Superfluous Matter
My Wife Has Cancer

Hi everyone. I haven't posted much lately and many of you know why. But for anyone I haven't managed to tell yet, on November 5, my wife Kim was diagnosed with Diffuse Large B-Cell Lymphoma (i.e. cancer of the lymphatic system). The cancer has also moved into her lungs, and as a result is automatically classified as a stage 4 cancer (one that has spread into other systems from the initial site).

It started back in October when Kim noticed a couple lumps in her neck. The doctor prescribed antibiotics and that seemed to help for a while. But the lumps came back and became painful and Kim eventually ended up in the ER due to the pain. They did various tests over the course of three days, cumulating in a complete biopsy of one of the swollen lymph nodes. We had the results a week later. Since then things have moved fast.

We met with a wonderful hematological oncologist at St. Michael's hospital and she ordered lots more tests to help stage the cancer. The tests included CT scans, radioactive dye tests and a painful bone marrow biopsy. As I mentioned, it is at stage 4 due to the lung involvement, but the cancer is not in Kim's bone marrow and so the treatment is more straight-forward.

This type of lymphoma is one of the most common types and so the treatment is extremely well researched and standardized. The treatment is also very effective at not just reversing the cancer, but ultimately curing it in many cases. Kim will be doing six to eight cycles of chemotherapy at three week intervals. The specific chemotherapy protocol is known as R-CHOP which is an acronym for the drugs that will be used (rituximab, cyclophosphamide, hydroxdaunorubicin, oncovin and prednisone).

We were well aware that chemotherapy has lots of side-effects, however we were totally unprepared for the fact that cyclophosphamide (particularly in the doses Kim will be getting) has a high potential for sterility. As we are planning on having kids in the next few years this news was upsetting. However, the fact that we were already planning on having kids meant that we were excellent candidates for In Vitro Fertilization (IVF). The idea is that they extract eggs from Kim, fertilize them with my sperm and freeze them for future use. Although it is possible to just freeze the eggs, embryos freeze a lot better so it's great that we were already at this stage of our life.

We were referred to a fertility clinic as soon as the initial diagnosis came in and we got started on the process to get Kim ready to extract eggs. This process was projected to take about two weeks which was also the estimated time it would take to prepare Kim for chemotherapy. So a lot was going on in parallel but it seemed like it would all line up nicely.

The IVF process was extremely involved. Both of us had to get lots of blood tests, and Kim had to go into the clinic every day to get injections of drugs to stimulate egg production. She also had to get ultrasounds and blood tests every other day to monitor her progress. The whole thing added a lot of stress to an already stressful time, but we managed. Unfortunately, the IVF treatments were well underway by the time we got the information about the cancer being stage 4. Looking back, we probably would have skipped the whole IVF thing if we had known the cancer was so advanced. However at that point we had already invested lots of time and money into the process and the oncologist assured us it was OK to continue. So we kept going.

Then about a week ago, it looked like Kim wasn't going to be ready for egg harvesting before her first chemotherapy treatment. She also started having more problems breathing due to the cancer in her lungs. This combined to produce a lot of stress. We contacted the oncologist and she was concerned enough about Kim's breathing to admit her to the hospital (St. Michael's) on Monday afternoon of this week. They started her on steroids (prednisone, the P from R-CHOP) to help clear things up and that worked quite well. They've also been running lots of fluids through her intravenously to help flush out any toxicity from degrading cancer cells. Despite all this craziness, we were still able to go the fertility clinic today to complete the egg retrieval. That process went extremely smoothly and they managed to extract 24 eggs (we will find out how many were successfully fertilized tomorrow). An hour after the procedure we were able to head back to the hospital and Kim has been resting ever since.

Tomorrow Kim starts on rituximab, the first part of her chemotherapy. Friday she will receive the rest. Saturday will be recovery and hopefully she can go home after that. As long as all goes well future chemotherapy treatments should only take a day and will be done as out-patient procedures. The first treatment was originally scheduled to be done as out-patient as well, but we're all pretty happy to have it done while Kim is admitted as an in-patient. It means we will get immediate help for any side-effects and it should make it easier for us to handle recovery from future treatments at home.

A lot of people I talk to about this are surprised that Kim is being treated at St. Michael's and not Princess Margaret or Sunnybrook. Although it is true that both of those places are great for cancer treatment, St. Michael's also has an excellent cancer treatment program and we have been nothing but thrilled with the care and treatment provided so far.

Both Kim and I have also had a ton of support and understanding from our employers, for which we are truly grateful.

Finally, all of the kind thoughts, emails and phone calls from friends and family have been much appreciated and will continue to be appreciated in the future. Anyone should feel free to send messages whenever, just understand that we may not reply right away due to the craziness of treatment plus the fact that we have still have to move to our new house in three weeks.

I intend to try to update this blog regularly now with how things are going. This will be easier for me than trying to contact everyone individually with updates. It's not that I don't want to talk to people, just that there isn't always enough time.

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