BROTHER EATING

My brother has finally eaten his second meal.  It was pancake and syrup.  He said it felt weird.  I know what he means.  If he keeps this up he'll have that PEG tube out soon.

He has an appointment with the Physical Therapy office to have lymphatic massage on his face and neck.  I asked him not to go as it is not safe during this pandemic.  He's having second thoughts.

BROTHER'S DENTURES

My brother finally got his dentures and they look great.  He has gone so long without teeth since they all had to be pulled prior to his chemo and radiation treatments.  Yesterday he sent me a photo of him smiling showing his new pearly whites.  It was great.

He said he was afraid to eat cause he didn't know what he could swallow.  I explained to him that he should start slow with small bites of something wet and slippery like pancakes with syrup or scrambled eggs with butter.

Then last night he texted me that he had eaten grits and eggs.  I was so happy to hear that.

 

MY 3 MONTH ENT FOLLOWUP

Got scoped yesterday and everything looks good down my throat.  Because I am 2 1/2 years out of treatment, I don't have to be seen again for 6 months.   

Today had appointment with my Cardiologist.  Had an EKG which was fine.  My blood pressure was high and had it taken several times during my stay in the exam room.  160/75

Was told to monitor at home and call in if it gets higher.

BROTHER HAS TUMOR ON LEFT KIDNEY

Transported my brother to his appointment with the Medical Oncologist.  He went over the results of his recent CAT Scans and Blood Work.  It was not good news.

My brother has a tumor on his left kidney the size of a nickel.  He has been referred to a Urologist.  The Oncologist said that they usually just keep an eye on this type of tumor and if it grows then they would do surgery to remove the tumor and not the whole kidney.  This is a much easier surgery to do on the patient.  Solid kidney tumors can be benign, but most often are found to be cancer.  About 90 percent of kidney cancers are a type called renal cell carcinoma.  

There are four stages: Stages 1 and 2 describe cancers in which the tumor is still in the kidney. Stage 2 means that the tumor is growing and is larger than seven centimeters across (2.7 inches). Stages 3 and 4 mean the cancer has spread either into a major vein, to lymph nodes, or to other organs.  My brother would be considered in Stage 1 as his tumor is about an inch in size.

His blood work showed that he is dehydrated, malnourished, and anemic.  He is not getting enough protein.  He has ordered 3 infusions a week for the next month.  I was glad to hear him say that.

He also encouraged my brother to begin eating and teaching his taste buds to taste again.  He also said to increase his water intake between tube feedings.

He mentioned something about his lungs but did not elaborate on this.

I always felt that his weakness was due to his diet not being sufficient.  Now if we can get this rectified he will have the strength to continue with his physical therapy and build up his muscle strength.  

My brother feels that he will  not survive a major surgery on his kidney.  He is so run down and weak and has so many other health issues so I can understand his fear.

He will be seeing Dr. Alexander for his tumor on the kidney.

BROTHER'S PHYSICAL THERAPY APPOINTMENT

Transported my brother to his first Physical Therapy appointment yesterday.  The therapist did an evaluation of his strengths and had him do different exercises.  She said he had some weak areas but was not all that bad.  She will be seeing him twice a week for 6 weeks.  Sure hope that helps with his overall weakness that he has been experiencing for several months now.

He has a little more lymphedema on his face than the last time I saw him a few weeks ago.  I encouraged him to watch the Youtube videos on how to do lymphatic massage.  If he doesn't move that fluid out it will eventually turn hard and be painful.  Informed him of a compression garment that can also be used.

He is still not eating by mouth and is 4 months out of treatment. 

BROTHER'S DENTAL APPOINTMENT

Transported my brother to his family dentist in order to get his impressions done.  Was a very short visit but they informed that the next visit will be about an hour long.  More impressions need to be done at that time.

The dental assistant said that his gums had not completely healed from the extractions done about 4 months ago.  Probably due to the Radiation Therapy.  There are some protrusions that he may be able to remove as they continue to come out of his gums.  She instructed him to use a q-tip to get them out.

He was given an appointment for a week from today.

BROTHER IS NOW N.E.D. - No Evidence of Disease

Transported my brother to the ENT doctor today to discuss the results of his Fine Needle and Core Needle Biopsy of the new lump on his neck.  Results show no cancer.  It is a Warthin Tumor not a lymph node.  

Treatment of Warthin tumor generally includes surgery to remove the tumor or careful observation to watch for changes in the tumor over time. Because Warthin tumor is almost always benign, additional treatment (i.e. radiation therapy and/or chemotherapy ) is rarely needed.

I asked the ENT doctor to look at the inside of his cheek as there is a white patch I am concerned about.  We don't know how long it has been there but was noticed a couple of months ago by the Nurse Practitioner.  Nothing was said about it at that time.

ENT looked at it and didn't say what it was.

We then had an appointment with the Medical Oncologist.  He informed us that there is no cancer in his neck.  I then asked him to look at the white spot on the inside of his cheek which is the size of a pencil eraser.  He looked and said it was Leukoplakia which could be precancerous.  It should be monitored and possibly have a biopsy taken.

I came home and did some research.

Treatment of Leukoplakia

Most patches improve on their own and don't require any treatment. 

If a biopsy comes back positive for oral cancer, the patch must be removed immediately. This can help prevent cancer cells from spreading.

Patches can be removed by using laser therapy, a scalpel, or a freezing procedure.

Removal of leukoplakia patches. Patches may be removed using a scalpel, a laser or an extremely cold probe that freezes and destroys cancer cells (cryoprobe).  Follow-up visits to check the area. Once you've had leukoplakia, recurrences are common.

These white or red patches might be harmless. But they can also be precancerous and contain abnormal cells.  Only about 5 out of every 100 people (5%) diagnosed with leukoplakia have cancerous or precancerous changes.

Within 15 years, about 3% to 17.5% of people with leukoplakia will develop squamous cell carcinoma, a common type of skin cancer. The likelihood of developing cancer from leukoplakia depends on the size, shape, and appearance of abnormal cells.

Leukoplakia usually doesn't cause permanent damage to tissues in your mouth. However, leukoplakia increases your risk of oral cancer. Oral cancers often form near leukoplakia patches, and the patches themselves may show cancerous changes.

Mild leukoplakia is usually harmless and often goes away on its own. More serious cases may be linked to oral cancer and must be treated promptly.

A biopsy will likely be taken to rule out other causes, such as oral cancer. During the biopsy, a small piece of tissue from the lesion will be removed to be examined in a lab. A numbing agent will be used so that you will not feel any pain.

Leukoplakia is usually harmless, and lesions usually clear in a few weeks or months after the source of irritation is removed. If eliminating the source of irritation is ineffective in reducing leukoplakia, the lesion may need to be surgically removed. The lesion can be removed either by your general dentist or by an oral surgeon.

So we got some good news and some not so good news.  I did not feel relieved after these two visits.  I was so hoping that we would all feel extremely happy but we don't.

My brother will be going to get his dental impressions soon and if he goes to his Oral Surgeon - he will be able to assess the white patch and do a biopsy if needed.