THE JOURNEY CONTINUES 

Dear Ones,                               August 18, 2017

Last Monday was another new experience at University of Michigan Hospital. Del’s appointment was with a Dr Dawn Owen, MD PhD—a radiologist/oncologist. We thought we would be seeing a professional-looking female doctor in a white lab-coat. Instead this dear little Asian/Canadian lady doctor came into the exam room. She was the sweetest person—extremely intelligent and well qualified. We found out that she grew up in Toronto, Canada, not far from where I grew up, so we had fun asking back and forth, “Do you know such-and-such street?”

Dr Owen spent a couple of hours with us explaining how radiation would be used, the possible side effects, the frequency, and rationale for using radiation at this point in Del’s treatment. She said that the U of M tumor board was pleased with how the chemo has worked on Del’s form of cancer, although there are still some suspicious lymph nodes probably containing cancer cells. The radiation is to keep the cancer from coming back.

There are two main forms of radiation for dealing with the cancer area. One is the ‘exterior’ beam which is given from outside the body. It’s what I (Bryan) had for colon cancer. The other is ‘interior’ (called brachytherapy) where they use a cylinder to place a radioactive seed in the area for 2-3 hours at a time. The doctor thinks only the ‘interior’ method would be best in Del’s case. Chemo does a good job on lymph nodes, but doesn’t seem to work well on that area. Del will have 9 infusions of chemo spread over the next 3 months. The radiation would begin one month after the chemo ends. Another advantage of the interior method is that there is minimal irritation of nearby organs.

Tuesday (15^th) Del had a follow up CT scan. This is the second time that she has had an allergic reaction to the contrast media. The report showed that there was a mix of results in the affected lymph nodes.

Last week Bryan had his 8^th semi-annual urinary stent replacement in Grand Rapids. He had a few more side-effects following this procedure, but once again it appears to be a success. So far this has prevented having to go through major surgery, for which we are thankful to the Lord.

We love you folks and appreciate your friendship and prayers so very much. Thanks for all of your encouraging email notes and cards.

Lovingly in Christ,

Bryan and Del Coupland                                 

Dear Ones,                                                                         August 7, 2017

We spent a half hour on the phone with one of Del’s doctors from U of M and we got more information on the pathology report from Del’s total hysterectomy surgery as well as some of the plans going forward. I will summarize the main points of interest here:

1.    The origin of the clear-cell carcinoma was the uterus, but cancer was also found on the other parts of the female organs removed.

2.   Del’s post-op appointment with Dr. McLean, her gynecologist/oncologist/surgeon, will be September 5. It seems like a long time away, but they want to make sure she is completely healed from the surgery.

3.   Dr. M is encouraged with how well the chemo has been working despite the ongoing side effects from the neuropathy.

4.   The doctor recommends three more cycles of chemo to treat any remaining cancer cells. [A ‘cycle’ is four weeks made up of one chemo infusion each week for 3 weeks, followed by a week off.] 

5.   Dr. M met with the tumor board after they had Del’s pathology report and they felt that she may need some radiation. This would be done at U of M, while the chemo will be given in Jackson. Del has an appointment with a radiologist/oncologist at U of M on August 14 to discuss possible radiation treatment.

6.   They did not remove any ‘lymph nodes’ since there weren’t any that appeared enlarged. The risk in removing nodes unnecessarily is that it can result in ‘lymphedema’ or swelling of the legs.

7.   Del will be having another CT scan on August 15 which will help determine her chemo schedule going forward.

8.   During the surgery, they did an ‘abdominal wash’ where they flush the abdominal cavity and check for cancer cells. There weren’t any!

9.   Tomorrow will be 3 weeks since Del’s surgery and she is feeling well and back to normal strength. How we thank the Lord for His healing in her body.

Well, that’s about it for updates. Thank you so much for your continued prayers and concern. You are such an important part of our lives and we thank the Lord for each one of you.

Warmly,

Bryan, for Del too