PET scan except for his main tumor in his colon/rectum.

The Jeep is coming along.. almost ready to drive! The airstream is pretty much the same mess, just a little more organized now. Work on the Airstream should start in the next month..

Here is our goal :)

IV Nutrition, Next Pet Scan update

Because of Curtis' "kink" in his bowel, he has lost a tremendous amount of weight the last 6 weeks. (about 20 lbs). We have decided to start IV nutrition. His port will remain accessed all the time and we will do a 12 hour feeding at home. Hopefully the feedings will help him to put on some weight. He is continuing to eat during the day what he can when he feels well. He actually has been feeling better and had more energy. He has been able to work on his Jeep this week and is installing the transmission today with some help from a friend. Here is a pic of his transmission he has completely rebuilt.

The plan with his chemo is to have another treatment tomorrow and one more in two weeks, and then they will do a new scan to see if they will keep him on the same chemo or change it to Folfiri. We see the doctors again tomorrow, so I will update if there are any changes..

Update

So, this time they are saying that Curtis has a kink in his small intestine just beyond his stoma. They are letting him eat "as tolerated". He is having some lunch now and we will see how he tolerates it. He is not in as much pain as yesterday and seems to be doing quite a bit better.

Back in the ER

Curtis started having abdominal pain, nausea, and vomiting. He got very sick very fast. He started passing out in between vomiting. He could not feel his arms or legs either. I called 911 and the fire department came and they brought him up here (U of U) in an ambulance. They did a CT scan but we do not have the results yet.. I will post again soon

You all thought we were kidding about the Airstream :)

Here she is :) She is completly gutted and in excellent condition. 1966 Airstream Ambassador 29ft. We are super excited :)

Home Sweet Home

They finally let Curtis come home last night. We were there for 4 days and he left in the same condition as he went in. He has not been eating much, so his stomach pain is a little better, but when he eats he is in a lot of pain. He has been on just liquids for a couple days now (and a chocolate cupcake he couldn't resist :)  For a cancer patient, he has quite the appetite. They are going to do nutrition via IV if he is not able to eat much by his appointment on Tuesday for chemotherapy. The new nodules in his lungs might both be a combination of a side effect of the study drug and new cancer growth. They are not really sure if the new cancer growth is actually cancer or just a nodule. His CEA level has increased (CEA is a tumor marker that increases when the cancer is more active), but the oncologist said this may happen with an intestinal obstruction as well. They want to keep him on the study drug and his normal chemo with Folfox and Avastin for now and monitor his CEA in a few weeks, if it keeps going up, they will change his chemo, if it starts to decline, they will continue on the same treatment. Curtis wanted me to make sure that everyone knows how much we appreciate all your love, support and prayers, it makes this situation more manageable.

We're back.. again..

Curtis is back in the hospital again.. Since he was discharged last Monday, he has had increased abdominal pain and abdominal distention. We have been giving him IV fluids both at home and at the Huntsman clinic, but it does not seem to be getting better. We came for our follow up PET scan appt today and the oncologist admitted to the hospital. They think he has an ileus which happens when a portion of your intestines stops working and it makes a balloon pocket and holds stool and fluids in there. We should know more tomorrow and I will keep you all updated.

Christy brought Tavner up to visit Curtis tonight. Here is a pic of them watching cartoons :)

PET Scan Results

Okay, we are home from the hospital.. He did not have an infection, he was severely dehydrated. He seems to be doing better, he is not having any nausea or vomiting anymore, just abdominal pain now.

Now, the PET scan.

Here is the summary:
Overall, there is a mixed response with findings consistent with therapy response and disease progression. Evidence of progression is seen within the pulmonary parenchyma (lungs) with numerous new sub centimeter pulmonary (lung) nodules (tumors) as well as enlargement and increased metabolic activity of previously identified nodules (tumors). In addition there is new mildly metabolically active abdominal ascites with areas of possible peritoneal spread of disease. (Ascites is the accumulation of fluid in the abdominal (peritoneal) cavity. The abdominal cavity is located below the chest cavity, separated from it by the diaphragm.)

Extensive metabolically active porta hepatis, inguinal, retroperitoneal and mediastinal adenopathy as well as hepatic lesions are decreased from the prior study.

I will scan a copy of the actual PET scan report for those who are interested.

So, from here, since the cancer is both shrinking on some places, and growing in others, it looks like they are going to change his chemo regimen. It looks like they are going to go with a treatment called Folfiri with Erbitux

Folfiri is a combination of:

• 5-fluorouracil (5FU), (five-flure-oh-YOOR-a-sill)
• leucovorin (loo-koe-VOR-in)
• irinotecan (eye-ri-noe-TEE-kan) or Camptosar® (CAMP-toe-zar)

5FU and irinotecan prevent cancer cells from dividing and growing, and can eventually cause cancer cells to shrink and die. Leucovorin is used to increase the activity of 5FU.

Curtis has been on both 5FU and Leucovorin with his prior treatment with Folfox.

The side effects are different with the addition of Camptosar and Erbitux such as hair loss, rash and dehydration due to diarrhea.

We meet with the doctors on Wednesday to discuss the new plan and when his next treatment will be.

Here are a few pics from the Survivors at the Summit Hike! Thanks to my sister Tawni for getting everyone involved and all her hard work :)

Curtis, Dave and Landen made it all the way to the top!

Being sent to Huntsman for the night

So, the ER is sending us up to Huntsman for the night so they can keep an eye on his labs and make sure his nausea/vomitting resolves. He is due for chemo tomorrow, and that's not going to happen..

No Obstruction :)

The CT does not show a bowel obstruction (should have listened to us).. They think he has a GI virus because his small intestine is very inflammed and irritated. They are going to keep him overnight to make sure his nausea and vomitting is under control and that he is able to tolerate liquids orally before letting us go home. I wish they allowed Pugs in the hospital, on second thought, I would then be listening to Curtis and Bella having a competition on who can snore the loudest :)

CBH

Here is a pic of Curtis, just getting back from his CT scan. He is very exausted, but I had him read my previous post and he laughed :)

Our Dreams..

Here is a pic of an Airstream that we want. We want to buy one, totally gut it and remodel it, then live in it on a big piece of land.. Curtis said I can have a goat if we live in an Airstream :)

Here is a picture of the dog Curtis wants:

And the dog I want:

And, of course, my goat:

Picture perfect!

ER at U of U

So, here we are in the University of Utah Emergency Room, again. Curtis started feeling sick last night with abdominal pain which turned into headache, fatigue and now severe nausea and vomitting. We called the Huntsman doctor on call and they wanted us to bring him to the ER. We got here about 9:30pm tonight and they took some blood, started him on fluids (2L) and oxygen because his O2 was down to 81 (should be at least 90-100). He had to drink some contrast and needed a lot of IV Zofran for nausea to drink half of the contrast for the CT scan. They are thinking he has a bowel obstruction and severe dehydration.. We will see when we get the CT scan back. They want to send him to Huntsman to stay overnight tonight if there is no bowel obstruction so we can make sure we get a handle on his nausea and vomitting. Curtis asked me to add to the blog more stuff about our family and stuff we like to do, so I will start doing that too. We went down to AZ for treatment and found out 2 hours before he was due for infusion that they can't do the infusion because of the study drug he is on at Huntsman. (Even though they were fully aware he was on a study drug, and spoke with his doctors at Huntsman several times before our trip). So, we flew out there Thursday am and came home Friday am. It was a very stressful trip and a total waste of time. Our tenants moved out of the condo so we have starting painting it and cleaning it for us to move in, hopefully this week.. AZ said they would pay for a portion of our COBRA premiums, which are $956 per month, and now they will not be paying for a portion of it, so I am not sure how this will pan out. If anyone knows of any organizations/groups that help pay for the ridiculously high cobra premiums for cancer patients, let me know.. Curtis just came back from his CT scan, so I will post again with the results. Good thing Starbucks is open 24 hours, looks like a long night is ahead for me. (PS I am supposed to have a 12 hour clinical beginning at 6am) That ought to be interesting..

Uggh, sorry for the delay

It has been a very crazy last few weeks. It has taken a lot of time (and pain) to get the dose adjusted correctly on Curtis' new pain pump. I wouldn't even say we are there yet, but it is better. We are having a very difficult time controlling his constant urge to use the bathroom. His doctors started him on a Prednisone dose pack for a few days to see if it will help with the inflammation and allow him time in between his constant trips to the bathroom. Lately, he has to go every 30-45 minutes, which obviously does not allow him much sleep. He has been taking some anti anxiety medications at night (Clonazepam) which seems to be helping now too. The steroids seem to be working too, but he can only stay on them for a short time (due to irritation to the stomach). We have an appointment to see the surgeon on August 11th and see if he has anything else to offer. We are also happy to announce that we have found a way to go back to Arizona. The plan for the next visit is to go back August 25th through the 28th. He will probably get his next PET scan at that time as well. He had infusion last Tuesday and actually has done very well with it this week. The dang mouth sores get him every time though.. Other news, we were denied Medicaid.. Apparently they think we have money, we clearly don't.. We will be getting on Cobra through my previous employer ($950 a month) that Huntsman and Cancer Treatment Centers of America have graciously agreed to pay half of the premiums each. HUGE HELP! Survivors at the Summit is Saturday also. It is at Snowbird and you can hike or ride the tram to the summit and fly a personalized flag in remembrance of a loved one you have lost to cancer, or someone who is fighting, or someone who has fought and won! All the proceeds go to the Cancer Wellness House. The Cancer Wellness House is a great place for patients and caregivers for support, yoga, massage, children's activities and tons more.. Here is more info on the hike

INFORMATION:
Survivors at the Summit 2011 marks the 15th year of this signature event for Cancer Wellness House, a non-profit organization dedicated to providing free resources to anyone whose life has been affected by cancer. This multifaceted event:

Symbolizes the challenges individuals experience when faced with cancer

Pays tribute to their courage and determination

Honors the memory of all those whose lives have been cut short by the disease

SATURDAY, AUGUST 6, 2011
TRIBUTE FLAGS:
Tribute flags honor loved ones who have faced the challenges associated with a cancer diagnosis. Personalized flags are displayed atop Hidden Peak at Snowbird at the Celebration of Life ceremony on Saturday, August 6, 2011. This event symbolize the individual “summit” each person with cancer faces and achieves. Personalized flags can be purchased for $20 each at Cancer Wellness House or by phone at (801) 236-2294. Flags sold at other locations throughout the community as well.
HIDDEN PEAK CELEBRATION OF LIFE:
Everyone living with a history of cancer, their friends and families, and those who have lost a friend or relative to cancer are invited to hike the 3.5 mile trail (or take a free tram ride) to Hidden Peak on Saturday, AUGUST 6, 2011. A sea of personalized Survivors at the Summit 2011 commemorative flags will welcome participants at the summit. Join in an inspirational Celebration of Life ceremony at the top of Hidden Peak (beginning approximately 12:30 p.m.). The celebration continues on the Snowbird Plaza Deck with the prize giveaway and activities for the entire family. Bring a picnic or buy lunch at Snowbird.
PANCAKES ON THE PLAZA:
This year, the Cancer Wellness House Board of Directors want to personally thank all of our sponsors, donors, hikers, members, survivors, and families with the third annual Pancakes on the Plaza event in conjunction with the Celebration of Life at Snowbird on AUGUST 6, 2011. From 8:00 – 10:30 a.m., CWH volunteers will team up with Snowbird’s chefs to offer steaming plates of pancakes to hikers, tram-riders, sponsors, and other participants to fuel their journey to the top of the Peak. A breakfast ticket can be purchased at the event for $4 per person. Bring your friends and family for a good, old-fashioned hiker’s breakfast while supporting families in need!
For more information contact: Cancer Wellness house at (801) 236-2294 or visit http://www.cancer-wellness.org/.

Pain Pump Update

Curtis did very well with the surgery. We are staying overnight at Huntsman tonight. It takes some time to get the first dose adjusted and we should go home tomorrow. Haven't got a pic yet, but I will soon :)

Pain Pump Surgery

Curtis just went back for his pain pump surgery. The procedure is about an hour and a half to two hours. He was quite nervous, but Dr. Brogan feels his quality of life will be much improved. Curtis is on a high dose of Fentanyl patches and has to change them earlier than normal, and generally has a "bad day" on the days his patches are due. The pain pump will eleviate the need for the patches and most of his oral pain medications as well. It can take a few weeks to get the dose right, but I think it will be a good decision in the long run. Good thing for insurance, the pain pump itself costs $10k. Yikes! I will give everyone an update when I see him tonight..

 I am going to post pics of the pump, so Jeff (Curtis' brother-in-law), don't look :)

Pain Pump Scheduled

The pain pump surgery is scheduled for next Tuesday, July 12th. Curtis will stay overnight at Huntsman Cancer Hospital. His doctor called last Friday and let us know that his blood work from Thursday came back and showed he has low white blood cell counts. Normal is 4.1-11 and his is 1.7. I am not yet sure if this will effect surgery. We should find out more about it today.. Hope everyone had a wonderful holiday!!

Update.. and Hernia :(

So, we met with the oncologist today at Cancer Treatment Centers of America. Since the treatment is working, they would like to continue his current treatment. We are trying to figure out if we can do some treatments here and some in Salt Lake at Huntsman. If we leave Huntsman, then Curtis will have to be taken off the trial drug, and it may be working. But, we like the nutritional support they offer here. His iron and Vitamin D levels are low, so they started him on supplements for that as well as fish oil. Statistics show that 40% of cancer patients actually die from malnutrition rather than cancer itself. But we are not sure yet if he can have treatment here every other treatment and still participate in the trial..

Also, we were changing Curtis' ileostomy bag this morning and noticed a bulge behind his ostomy. We had a ostomy nurse look at it today and it is a hernia which will eventually require surgery. How soon he will need surgery, we don't know. He will have to stop his chemo for 6 weeks and 4 weeks after the surgery.. We will have a consult with a surgeon when we get back to Salt Lake about the hernia..

On a good note, we found out that the lesions on his liver are essentially undetectable now :)

Phoenix and PET scan

So we arrived to Phoenix Sunday. It is warm and sunny everyday! I love it! The Center here is nice too. We got the results of the PET scan that was done yesterday and it showed "overall improvement." His tumors are shrinking and he is responding to treatment!! We are super excited! We saw the gastroenterologist today and we see the oncologist tomorrow. We are trying to decide if we should do his treatment here Friday and try and get back to Salt Lake in time for treatment Friday at Huntsman. We don't know if they will recommend any change in treatment here until our appt tomorrow. Curtis has had a good week. He even went to the pool with me yesterday and enjoyed some sunshine. I will update tomorrow after our appt (as long as the wireless at the hotel cooperates).. I think they may be running off dial up or something :) super slow.. It's a good day :)

Happy Birthday Mom!!

We wanted to wish my mom a Happy Birthday today! My parents have been incredible during this journey with us! We love you guys!

Phoenix

Tomorrow is the big day... We are going to Phoenix's Cancer Treatment Center of America to see if there are any other options that are not available at Huntsman. We will be there 3-4 days depending on what options they have for us. I will keep the blog updated during the visit. Wish us luck!!

PS We celebrated our 2 year Anniversary on Monday. Curtis made me an amazing collage on the back of a quilt I have been wanting. It was absolutely perfect!!

Infusion Again.. Possibly pain pump?

Curtis is having another infusion today. He actually did quite well with the last one. He had a nerve block a little over a week ago, with little relief. The next option is a pain pump which we are considering. Curtis was doing some research on some alternate treatments and found cryotherapy where they freeze the cancer cells. This lead to more research and we found a facility in Phoenix that does a lot of alternative treatments for specifically stage 4 cancer patients. We will be flying down to Phoenix to see what they can do for him in the next few weeks. If we do decide on treatment there, we will need somewhere to stay during the treatments. If anyone has family/friends in the Phoenix area that would be willing to let us stay for a few days let me know :)  Here is some info on the pain pump. I will post info about the other options if we find out that they are infact options in Curtis' case.

What Is a Drug Pump?

Drug pumps (intrathecal drug delivery systems) delivery pain medication to the fluid around the spinal cord, called the intrathecal space. Because the drug pump releases medication directly to the pain receptors in the spine, pain relief can be achieved with a small fraction of the oral medication dose.^1-6

  SynchroMed II Drug Pump

About the Drug Delivery System

The system consists of a pump and catheter, both of which are surgically placed under the skin. The pump is a round device that stores and delivers pain medication. It is placed in your abdomen. The catheter (a thin, flexible tube) is inserted into your spine and connected to the pump.

During the surgery, your doctor fills the pump with pain medication using a needle. The pump sends the medication through the catheter to the spinal area where pain receptors are located. You return to your doctor for more medicine when the pump needs to be refilled.

How It Works

The spinal cord is like a highway for pain signals that are heading to the brain. When the pump sends pain medication directly to the spine, it interrupts the pain signals before they reach the brain.

Medtronic Products

Drug delivery therapy from Medtronic may help manage your cancer pain so you are more comfortable and able to perform your usual daily activities, although it may not be possible to eliminate your pain completely.

The Medtronic SynchroMed^® drug delivery system consists of:

• A battery-operated pump surgically placed under the skin of the abdomen
• A soft tube called a catheter, surgically placed under the skin, that carries the medication from the pump to the intrathecal space of the spine
• A handheld programmer your clinician uses to adjust the medication dosage to treat your pain
• A handheld patient control device called myPTM^® that allows you to give yourself an extra dose of medication (within physician-set parameters) in response to intermittent pain (ask your clinician if this device is appropriate for your condition and if it is covered by your insurance)

It is important to note that the system can be surgically removed if you decide to discontinue the therapy.

Treatment Update

Curtis has been doing fairly well with chemo treatments. He has had 2 cycles so far. Side effects: mouth sores, numbness in hands, nausea, vomiting, and fatigue. He had a very painful and swollen toe on his right foot last week. I took him in to have it looked at and they think it might be gout. He started the medications for gout and he was better soon after starting. (Gout is a side effect of chemo) It is still sore, but he is able to walk on it now. His biggest problem now is his frequent trips to the bathroom. We are hoping the nerve block with help that..  His dad is in town from Ohio to visit and they have spent a lot of time trying to get his transmission for his Jeep put back together with his help.. He has his good days and bad days, let's hope for more good :) Here is a picture of Curtis with our beautiful new niece Zoie Bailey.

Curtis goes in for a nerve block tomorrow at 1pm. Originally we were going to do a temporary one, but have decided to do a permanent one (lasts 3-6 months). The nerve block is scheduled for 3pm. Here is info on how the nerve block works:

A nerve block relieves pain by interrupting how pain signals are sent to your brain. It is done by injecting a substance, such as alcohol or phenol, into or around a nerve or into the spine.

Nerve blocks are used to treat chronic pain when drugs or other treatments do not control pain or cause bad side effects. A test block is usually performed with local anesthetic. If you achieve good pain relief from the local anesthetic, your doctor may inject a nerve block, such as alcohol or phenol.

Nerve blocks numb the nerves touched by the drugs. This relieves pain by interrupting the pain signal sent by the nerves to your brain. Depending on the type of nerve block, your pain may be numbed for a short time or a long time.

Nerve blocks for chronic pain may work for 6 to 12 months. They may have to be repeated.

Nerve blocks are used to diagnose the causes of pain. They also are used to treat chronic pain when drugs or other treatments cause bad side effects or do not control pain.

Nerve blocks often relieve pain. They work well in pain control for people who have advanced cancer and painful nerve conditions.¹

Nerve blocks work especially well for some types of cancer pain, such as pain from cancer in organs such as the pancreas.

Nerve blocks can cause serious complications, including paralysis and damage to the arteries that supply blood to the spinal cord. Other possible side effects include severely low blood pressure (hypotension), accidental injection of the alcohol or phenol into an artery, puncture of the lung, damage to the kidneys, diarrhea, and weakness in the legs.

Infusion Update

Infusion is almost done. He will go home with 5FU for 46 hours now. No side effects so far, he is just tired and excited for Supercross tomorrow!

Folfox +Avastin and Afinitor Infusion

We are at the infusion clinic starting his first round of Folfox with Avastin and Afinitor. The infusion takes about 6 hours total and he will go home with the chemo ball of 5FU for 2 days. A home health nurse will come and disconect him on Sunday. The doctor said she thought he would tolerate this better than the chemotherapy and radiation combonation. I am taking Curtis and Tavner to Supercross tomorrow! We are all very excited! We really appreciate everyone's support and love.. Curtis says this will be him when he is "all healed up"

PET Scan Reading

We got an actual copy of the PET scan results today at our appointment. The reading yesterday was visual because the report was not ready yet. There are no tumors or affected lymph nodes in his brain. There is on 7mm lingular nodule, 4mm, 5mm, along with several through out the right lung in both the upper and lower lobe. Subcarinal node measured at 1.2 cm, Cluster of prevascular adenopathy spanning 3.5 cm, Bilateral hilar adenopathy 1cm. See picture.

There are 2 hypermetabolic areas in the liver, however no anatomic lesion is seen to coorispond with the activity. (Meaning, there is signs of cancer in the liver, but they are unable to see a lesion or tumor)

The tumor in is rectum has shrunk some and is less metabolically active.

There are multiple porta hepatis nodes, largest measuring 1.3cm. (Near his liver)

There is a large cluster of retroperitoneal adenopathy (swelling of lymph nodes surrounding the abdomen)
There are multiple retrocrural and retroperitoneal nodes identified (back of abdomen, behind intestines)
Left pelvic lymph node measuring 9mm.
Inguinal nodes are present bilaterally, right measures 1.4cm and left is 1.8cm.

*A dime is 17.8 mm (millimeters), a cm (centemeter) is about the width of a fingertip.

There is extensive growth of the cancer since his last PET scan. Chemo will start Friday. Wish us luck!! Survivor stories are always welcome!!

PET Scan Results

We saw Dr. Sharma today, the oncologist after the 2 1/2 hour PET scan. Although I have not seen the written report yet, this is what was found: Curtis has cancer in lymph nodes in his lungs, more in his abdomen and possibly in his liver. They also did genetic testing to see how well his genes will respond to chemotherapy. His genes look very good and they expect he will respond well. They also provided information about a clinical trial of Everolimus (RAD001, Afinitor) to be used with Folfox (5FU, Oxaliplatin, Leucovorin) and Avastin. We go back tomorrow morning for blood work and to do tests for the clinical trial. The oncologist said that he thinks Curtis has a 60-70% of the cancer responding to this chemo. After 2 months (or 4 cycles) of chemo, they will do another PET scan to see how he is responding. He will go in for 6 hours of infusion of Leucovorin, Oxaliplatin and Avastin. He will go home with the infusion ball of 5FU for 46 hours and will have a home health nurse come and de-access his port. He should start this week. Here is information about how each chemotherapy drug works:

How 5-FU works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur.  The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.
5-FU belongs to the category of chemotherapy called antimetabolites.  Antimetabolites are very similar to normal substances within the cell.  When the cells incorporate these substances into the cellular metabolism, they are unable to divide.  Antimetabolites are cell-cycle specific.  They attack cells at very specific phases in the cycle.  Antimetabolites are classified according to the substances with which they interfere.

How Avastin works:
Monoclonal antibodies are a relatively new type of "targeted" cancer therapy.  Antibodies are part of the immune system.  Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) entering the body.  The antibodies attach to the antigen in order to mark it for destruction by the body's immune system.  In the laboratory, scientists analyze specific antigens on the surface of cancer cells (target) to determine a protein to match the antigen.  Then, using animal and human proteins, scientists work to create a special antibody that will attach to the target antigen.  Antibodies will attach to matching antigens like a key fits a lock.  This technology allows treatment to target specific cells, causing less toxicity to healthy cells.   Monoclonal antibody therapy can be done only for cancers in which antigens (and the respective antibodies) have been identified.
Avastin works by interfering with the process of angiogenesis by targeting and inhibiting human vascular endothelial growth factor (VEGF).  VEGF is a cytokine (a small protein released by cells that have specific effects on the behavior of cells) which when it interacts with its receptors in the cell leads to new blood vessel formation or angiogenesis.

How Oxaliplatin Works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur.  The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.
Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer.  Although these drugs are divided into groups, there is some overlap among some of the specific drugs.  The following are the types of chemotherapy:
Oxaliplatin is classified as an alkylating agent.  Alkylating agents are most active in the resting phase of the cell.  These drugs are cell-cycle non-specific.  There are several types of alkylating agents.

How Afinitor Works:
Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells.  To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly.  Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects. 
Targeted therapy is about identifying other features of cancer cells.  Scientists look for specific differences in the cancer cells and the normal cells.  This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects.  Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells. 
There are different types of targeted therapies, defined in three broad categories.  Some targeted therapies focus on the internal components and function of the cancer cell.  The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die.  There are several types of targeted therapy that focus on the inner parts of the cells.   Other targeted therapies target receptors that are on the outside of the cell.   Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.
Researchers agree that targeted therapies are not a replacement for traditional therapies.  They may best be used in combination with traditional therapies.  More research is needed to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer. 
Afinitor is an inhibitor of mTOR.  mTOR inibition blocks the translation of genes that regulate cancer cell proliferation.  It also results in reduced levels of certain cell growth factors involved in the development of new blood vessels, such as vascular endothelial growth factor (VEGF). 

PET Scan

On Thursday during our appointment with Dr. Sklow (the surgeon), cancer was found in Curtis' inguinal nodes. Originally we were told that it looked like the cancer had spread there both during and after his chemo/radiation treatment. The mortality rate with colorectal cancer with spread to these nodes is very high. After speaking to Curtis' radiation oncologist, Dr. Anker, he thinks that the cancer may have just grown there and not necessarily spread. These nodes were not in the original field of radiation because they did not show in the PET scan from January. It is possible that there was a small amount of cancer cells in these nodes and they were not detected during the initial PET scan. If this is the case, there may be an option to do additional radiation on those nodes and do the surgery later. The surgery has been cancelled for now. The PET scan takes about 2.5 hours, so we should have more info by 11am today. I will update as soon as I can. Thanks for everyone's support during this extremly difficult time.

The body has between 500-700 lymph nodes. Here is a picture of where they found the new cancer growth.

Urologist

We met with Dr. Dachet, the urologist at Huntsman, on Thursday. They did a scope of the inside of Curtis' bladder and he said the inside looks good. But the tumor is either attached to the prostate or the bladder, and they think it is the bladder because when Dr. Griffen did his ileostomy, he said that it was attached to the bladder. We really won't know anything else until surgery. If they have to remove the bladder, they automatically remove the prostate as well because the prostate is so close to the bladder, if the tumor invaded the bladder, it most likely did the prostate as well.. After looking at the inside of his bladder he says that he is "encouraged" and hopes to not have to remove the entire bladder. If they do have to remove the bladder they will do this procedure:
ILEAL CONDUIT
An ileal conduit is a small urine reservoir that is surgically created from a small segment of bowel. The ureters that drain urine from the kidneys are attached to one end of the bowel segment. The other end is brought out through an opening in the skin (a stoma). The stoma allows the patient to drain the collected urine out of the reservoir.
People who have had an ileal conduit need to wear a urine collection appliance outside their body at all times.

The urologist will save what he can while still "curing" Curtis, but if there is a chance of leaving any cancer behind, they will remove what they need to. Curtis is having an especially difficult time the past few days trying to cope with the new news.. I am surprising him with a night at the Alaskan Inn tonight and we are going to go around downtown Ogden and the train station where we had our engagement pictures done.. So, SSHHHH... DON'T TELL..

New Surgery Date

Surgery will now be May 20th. The urologist is unavailable May 6th. We see the urologist today. I will update again after the appointment..

Surgeon

We met with the surgeon today at Huntsman and did the MRI. The MRI report showed the tumor size was 1.2 cm (previously 15cm). However, when the physician did the exam and looked through the scope the tumor is much bigger than 1.2cm. He stated that it was "enormous" before and now it is "moderate" in size. He also stated that the tumor is still attached to something. The MRI showed that there was no bone involvment, so he believes it is attached to the bladder. The surgeon requested that the MRI be re-read, because the tumor size is very different on the MRI than what he saw. The surgeon does not feel that he has clear margins to reconnect Curtis' bowels without a permanent colostomy. We will see a urologist regarding the bladder involvment on April 14th and follow up with the surgeon on April 21st. We are considering a second opinion on the resection, we will let you know how that goes.. 

MRI and Surgery Date

Curtis goes in for an MRI tomorrow morning at 7:15 at the UofU Hospital. The MRI will be able to tell us if the tumor has shrunk or spread at all. Pray for good news:) We see the long awaited surgeon after that. He will review the MRI with us and discuss which surgery will be best for Curtis. His surgery is scheduled for Friday, May 6th. (Lacey, please tell Zoie to wait to come, Curtis really wants to go to the hospital to see her!!) I will update tomorrow after the appointment. Wish us luck!!

Overdue Update

Sorry everyone, I know this is long overdue.. Curtis is doing ok this week. We have had a pretty busy week.. He has actually been feeling more sick since stopping the chemo and radiation. He has had some nausea and vomiting lately, mostly in the middle of the night.. He is working hard on gaining some weight before his surgery, although so far, he has been maintaining his weight, not gaining.. We took a nice drive today to see my aunt Marilyn (she had a knee replacement last week) and my grandma (she had skin grafts done on Friday) and visited my grandpa. We have received a lot of support from neighbors, friends and family (and people who don't even personally know us), and could'nt be surrounded by more caring and loving people. From the depths of our hearts, THANK YOU!!

"When Cars Fly"

Where to start... Sunday afternoon Curtis, my sister, Tawni, her 18 month old daughter, my parents, Phil and Sharon, and myself were getting ready to go visit my grandma in Logan who has severe burns from an accident last Sunday. Curtis was going to stay home and take his son Tavner to the car show that day. We went back and forth on which car to take, either Tawni's Jaguar or my mom's Toyota Corolla. We all wanted to take the Jaguar because it is much bigger, but my mom was insistant that we should take her Corolla. We ended up deciding to take the Corolla. I got in the passenger seat and gave Curtis a kiss goodbye. Next thing I heard was really loud screeching sounds coming and we got hit. I got out of the car screaming trying to find Curtis and see if everyone was ok. I saw Tawni holding Taylor and then I looked over toward the house and Curtis was laying there with his eyes closed. His feet were up the stairs of the porch and his head was lifed up a little against the house. He was pale and not moving. Blood was pouring from the back of his head. I got my phone out of the car and called 911. I went back to Curtis and he opened his eyes and tried to move. I told him to lay still while I run inside. I went inside the house and got a towel and tried to tell the dispatch operator our address and have them send paramedics. I ran back to Curtis and put the towel under his head to try and stop the bleeding. He could feel his hands and feet but didn't talk. He had dirt and glass all over his body. I kneeled beside him holding the towel on the back of his head while the paramedics arrived. Tawni and her daughter were sitting on the porch, trying to keep her daughter away from the trauma. I looked at the scene and saw a Cadillac on top of my sister's Jaguar and the back of my mom's Corolla with the Cadillac's front end embedded in our porch pillar. There was a tree  on top of the Jaguar with literally no way out. The paramedics made my stand on the porch while they put Curtis in a C collar and put him on a stretcher. His chemo was disconnected in the crash and was leaking beside him. (I didn't even notice until I was told about it at the hospital). The paramedics lifted Curtis up and tried to get him to the ambulance. There was a narrow exit over some bricks and the hood of the Cadillac that they handed him over. I signed a release that I declined to be medically evaluated so I could ride in the ambulance with Curtis. He was already in the back when I got there and I rode in the front. We went to the University of Utah hospital. When we arrived to the ER they had a trauma room ready for him filled with at least 10 doctors, nurses, etc. They put 7 staples in the back of his head and did CT scans and Xrays. Curtis' right shoulder was hurting so they focused on that area. When Curtis was getting xrays, Tawni came in on a stretcher. I followed them down the hallway and something happened to her knee and foot. She doesn't remember what happened because she was concerned about finding her daughter. It is interesting how different things hurt after all the adrenaline is gone, and you didn't even know you were injured. I talked to Tawni, and my mom went to Primary Children's Hospital with Taylor (Tawni's daughter) to have the cut on her eye evaluated. She didn't need stitches and now has a black eye. Tawni had xrays and she ended up with a strain and a sprain in her knee, and we are thinking that he foot was run over by the Corolla because her foot was in front of the tire of the Corolla as she was buckeling Taylor's car seat in. Family starting pouring in at the hospital. Braxton, Britney and Ryan came first, Nate and Christy Mc came next. My aunt Marilyn and my cousin Skye drove all the way down from Logan to come help us. Sandy and Mike (Curtis' parents) and his sister Lydia came next. More family wanted to come, but they would only allow 2 people at a time and people were already waiting in the hallway to see him.  Curtis ended up having a concussion, 2 fractures in his scapula, whiplash, and 7 staples in the back of his head. We are all very lucky to be alive. Here is a story from KSL which is pretty accurate..

Airborne car injures 3; police tackle suspect

March 6th, 2011 @ 5:59pm

By ksl.com

SALT LAKE CITY — Six family members were in their front yard when an airborne car driven by a man fleeing police flew into their driveway and injured three of them as it skidded into the house at about 11 a.m. Sunday.
A KSL camera caught the dramatic capture of the driver on tape.

Shannon Howard said her husband, 31-year-old Curtis Howard, her 28-year-old sister, Tawni Stamm, and Stamm's 18-month-old daughter were all injured when the car came crashing into the yard of their house at 251 E. Downington Ave.

The Howards live with Shannon's parents, who were also in the front yard, when a tan Cadillac speeding down the street careened out of control and hit a car parked on the street and then a large tree in the yard next door. The impact pushed down the tree, which acted as a ramp that launched the Cadillac over a Jaguar parked in the driveway where the people were standing.

Salt Lake Police Lt. Bryce Johnson said the Cadillac hit the man as it came down. "It hit the male and launched him into the house." All three of those injured were taken by ambulance to area hospitals.

The group was getting ready to leave the house, deciding whether to take a Toyota or the Jaguar parked behind it in the driveway. "We were contemplating whether to take the Jaguar that was in the back or the Toyota, but my mom pretty much forced us to take the Toyota," Shannon said. "I was just buckling the car seat in. My sister had her daughter, standing on the other side of the car. I just heard screeching and we got hit."

"If we were in the Jag we would have been killed. We would have been putting stuff in the trunk, in the Jag, and that's exactly where the car came across. We would have been really in bad shape. We would have been standing literally where that (Cadillac) was," Shannon said. The Cadillac hit the Toyota as well as the front of the house before it came to rest.

Shannon said firefighters' hazardous materials crews were called in because the impact ruptured a container of her husband's chemotherapy drugs — he is in treatment for cancer. The group was on their way to visit a relative in Logan who had recently suffered serious burns.

Witnesses told police they saw the driver of the Cadillac climb out through the window and run away. Officers said they were looking for a 5-foot-10-inch black man wearing a black hoodie and black pants.
"I heard somebody say, 'stop him' so I picked up the rake and kept him from going in the backyard," said witness Michael Hinckley.

"It hit the male and launched him into the house. The mother, I understand, was holding the child." - Lt. Bryce Johnson

Shannon said she did not see the driver get out and run away. "I just ran to my husband. I put rags under him until paramedics arrived."

Gust Melonas lives in the house next door, where the Cadillac hit the tree. "I was watching out the window and heard some screeching from a car coming down the road," Melonas said. After the Cadillac hit the car parked on the street, it "came up on my lawn and hit a tree. The tree laid down, and this car that he was driving, it launched it right in the air, right into the neighbor's yard" where it also hit and damaged the house.

Officers with automatic weapons and search dogs scoured the area north of the crash scene looking for the driver. Police were going door to door when a man bolted from a back yard and was chased by police, who tackled him near 1700 South and Edison (150 East) just before 1 p.m.
"I'll tell you what, a little bit of excitement and adrenaline -- I hope I never see it again," said Hinckley.

Police arrested 20-year-old Albino Gabriel Juak. He was taken to an area hospital for treatment of minor injuries, said police Lt. Isaac Atencio. "I don't know whether we'll be guarding him at the hospital or whether he will be booked into jail."

Johnson said police first noticed the car at a 7-Eleven on 500 East and 1700 South. An officer noticed it did not have a rear license plate. "Our officer pulled in behind in an attempt to pull the car over," Johnson said. "When the officer did that, the car fled from her. The officer followed our policy and shut down her emergency equipment and pulled to the side of the road" because the suspect's vehicle was in a residential area.

The car sped away toward 300 East then turned west on Downington Ave. (1820 South). Another officer at the crash scene estimated the car was traveling about 80 mph before the driver lost control, careened off the car parked on the street then took out the tree.

Shannon said her husband has two fractures in his shoulder, a concussion, and a brick-shaped laceration in the back of his head. "He's doing OK. He's still at University Hospital." She said Stamm and her daughter were treated at two different hospitals and have since been released. "Her daughter went to Primary. She has a laceration on her eye and a black eye and stuff. My sister's got some torn tissue in her knee."

KSL did an interview with us today which will be on today at 5pm Tuesday, March 8th.

IV Fluids

Curtis is doing better now. He got some fluids when they switched his chemo ball on Wednesday, but was still very light headed and dizzy on Thursday. So, Friday I took him to radiation and they gave him some more IV fluids. He was feeling a lot better Friday afternoon and today he has been good too. He has some radiation burns on his skin, but overall he is doing better. Last day of chemo and radiation is next Friday! He had a nice bath at Shelly's house today (Curtis' sister) while the girls planned Lacey's baby shower (Curtis' other sister), so that was fun. We see the surgeon and genetic counselor at the beginning of April so I will let everyone know how those go..

Happy Birthday Phil!

I just wanted to say Happy Birthday to my dad, Phil! He and my mom have been great letting us stay with them during Curtis' treatment! We appreaciate all their love and support!

Doctor Today

                                     One of my favorite pictures from our wedding

We went to the doctor again today. Curtis hasn't been eating much and is still losing weight. The doctors put him on Marinol that will help with his appetite and also nausea. He has been having some nausea intermittently. He has 3 more weeks of chemo and radiation that is supposed to end March 11th. He is supposed to have an 8 week break before his main surgery which will be mid May. He is doing pretty well otherwise, very tired. Curtis could really use some encouragement this week, if you would like to leave a comment I will make sure he sees it:)

Update

Sorry for the delay, we moved in with my wonderful parents and have been trying to get unpacked this week. The benefit dinner was amazing! We got enough to help with our deductibles, co-insurance and Curtis' chemotherapy which is $50 a week. We are truely greatful for everyones help and support! I wanted to thank both our friends and families that spent hours and hours preparing for the event. Curtis' dad did a great job with the food and it was delicious! Thanks to Heidi N Photography for setting up the photo session at the dinner. Her work is amazing : http://heidinphotography.blogspot.com/. Curtis is doing great this week! He is feeling pretty good most the time and has been sleeping much better! He was especially excited to watch his Packers win the Superbowl!!

Here is a list of the items that will be auctioned

When bidding on an auction item please refer to it by listed name (A, B, 16, etc.) If you would like to bid on an item because you can't come to the benefit dinner, email or text me and I will put your bid down and update you with the highest bid for that item. curtisandshan@gmail.com or text 801-694-2066

A)  Cater your event for up to 100 people with the best Dutch oven style dinner (or breakfast) this side the Mississippi!  Options include BBQ chicken with potatoes and cobbler, BBQ ribs with potatoes and cobbler, Lasagna and vegetables with cobbler, or Mountain Man breakfast. Valued at over $1000.  Starting bid: $500

B)  Experience the adventure of a lifetime on a trek in the beautiful Grand Canyon, The Tetons, San Juan Mountains, The Lower Paria Canyon, High Uintahs Wilderness, or top Mt. Whitney! Have somewhere else on your bucket list?  Your guides will take you and up to four of your friends there during the 2012 season, after the coaching, training, guidance, and support needed to be prepared for such a backpacking trip. Make sure you take a camera!  Valued up to $2,000.    Starting bid: $300

C) Fly over the city in a helicopter with your sweetie, or if you’d rather a buddy.  The winner of this auction will enjoy an hour of riding in a helicopter with up to three adults or two adults and 2 children.  (Based upon weather conditions and availability.  Good through May 31, 2011) Valued at up to $700.00  starting bid $200

D) Wrap yourself or a loved one in a fabulous hand stitched heirloom quilt.  Valued up to $500 starting bid $50

E) These tickets will take you and someone special to the Sarah McLaughlin concert February 14, 2011.   $25 towards dinner at Braza and a week of tanning are also included.  Valued at $300.  Starting bid:  $150

F) Take a vacation to Puerto Vallarta, Mexico!  Beaches, shopping, history, restaurants!  This bid will get you 7 nights and 8 days for up to 4 people in a one bedroom unit at Raintree’s Club Regina!  Valued at $2079.  Does NOT INCLUDE AIRFARE.  Starting bid:  $300

G) Three days of that new car smell will be yours with this rental certificate from Budget Rental Car.  (Must be over age 21.  Some restrictions apply.)  Starting bid:  $50

H) Take a three day weekend with shiny new wheels!  (You have to give it back after the weekend.  Some restrictions apply.)  from Budget Car and Truck Rental of Utah. Starting bid:  $50

16)  2 tickets to the Hale Center Theater “A Tale of Two Cities”  3/15/11 at 7:30 and $25 to Salt City Burger starting bid $25

17) Repertory Dance Theater tickets to Dancing the Green Map 3/31/11 at 7:30PM, $40 towards a dinner at Madeline’s Steakhouse, and 2 Log Haven Signature Desserts  Value:  $100+  Starting bid:  $25

18)  Two tickets to the Utah Symphony, $50 to Tiberon Fine Dining, and 2 Log Haven Signature Desserts Valued over $100.  Starting bid: $50

19) 2 tickets to the Hale Center Theater “A Tale of Two Cities”  3/15/11 at 7:30 and $30 to Asian Star  Starting bid $30

20)                    2 tickets to the Hale Center Theater “A Tale of Two Cities”  3/15/11 at 7:30 and $50 to Temple Square Hospitality (The Roof, etc.)  starting bid: $30

21)  2 tickets to the Hale Center Theater “A Tale of Two Cities”  3/15/11 at 7:30 and 2 free dinners at Rodizio Grill  Starting bid:  $30

22)2 tickets to Ballet West Bolero with Chaconne and Sinfonietta April 8th and 9^th and April 13^th-16^th, $25 to Ruths Chris Steakhouse and a pound of Sees Chocolate.  Valued at $95  Starting bid:  $60

Chemo and Radiation

Chemo and radiation started on Thursday. Curtis is doing very well with it. He has not had any nausea yet. He is still very tired, as usual. Here is a picture of what the chemo ball looks like full. He gets 2 ml's per hour as a continous infusion for 6 weeks. He will go in every Thursday to get the needle from his port changed and a new ball.

Staging Update

Curtis' radiation oncologist called today. They have their weekly meetings on Tuesdays with his whole team and had some new information. Some of his lymph nodes that are affected are high up in his abdomen. Because they are so far away from the original cancer source (rectum and colon), the lymph nodes are considered metastasized. Curtis is officially a stage 4. They are not concerned about his liver, they said the CT scan does not look like it has spread there. I am not sure if this new staging will affect treatment, we will talk with them more tomorrow.

PET Scan results

We got the results back from the PET scan. Curtis has at least 6-7 lymph nodes with cancer, with the highest being in his upper abdomen. This means they will increase the area of the radiation to include these areas. There was also a section on his liver that was slightly elevated with glucose, so they are going to talk with the radiologist and see if they want to do an MRI to look at the liver in more detail. Chemo and radiation start Thursday. Wednesday we see a urologist because one of Curtis' urters is larger than it should be. Really busy week this week!

PET scan today

The PET scan was this morning at Huntsman. The entire process took over 2 hours. They wouldn't even let me back with Curtis because he is most radioactive right after they put the dye into his veins. So he waited for about an hour after he got the dye before they did the actual scan. We should know the results tomorrow or Thursday. We meet with Dr. Adler on Thursday at 9am (he is the one that will be doing his rectal ultrasound on Friday). I will post when we know the results of the PET scan.

PS Thanks to my parents, Shelly and Jeff and Mike and Sandy for allowing Curtis and I to not have to cook for 3 days in a row now (dinner delivered to our house) We are spoiled:)

Surgery Update

Surgery went well yesterday. We were at the hospital/Huntsman from 8am to 730pm. Super long day. He is doing well, a little bit sore today. Next item of business: PET scan tuesday. Here is info about how the PET scan works:

PET Scans and Cancer

PET can help physicians effectively pinpoint the source of cancer. This is possible because many cancer cells are highly metabolic and therefore synthesize the radioactive glucose (sugar) that is injected in the patient prior to the exam. The areas of high glucose uptake are dramatically displayed in the scan imagery, as opposed to the anatomical imagery of CT or MRI, which cannot detect active, viable tumors.

Surgery Scheduled

The surgery for the port placement is scheduled to start at 2:30pm tomorrow, we need to arrive at the UofU hospital at 1pm. The procedure should be outpatient, so we should be able to go home tomorrow night. We'll see how that turns out :)

Back in the hospital

Curtis was re-admitted to the hospital yesterday. We went to the ER yesterday morning because he was not having any output in his bag for almost 30 hours. (Normally, he empties 6 times per day). They did a CT scan and it showed he has a 4.5 cm blockage behind his stoma. He was also dehydrated which may have contributed to the blockage. We get to go home this afternoon because his bag is working again now. We have a busy couple weeks with Huntsman. Tomorrow we go meet with the radiation oncologist, Chris Anker, and they figure out where exactly they will target the radiation. Then he will surgery to have his port placed. Tuesday we go back to Huntsman for the PET scan. Thursday we go to Huntsman again to finalize chemotherapy, and Friday he will have a rectal ultrasound. Here are some pics of Tavner's visit and him trying out Curtis' breathing spirometer.