Page Updated: 2/13/2002
1935-2002
Kirk Woodward
Non Small Cell Lung Cancer
Diagnosis & Treatment Diary
Page Updated: 2/13/2002 |
July 30, 2001 Regular six month
check with primary care physician. I mentioned that for the past two
weeks I'd had trouble finishing my stationary bike routine because I
became short of breath. A stress test was scheduled and two chest
x-rays were taken before I left the office. |
|
August 1, 2001 The chest x-ray is
abnormal. I'm referred for CT Scan. |
| August 2,
2001 The CT scan is also abnormal. The stress test is cancelled in
favor of seeing a pulmonologist. |
|
August 8, 2001 Pulmonologist drains two
liters of fluid from my right lung . . . an immediate improvement in
breathing and an instant 5 pound weight loss. Samples of the fluid are
sent to pathologist for examination. |
| August
13, 2001 There are Non Small Cell Lung Cancer cells in the fluid. Dr.
Washington (the pulmonoloigst) strongly recommends beginning treatment
because of my high functionality (i.e., still walking around). Without
treatment he estimates my survival at between 6 and 18 months. With
treatment the 5 year survival rate is 10%. Not much of a chance, but
none the less a chance. My tumor is staged at IIIB. I am referred to
Texas Oncology, a subsidiary of
U.S. Oncology.
|
|
August 15, 2001 Dr. Singh, Texas
Oncology, discusses treatment options. Mentions a Clinical Trial for
my particular cancer and suggests I visit with the Research Nurse,
Jayne Mettahale. Jayne explains that there are two arms of this
particular Trial. Arm 1 receives Taxol and Carboplatin - two standard
chemicals for treatment of my cancer. Arm 2 receives Taxol,
Carboplatin and a third Investigational drug. The Arm assignment is
made by random assignment. |
| August
17, 2001 I agree to participate in the clinical trial. Lab samples are
gathered and an additional CT scan of my head is done to insure that
the cancer has not spread to distant sites. |
|
August 24, 2001 I have been randomized
to Arm 1 of the clinical trial . . . the standard treatment. Arm 2
calls for a degree of poking and prodding that I've come to wonder if
I could handle it. I take my first chemotherapy treatment of 4 hours,
45 minutes duration with no major difficulty. |
| August
27, 2001 Surgical Associates implants a Triumph-1 Vascular Access
System. A port just beneath the skin of my right collar bone that
facilitates drawing blood samples, chemotherapy, etc. It is the most
unpleasant experience of my treatment to date. Not the surgery. I was
asleep. The preparation. Nothing, not even water, for the twelve hours
prior to the surgery. The chemo effect - flu like aching, etc., is
just kicking in and I spend an uncomfortable half day waiting for the
implant. Perhaps the undertaker removes the port . . . I wouldn't want
to repeat the 'get ready' of the surgical process. |
|
August 31, 2001 First follow-up
appointment with Michelle, Dr. Singh's nurse. Billed as a Lab
appointment, blood is drawn and then we discuss the findings. Michelle
is very upbeat . . . great numbers. The major concern is white cell
and red cell counts. They are triple what they would need to be to
continue chemo and nearly normal. Normal being a very slippery term
the past month or so. We also spend some time discussing/adjusting
medication. My pain pills have been hitting too hard, so we will break
them in half. Michelle phones in another prescription for sleep
medication. Sleep would not have been possible without the pain pills
during the week and because I disliked the stoned feeling of a full
pain pill, I've been tolerating considerable discomfort during the
day. |
September
15, 2001
Second cycle of chemotherapy went fine yesterday. Hair is starting to
loosen up so I got a crew cut to cut down on the mess. On the upside:
The beard also stops growing. Doc did a more complete description of
my tumor. Staging is really somewhat more than IIIB in that fluid
containing cancer cells covers my right lung and heart, there is a
'questionable involvement' on the 5th rib, lymph notes at the base of
the my neck are 'suspiciously enlarged.' Yet no spread to abdomen or
brain. There is a five year 10% survival rate for IIIB, 'rare' for IV.
Glad to be betwix and between. At diagnosis the tumor was irregular in
shape, 5cm wide, 3cm high. The first measurement of what chemotherapy
may have accomplished comes up October 2nd when they repeat the CT
scan of my chest. 'Tumor shrinking' and 'No change' are the hoped for
results, 'tumor growing' gets me off the chemo cycling but with a
pretty grim prognosis. In the absence of any treatment the best guess
is that I would die in January, 2002. With treatment? Well, stay
tuned. Anything beyond January, 2002 will be gravy.
My son-in-law had a heart valve
replaced earlier in the week and is doing fine. That has had the
effect of shifting focus from me. Not much fun to be in this
spotlight.
|
Some
links I've found good information in . . .
Lung Cancer
National Cancer
M.D. Anderson,
Houston
National Institutes of Health
The medicines I'm currently taking .
..
Taxol
Carboplatin |
|
Misspelled words
used to find this page 3 of 14.emvironmental,
environmentla, environmenatl, environmetnal, environmnetal,
environemntal, enviromnental, envirnomental, heledytery,
heretitarie, hearditalie, hereditary, heredetarie, healdetary,
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chemotherapie, chemuthelapi, chemotherepy, chemotherapi,
chemotehrepy, |
September 24, 2001
Over the past weekend the billing summary from Medicare arrived.
Yikes! ALL the numbers are in the hundreds and my first chemo session
totals out at $18,465.00!! The 'plan' is for six. $110,790.00!! And my
memory is clear on one point. We are not after a cure. Only 10% of
people with my condition survive 5 years. We are just seeking an
extension of life. And these treatments are no day at the beach. Plan
on REALLY punk for the week following infusion. I leave a message on
Jayne's voice mail . . . 'Has a decimal point been misplaced?' She
returns my call to report that - somehow - they made a $7,000 billing
error in my favor. Gasp. The treatments are $11,000.00 each. $66,000
for the planned cycle. A considerable saving, but, gee, why mine for
gold when there is cancer out there? It is tough to tell right off how
much of this tab I'll be expected to pay. Medicare pays, then United
Health Care pays, then me. Looks like a max of 30% of the grand total.
Gulp. |
September 28, 2001
This is the regular Friday lab check and hand hold with the nurse,
Jayne. My white cell blood count is way down. Down far enough that if
this were chemo day, they would postpone the infusion. The 'down' is
to be expected at this stage of the cycle (known as the nadir) but it
does turn on some caution lights. No leafy greens, no fruits or
vegetables unless they are peeled. Avoid crowds, people with colds,
anyone with a recent immunization, etc. Low white cells means you are
pretty much a sitting duck for an infection. Also I'm to watch
temperature VERY closely. Anything over 100 degrees means to contact
the clinic 24/7. They don't want a bug to get any sort of head start.
|
October 4, 2001
They did a follow-up CAT Scan of my chest and abdomen Tuesday, October
2, 2001. While I hoped for yes/no, black/white, bigger/smaller, on the
tumor, it was not to be. CAT scan was distorted by a return of the
fluid that was present in my right lung back in August. Terribly
discouraging in that so much of my future is linked to the tumor's
reaction to the chemo. After much thought, I've decided not to take
the third cycle of chemo scheduled for Friday, October 5, 2001, until
something more definite is known about what the first two cycles have
or have not accomplished. Given my really desperate situation, I can't
imagine a delay of a week or so is going to mean much. There IS
consensus that the fluid must come out, and the CAT scan repeated so
if I take the chemo scheduled for October 5, I'll be in the midst of
those painful side effects when the fluid is drawn. Not a happy
combination. Jayne told me that Dr. Sing wants to talk to me about the
scan and I for SURE want more information. Has there been a spread
into the abdomen (drank 32 ozs of barium sulfate before the scan)?
Does the 'involvement' of the 5th rib seem more definite? How about
the 'suspicious' enlargement of lymph nodes in my neck? Other than a
really joyful visit from my son Ted, this hasn't been a good week.
|
October 5, 2001
Met with Dr. Sing. He contacted the pulmonologist, Dr. Washington, and
made arrangements to withdraw the fluid from the right lung tomorrow
morning. The 5th rib thing and neck glands are issues for later
examination . . . bigger fish to fry right now. White cell count is
now back up to a level that would permit chemotherapy and eating leafy
vegetables and other fruits and vegetables without having to peel
them. Got a copy of the CT scan report. Lots of big words but,
happily, there is no metastasis to abdomen and the fluid has distended
the lung enough to make an accurate reading of the tumor impossible. I
look forward to drawing the fluid. In August it resulted in an
immediate improvement in breathing which has been difficult the past
two weeks. |
October 6, 2001
Dr. Washington drew three liters of really awful looking fluid from my
right lung. A pathologist will look at a sample of the fluid. Likely
it will still be Non Small Cell Lung Cancer, but one does hope, you
know. For now: Immediate improvement in breathing. I can come
up stairs without having to sit down. Slept better last night. Also
7.5 lb weight loss . . . although I can't recommend this as a weight
control program. We'll check fluid again in three weeks time. If it is
back in this volume, we'll do an additional procedure to drain ALL
fluid and inhibit its return. |
October 8, 2001
Long, very frank visit with Dr. Singh (the oncologist) today. Whatever
another CT scan would show in the absence of the fluid, Singh believes
the tumor is larger. Maybe as much as 20%, perhaps less. Not worth
another $800 to get a precise measurement. It certainly is not smaller
or the same size as when I started treatment. Singh discussed other
chemical combinations, treatment protocols etc,. but I said that
having received $25,000 of treatment and become worse, I now wanted a
referral to the M.
D. Anderson Cancer Center in Houston, TX. Anderson, along with
Sloan-Kettering in New York lead the cancer treatment field. In fact,
Singh was at Sloan for a time. Singh graciously acceded to my decision
and said he would expedite the referral in every way possible. Dr.
Washington was equally supportive of my decision on Saturday. I am
maintaining future appointments with both Singh and Washington.
Certainly not interested in burning any of the bridges so
painstakingly built over the past two months. Good news in all this?
Well, Dr. Singh who guessed I would die in January, 2002 without any
treatment, now sees me functional through June, 2002. It is kind of
like the insurance tables . . . if you make it to here, there is a
good chance you'll make it to here + x years. Having survived two
months since diagnosis, I get some more months tacked on to the
January date. I'll take all I can get. It will take some time to
actually get an appointment at M.D.Anderson. They want all the
materials developed since my diagnosis AND a basic summary from my
primary care physician. Those things are spread over four offices and
two cities and I'm totally dependent on the 'providers' to locate what
Anderson wants and get it off to Houston. I've got their phone numbers
in my speed dialer. Stay tuned.
Later in the day, Dr. Singh ordered
a Doppler Test. I'd call it a sonogram of the heart. It produces a
picture like you see of babies in the womb, only LOTS more
movement/action. Incredible to see a little valve open, then close
over and over and over and over. It has been doing that little job
without trouble or complaint for 66 years. Wow. The test was done
because all the CT scans have showed the fluid around my lung also
around the heart and Dr. Singh wanted to know how it is affecting
heart function. It could put the squeeze on the heart that it
does on the lung, impairing function. |
October 10, 2001
Firm appointment at M. D. Anderson Cancer Center in Houston, TX,
Tuesday, October 16, 2001, at noon.
Frank Fossella, MD. His cv. sounds encouraging. And I'm encouraged
by the fast 'turn.' Generally you don't expect an appointment this
quickly. Obviously the front running on the part of favorite son, Ted
et al, has speeded things up dramatically. I've been successful in
locating everything they want at MDA (shorthand for M. D. Anderson
Cancer Center) but still need to get the pathology slides FedExed to
them and get the CAT scans into my hands for taking with me to Houston
on Tuesday. Apparently they have enough info in hand to do the initial
appointment, but it would be nice to have the base line CAT film and
avoid gathering another fluid sample. MDA's FAQ section says to plan
on being in Houston 3-5 days. American Airline's price of $65 round
trip beats cost of gas to drive it . . . 270 miles one way. Still
shopping for hotel/motel space. |
October 12, 2001
Whew! Everything has been pulled together. In fact, Michelle, Dr.
Singh's nurse, advises that the report on the Dopper scan of my heart
is also available to go to MDA along with the CT scan films. Confirmed
airline and hotel as well. The $65 fare on American was based on 14
day advance purchase. I explained that I didn't know about the
appointment until Wednesday and asked - in view of the nature of the
trip - for 'compassionate' waiver to no avail. Southwest's Senior fare
for the round trip is $109 . . . so I booked that. Nothing to do now
but wait . . . the hardest part, no? |
October 16, 17, 2001
Long awaited visit to M. D. Anderson Cancer Center in Houston, TX. Saw
Dr. Fossella in the afternoon and trotted around for blood draw and
x-rays following. Declining Clinical Trial participation effectively
reduced the trip to a 'second opinion.' Which is: This type of tumor
is notoriously unresponsive to chemotherapy. We need to move on to
other combinations. Specifically: Chemo every week for four weeks,
then two weeks of 'rest.' Then repeat, then a CT scan to see how
things are going. Then? Well, looks like there are about a dozen
bullets to shoot. I'd be delighted to be around for the year or so it
would take to work through them all. Happily the treatment regime can
be carried out locally rather than in Houston. MDA also suggested the
Denver Catheter. A 'permanent' tube placed inside the chest to make it
possible for a person to do their own thoracentisis - drain the fluid
that accumulates. They showed me a video of the process and it seemed
to me to be something I shouldn't attempt. Really the type of thing a
doctor rather than a patient should be doing. I have an appointment
with the pulmonologist, Dr. Washington, next week and it seems likely
that we will proceed with an in-patient procedure - 3-5 days
hospitalization - that will drain all the fluid and inhibit further
formation. X-rays at MDA suggested that another liter of fluid has
collected since the three liters were drawn October 6. At that pace,
thoracentisis (no day at the beach by itself) would become a weekly
chore. |
October 20, 21, 22, 2001
Delightful visit from big brother Tom and his wife Sara from
Pittsburgh, PA. They wax enthusiastic about everything we suggest,
making entertaining them super easy. We'll see a preview production of
The Front Page and they hitch hike nicely with Granddaughter
Heather's 11th birthday. This being sick isn't unrelenting bad news!
|
October 23,2001
Dr. Washington says the rapid accumulation of fluid in the right lung
suggests a 'tube and talc' procedure. I'm admitted to Baylor Hospital
in Grapevine and Dr. inserts the tube a little after 7pm. Immediate
improvement in breathing as before. We hit 10 on the pain scale
several times during the insertion process. |
October 24, 2001
The chest tube almost immediately re-inflates the upper lobe of the
right lung. The lower part of the lung remains partially collapsed
even though the fluid is now gone. Allowing for a week in the hospital
makes sure we get all the fluid that comes . . . . so we'll just wait
and see what develops. They are taking x-rays every morning to see
where we stand. |
October 28, 2001
Day light savings ends with the earlier sunrise this morning. Dr.
Turner is not optimistic that further drainage will re-inflate the
middle of the right lung. This leaves 3 options. #1. Transfer to
H.E.B. (they have the necessary equipment) as an in patient for 5
weeks of radiation treatment. Chest tube remains in place until
radiation is completed or the lung reinflates. #2. Remove chest tube .
. . do radiation as an out patient . . . deal with fluid build up as
needed. #3. Chest tube might remain in place while doing radiation . .
. this would be more Dr. Washington's call than mine or Dr. Turner.
|
October 31, 2001
Dr. Herman . . . a colleague of Dr. Washington . . . explains clearly
and concisely the options from this point. Pem and I decide on
radiation treatment of the lung section that has not re-inflated while
leaving my chest tube in place to facilitate removal of any fluid
build up. The major draw back: has to be done on an in patient basis
because of the chest tube, ergo, a transfer to Harris Methodist HEB
where they have radiation equipment needed. Also the transfer will be
done in an ambulance which seems sizeable overkill given how good I
feel. Sigh. |
November 1, 2001
Transfer to Methodist H.E.B. for access to radiation equipment. Visit
with radiation doc who paints a less than glowing picture of what
radiation might be able to do. Best case: The lung, cleared of the
blockage, re-inflates to the chest wall, thus making the 'talc' part
of 'tube and talc' a possible 'permanent' solution to the fluid
collection. Worst case: Lung does not inflate. Radiation course is of
no avail. Looks like a two week time frame to see any sort of
indication of how the radiation can help the situation. In both cases,
of course, the treatment is carried out on an inpatient basis. These
hospitals are not much fun and very expensive. The major annoyance is
being away from home for the many, many hours of 'custodial care.'
Although I doubt that fierce pain of this first night could have been
dealt with at home. |
November 2, 2001
First radiation treatment . . . about 5 minutes with much whirring,
clicking and cranking of enormous equipment at the Edwards Cancer
Center associated with HEB Hospital. Later first chemo with
docetaxel lasted about an hour and was done in my room.
|
November 3, 2001
A Saturday, cancer only fought 5 days a week. |
Sunday, November 4, 2001
Early this morning the chest tube pulls out. Odd sound from the
suction machine is the first clue. The doc covering for Dr. Washington
stops in and suggests re-inserting the tube. I went 'in patient' just
to avoid such a occurrence, so request discharge from the Hospital and
switch to outpatient treatment for radiation and chemotherapy. Dr.
agrees and we leave the hospital shortly before noon. |
Monday, November 5,
2001
Being home is wonderful but triggers two very bad days. Terrible
constipation is followed by near catastrophic diahareaa. The radiation
appt is shifted to 1PM, but I am unable to make it. If not for wife
Pem's constant ministrations and encouragement, I would have totally
collapsed before the end of the day, totally unable to care for
myself. A close call. |
Tuesday, November 6, 2001
Get radiation at 1PM but in very shaky condition and need to be moved
around in a wheel chair. Consult with Dr. re G.I. track troubles and
get additional medication for nausea and drug induced constipation. Go
across the street to Texas Oncology for bag of fluids which helps a
lot. |
Wednesday, November 7,
2001
What a difference two days has made! Carefully following Pem's and
Dr's instructions regarding diet, rest, medication, I'm feel nearly
normal, have resumed daily radiation treatments and can look forward
to visit from Ted, Sheri, Helen and Miriam on Fall school break from
New Jersey. It is a joy to see them. |
Friday, November 9, 2001
I close out this roller coaster week with a radiation and chemo
session. We finally get real Fall weather, rain, cool, wind, but my
outlook is much brighter than it has been for many weeks. It seems
we've gotten a 'balance' between medications. We have lots of people
around to sing Happy Birthday for Pemmie. She says she is joining
Margot in calling a halt to birthdays. She plans to hold right here,
which suits her well. |
Friday, November 16,
2001
8:00AM
Dr. Dubay is not able to tell definitely what progress the radiation
treatments have made (9 treatments) because the fluid has returned to
the degree that it obscures the middle lobe of right lung which has
been the focus of the treatment. He plans to 'confer' with Dr. Turner
on Monday and I mentioned bringing Dr. Washington 'in loop' in that if
anything is done about the fluid, he'd likely be the guy to do it.
1:15PM
Dr. Singh has returned from vacation and has set my next chemo for
December 14, 2001. Joy! The nausea following this new juice has been
profound. Two weeks off seems a marvelous gift. Singh is also pleased
at the 'sound' of my right lung . . . less fluid than in the past.
|
Wednesday, November 21, 2001
Dr. Washington does my third thorencentisis and drains 2.5 liters of
fluid. The usual immediate improvement in breathing and comfort is
most welcome over the long Thanksgiving weekend. Dr's opinion now is
that a more 'permanent' solution must be employed on the recurring
fluid. The Denver Catheter is such a device and would enable me to
draw fluid at home every day if necessary. |
Friday, November 28,
2001
Completed with some delight the radiation portion of my current
treatment protocol. In that I'm 'on break' from Chemo, I've got two
whole weeks of 'rest.' I need it. Nausea and vomiting has become more
difficult to 'manage.' On Wednesday, December 5th, I have an
appointment with Dr. Washington. If fluid is back, we'll install the
Denver Catheter. |
Monday, December 17, 2001
Sometimes up, sometimes down. We 'make' the schedule of doc
appointments and do install the Denver Catheter. Pemmie can now -
under visiting nurse's guidance - drain the fluid from the right lung.
A major improvement over having to have a daily thoracentisis. Much
more comfortable. Dr. Washington also prescribes a derivative of
marijuana for the nausea - which, this morning was continuous. The
food didn't even go to body temperature before coming back up. Between
these new pills and daily draining of fluid, there is hope for some
comfort from side effects. |
Monday, February 4, 2002
From son-in-law, John:
After going into the hospital to be
treated for dehydration and disorientation on January 23, 2002, Kirk
was admitted today to hospice care at All Saints Hospital in Fort
Worth. The personnel there are doing a fine job of "making him as
comfortable as possible." Pam has requested that any cards be sent to
the house -- 2024 Heatherbrook, Grapevine, TX, 76051. When scheduled,
we will be posting memorial service details. Thank you all for your
continuing thoughts and prayers. |
Monday, February 11, 2002
Obituary Kirk Woodward
A memorial service for Kirk Woodward of Grapevine, TX, will be held at
11:00 AM, Friday, February 15th, at the Martin Thompson Carriage House
Chapel, 224 E. College, Grapevine. Kirk Woodward was born to Thomas A.
and Jessie G. Woodward in Beatrice, Nebraska, March 25, 1935. He
attended the University of Nebraska and was inducted into the Army in
1955, where he served in Korea, and received an honorable discharge in
1957. He married Pearl (Pam) Bremer on August 16, 1958. They moved to
West Lafayette, Indiana, and then on to Peoria, Illinois, where he
worked for Radio Station WIRL. While in Peoria, a son, Ted, and a
daughter, Margot, were born to them. They moved to Abilene, Texas, in
1965, where he and Pam raised their two children. Kirk was associated
with Radio Station KRBC for twelve years in various capacities
including Sales Manager, then became Vice President-Marketing for
First Security Savings and Loan, and finally served as Vice
President-Membership Director of West Texas Chamber of Commerce before
forming his own company, People Centered Programs. From his company,
he provided various professional services, including public speaking,
seminars, and training manuals. While in Abliene, Kirk was active in
community theater groups, Rotary Club, and an avid sailor in the Fort
Phantom Yacht Club. After founding People Centered Programs, they
moved to Grapevine, Texas, in 1987. In Grapevine, he served as a
Mutual Fund Representative for Fidelity Investments. Once more drawing
upon his entrepreneurial skills, in 1994 he formed a marketing,
publishing, and video production corporation, HHJM, Inc. A motorcycle
enthusiast, he founded the annual Motorcycle Mother Road Ride/Rally
for Historic Route 66, which is now in its 8th year. Following a six
month battle with lung cancer he succumbed to the disease at All
Saints Hospital, Fort Worth. He is survived by his wife of 43 years,
Pam; son, Ted Kirk Woodward, Ph.D., and wife, Sheri Woodward, Ph.D.,
of Holmdel, NJ; daughter, Mrs. Margot Quinn, CPA, and husband, John
Quinn, of Irving, TX; brother Thomas A. Woodward, Attorney, and wife,
Sara Woodward, of Pittsburgh, PA; four grandchildren, Helen Woodward,
Miriam Woodward, Heather Quinn, Jacob Quinn; an aunt, Mrs. Mollie
Hungate and husband, Dr. Frank Hungate, of Seattle, WA; sister-in-law
Mrs. Flo Havens and husband, Dick Havens, of Fremont, NE;
sister-in-law Mrs. Nancy Bremer of Stanton, NE; 5 nephews; and 3
nieces. |
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