Hap had an appointment on Wednesday with his main doctor to receive his monthly treatment injection and to discuss the surgeon’s report.
The surgeon had expressed his concern of one of the pelvic tumors growing into a nerve area. He is concerned that enlargement of this particular
tumor could result in encasement of the right sacral nerve roots; thus compromising the right leg functions and make surgery more complicated or perhaps impossible.

Hap’s main doctor would like to gather more information from two different scans. In May, Hap will have another octreoscan (nuclear) to determine the uptake (activity) in the tumors and another CT scan to determine growth. With the results of both, his doctor can decide if surgery is necessary to prevent future nerve complications.

This past month Hap also experienced a few episodes of “flushing”, which is usually a result from the liver. The only way to explain the flushing is to compare it to “hot flashes”. The scans will also be used to make sure the liver stability hasn’t changed.

Back in 2008, Hap had a dear friend tell him he would be with him each step of this race. Hap now refers to this race as a “marathon”.
Mary said he is a great marathon runner…staying focused, staying strong and trying not to miss a step.

Last week, Hap had 2 appointments at Sloan. On Monday he had his monthly treatment injection and met with his main doctor to discuss his recent scans. His scans continue to look good showing continuous
stability in the liver and pelvic tumors. Mary and Hap asked the doctor if they should pursue another treatment to the pelvic tumors while Hap is strong. His doctor’s response was that every treatment comes with it’s own risks and that unless Hap becomes more symptomatic we should relax and enjoy this “stable time”.

On Thursday, Hap met with the same surgeon that he met with back in September, 2008. He compared Hap’s original scan in 2008 to his most recent. The tumor that is probably causing most of Hap’s discomfort is the obturator lymph node. Although Hap’s scans show that his condition is stable, this tumor has slightly infiltrated into the muscle wall which has a heavily concentrated area of nerves. The surgeon is concerned that if
we do not resect this tumor soon, we may loose the “window of opportunity”. This surgeon plans on discussing this with other doctors at a conference. Hap will follow up with his main doctor in April.

Spring Training and Lent …. 2 good reasons to stay focused!

Not only are the Yankees gearing up for the 2010 season, Hap’s doctors are teaming up to determine the best procedure for battling the pelvic mass and compromised lymph nodes.

A couple of weeks ago, Hap went to see a radiation oncologist to discuss the possibilities of radiation to the pelvic mass and surrounding lymph nodes. One concern would be the closeness of the small intestines and the bladder. With encouragement Hap’s doctor agreed to take Hap’s case to the Tumor Board to discuss options. She also wanted us to follow up with a doctor at Sloan, who specializes in evaluation and treatment of neuromuscular, musculoskeletal and functional complications of cancer, to evaluate the reasons for the pain in the pelvic area.

The Sloan Memorial Tumor Board met a week ago to discuss Hap’s status. Present at the meeting was Hap’s main doctor, his Interventional Radiologist, the Surgeon that saw Hap saw a year ago and his Radiation Oncologist. Hap, Mary and Lisa (sister) attended Hap’s appointment last Monday to discuss the outcome of the board’s recommendations with his main doctor. A clinical trial was discussed, but after close research by his doctor it was determined that she does not feel comfortable with the side effects this trial would produce. At this time, Hap’s condition is considered somewhat stable. This clinic trial drug only has an 18% response rate. His doctor would like to see if Hap becomes symptomatic before his next scheduled scan.

Last Thursday, Hap and Mary saw the doctor recommended to evaluate the cause of his pain in the pelvic area. This doctor described himself as the “sports medicine doctor” for cancer patients. He, along with a neuro-radiologist, determined that the sporadic pain episodes that Hap has been experiencing are most likely caused by the obturator lymph node. This lymph node is surrounded by nerves that are being pressed up against the pelvic bone as the lymph node becomes inflamed. He will leave it up to Hap’s main doctor to decide if they should treat the node in the near future. Meanwhile, he prescribed a prescription to manage the pain during any future “flare-ups”.

Hap’s next scan is March 10 with later follow-up appts with his main doctor and a surgeon.

A Thought for the Day: With national economic worries, the devastation to Haiti, and individual challenges, everyone needs the season of Lent for inward spiritual reflection in our lives to renew hope.

Happy New Year!

The end of December and early January have been very busy for Hap & Mary. Hap has had a few setbacks. On December 30th, he ended up in Sloan Urgent Care Emergency Center with severe pain around the pelvic mass and numbness in his right leg and foot. His CT scan was moved up to this day to attempt to find the cause of his pain. Then a week ago, the same pain returned without the numbness in the leg, and lasted for three long days.

On January 18th, Hap had 3 appointments starting his day at 7:00 A.M. with an MRI of the pelvic area, followed by an appointment with his main Oncologist, his monthly Octreotide injection and finally an appointment with his Interventional Radiologist. At this time, it is uncertain why he has become more symptomatic with the pelvic mass. One of the theories is that it is possibly related to surrounding nerves around the tumor and lymph nodes.

There are no studies to compare this mass to because the mass is a “first seen at Sloan” in this location.

Possible options for future procedures were discussed and are being actively pursued. They include, an alcohol injection to the tumor, cryoablation, a resection of the pelvic tumor and 3 compromised lymph nodes, targeted radiation or treatment in Europe.

The absolute BEST news is the latest round of scans are unchanged with the liver remaining stable with no new growths.

In February, Hap will see a neurologist and a radiation specialist prior to returning to his main Oncologist at Sloan.

Merry Christmas to Everyone!

On Monday, Hap had his monthly blood work and octreotide injection. He has a scan scheduled for January 11 and then back to the city
on the 18th to review the results and future procedures.

Hap, Mary and their boys are really enjoying the down time away from any procedures. This has been a nice reprieve for four months, other than their monthly appts.

Happy Thanksgiving!

Hap and Mary would like to wish everyone a Happy Thanksgiving! This is definitely a time to count our blessings.

On Monday, October 26, Hap and Mary, along with team members Lisa and Nick went to Sloan for a VERY long inning. Hap started with his day with a 2 hour scan that was repeated due to last week’s incomplete scan of the pelvic mass.

Late that afternoon, they attended the appointment with Hap’s main oncologist to discuss his results and to receive his octreotide (sanostatin) injection. The good news is that the liver continues to look stable. There is one tumor in the liver that is not completely embolized: however, it has not changed. There is some disappointment with the pelvic mass as there has not been much change since the embolization in August…although not any change for the worse.

The last appointment for the day was with the Interventional Radiologist. She viewed the recent scans with them and discussed two other possible procedures; ethanol injection with CT scan visual guidance and
Cryoablation that uses cycles of freezing and thawing to kill cancer cells.

Since Hap’s symptoms are minimal at this time and his liver is stable, they have decided to hold off on any decisions until his next scan. At this time they are deciding whether to do the scans in November or wait until January. Either way, it looks like Hap may be able to enjoy the holidays this year without having to recover from any procedures…Yeah!

Wednesday, October 28th marked a year since Hap’s first procedure. Team Member, Nick felt it was important to celebrate Hap’s progress, determination to always move forward and the blessings he has received
and decided they should end their long day with a nice dinner at Fratelli’s.