diagnosis

Here's a letter my husband Robbie sent out to some family and friends after my first doctors' appointments: 

I'm writing to provide an update on Juliana's diagnosis and treatment for cancer. 

We learned last Tuesday that Juliana had a cancerous tumor in her colon. Colon cancer is easier to say but technically speaking it is colorectal cancer.

She had a CT scan last Friday which gave us the good news that it had not spread to other organs. The rates of recovery and cure are very high for this type of cancer. 

On Tuesday we met with Dr. Ron Bleday a colorectal surgeon at Brigham & Women's Hospital in Boston. He ordered an MRI to determine what stage it was.  Juliana had an MRI done today which showed that the tumor has grown through the muscle wall. The MRI was "equivocal" with respect to whether or not the lymph nodes are "involved" which will make the difference in whether it is considered stage 2 or 3. Another radiologist is going to read it tomorrow and weigh in on this though it seems that this doesn't make much of a difference in terms of what the treatment will be. We also met with an oncologist yesterday, Dr. Gina Divenuti, who gave us the rundown on the likely treatment protocol which is roughly:

-install a "port" under her skin for IV chemo on 2/15

-start 6 weeks of chemotherapy via continuous infusion (she will carry around a fanny pack with a vcr-tape sized infusion pump 24 hours/day, Monday through Friday). The chemo drug they will give her is called 5FU.

-6 weeks of radiation concurrent with the chemo, which consists of a short daily visit to the clinic to have the local area radiated in a machine.

-Following the 6 weeks of this chemo/radiation treatment, there will be 8 weeks during which the effects of the therapy continue to treat the tumor, causing it to shrink, making the eventual surgery easier.

-Approx. 8 weeks after the chemo/radiation ends, she will have surgery to remove the tumor. She will go to Brigham & Women's in Boston for the surgery, which will likely be early June.

-After 3-4 weeks of recovery post-surgery she will resume chemo (but no radiation) to make sure it doesn't come back. This "adjuvant" chemo is likely to last 4 1/2 months. The chemo they will probably use then is called FOLFOX.  This treatment regime has been very successful in lots of cases with this type of cancer so it will be a long road but we have reason to be optimistic.

Juliana is doing well under the circumstances and is mostly just tired from trying to process all of the information that has been coming at us. Your good wishes, love, and prayers are always welcome and appreciated, please don't be offended if you don't hear back from her.

Juliana has no desire to keep this secret, so please feel free to share this information with anyone else who might be interested. 

This email is terribly clinical and I'm sorry for that. For us, as we have learned more about exactly what it is and how it will work, it has become less terrifying and incomprehensible. I hope that all this jargon has the same effect on you. 

Rob