Note: The following is Steve's update of November 20, 2011, reposted here for those who missed it or would like to catch up.
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Dear friends and family,
So many people have sent encouraging and supportive messages. I never knew how powerful
the effect of such messages is. When I had been on the sending side of such communications,
I always thought that such a gesture, sincere as it might be, meant something, but was soon
displaced by the more significant issues of the moment. Now, on the receiving side, I see that
the power of these messages, singly and cumulatively, is that they can move aside even the most
grave and debilitating pressures that a person in my situation has to deal with. I never knew that
before. Thank you all for whatever you added to the cause.
I waited until the end of the week to send the update that many of you have asked for because
this week was full of office visits and tests, and I assumed that by Friday I would have a lot to
share. And I do. Unfortunately, the news is not good.
The most significant thing, and the only one I'll explain in any detail, is the result of the PET
scan I had on Friday. It shows that in addition to the tumor in my esophagus, the cancer has
spread to several other locations in my body, and therefore, surgery is not a viable treatment.
The doctors will shrink the esophagus tumor with radiation, and when that treatment is over, use
chemotherapy to try to control the spread of the cancer elsewhere. There are too many sites to
operate on--they can't surgically remove the spots from my lungs, my liver, my lymph nodes, etc.
Surgery on the esophagus is not advised in this case because the tumor is located near my lungs,
my stomach, my liver, my heart--it's a serious situation. Esophageal cancer is very aggressive
and spreads rapidly and far. There is a lot to deal with.
The radiation treatment will begin early in the week, perhaps Monday or Tuesday, with a
simulation visit during which the doctors will take images to see exactly where the different
organs in my body are so that they can plan the attack of radiation. It takes a few days to gather
all that information and interpret it, and then to plot out the treatment. The first actual radiation
dose will probably be the Monday after Thanksgiving. There will be two weeks of treatment,
Monday through Friday. After two weeks the radiation should be done, and when we see how I
responded to that and how strong I am, we can make decisions about the chemotherapy.
The doctors indicated that they don't see chemotherapy as a cure, only as an effort to control.
What else can I say without saying it?
I am told that I should notice some relief from the radiation almost immediately, relief in the
form of the tumor shrinking and my being able to swallow with less difficulty. Right now I am
getting by on an entirely liquid diet. Even applesauce is giving me a little bit of a challenge.
I hope you can appreciate the great cosmic irony here. Imagine my response to the macabre
situation of having everyone in my family and all my doctors telling me that I have to eat more,
eat more, eat more. The radiation oncologist even used the expression "fatten you up a little."
Of course, they are right. I have lost a lot of muscle and I am very weak. I am aiming for 2000
calories a day and have yet to break 1000, even though I am trying very hard. I have to get
stronger, and I'm hoping that once the radiation begins I will be able to swallow more and get
more food down. Even if nausea is a side effect, I believe that is responsive to anti-nausea drugs
and the overall effect will be for the better.
All of you who have written to me, as well as some who have not, are receiving this message,
and I invite you to share it with other friends whose addresses I may not have. I am looking
forward to a family gathering for Thanksgiving just as we have every year. I'll be in my chair
at the end of the table with a bottle of Boost, and I'll be thankful for my family and friends who
have gathered around me and offered (not to mention given) me so much support in what is
clearly the most difficult experience of my life. I hope you all have happy holiday gatherings,
and that you take a moment to appreciate the people who love and support you in whatever ways
you need them to. It shouldn't take a crisis to make us realize how our lives are so intertwined,
but sometimes it does.
I expect that I will be telling you more some time in the middle of the week following
Thanksgiving, when the radiation treatment is underway.
Steve
