Friday, November 21, 2014

Josh's Cancer Diagnosis and Treatment

The last 60 days have been rough for us.
In late September, my husband Joshua D. Smith felt some pain in his abdomen and decided to have it checked. After a CT scan, MRI, and endoscopy, we learned on October 1st that he had a cancerous tumor in his pancreas. It wasn't pancreatic cancer, but due to the fact that the tumor had two different types of cancer cells within it, made it very rare (less than 100 cases reported kind of rare). The majority of the tumor (they thought) was called a neuroendocrine tumor, which is fairly common. In fact, the surgeon first told us, "If you are going to have a pancreatic cancer, THIS is the one to have." I don't find that very comforting. The more rare part belongs to an Aciner cell carcinoma, which is more rare on its own, let alone in someone his age. However, the crazy rare part is that the Neuroendocrine tumor and the Aciner cell are in the same tumor. The Aciner cell is more aggressive than the Neuro, and they aren't sure which is taking up the majority of the tumor.

So we scheduled an appt with the surgeons at MD Anderson Cancer center in Houston. His surgery was scheduled for Thursday, November 13th to remove the tumor and a portion of his pancreas.
We arrived, with our son, a couple days early for pre-op appointments and a little fun around Houston. Our plan was to take in a museum or the space center before the surgery, then during the surgery, Lincoln and I would go to the Zoo to keep our minds off of Dad being in a serious surgery. That didn't happen.

Upon our arrival, we were told that Linc would not only be banned from going to Josh's pre-op room, he would not be allowed in his hospital room after surgery. That threw a wrench in our plans. I had to call for back up. My mom was able to drive down to get Linc while I stayed at the hospital, waiting for surgery to begin. We arrived at 10:30 am. They FINALLY took him back to prep at 4:00 pm. I left the hospital to get something to eat and returned around 5:15. As I was settling in to eat and watch a movie, the nursing staff came to update me on his status. All was well, his vitals were great, and they had begun the surgery. Ten minutes later, they came back to tell me the Doctor needed to talk to me.
That was the scariest 4 minutes of my life. The worst ran through my mind. Had he died? Had the cancer spread so far that surgery was no longer an option? Am I going to have to raise my son as a single parent now? How will I go on?

Thankfully, the first words out of the Doctor's mouth were, "He's ok." Scenario one averted. "But it's a nasty one...the tumor is bigger than we thought. It hasn't spread outside of his pancreas," (scenario two averted) "but I have to take his entire pancreas. I need your permission to do that, since I don't know what he would have wanted." After a brief moment of questions as to whether chemo first could shrink the tumor to save some of the pancreas was an option, only to hear that it was not, and a quick call to family, I gave him permission.

I knew that Josh was NOT going to be happy. That's all he ever talked about before the surgery was how he wanted to keep his pancreas. I was going to be in trouble when he woke up, either way.
Seven hours later, the Doctor reported to me that he was able to remove all of the tumor and any lymph nodes they thought could be affected. He considered it a success.

To skip to the most important details, his recovery will be long and hard but we are grateful the surgery was successful. However, because he no longer has a pancreas, which produces both insulin to stabilize blood sugar and enzymes to help break down food, he has now become a life-long diabetic and will need to take enzyme tablets at each meal to aid in digestion. I never knew how important your pancreas actually is until now.
And due to the removal of his spleen, his immune system will be a greater risk for disease and colds. However, he had already begun a series of shots to help build his immune system back up to wart off anything.

Thank you to all who have sacrificed your time and schedules to help. We are forever grateful to you and all those who have kept us in your prayers. We will need many more prayers and patience during this time as we still don't know if chemo will be necessary, but know that we can make it through this storm together.
I will add updates to this blog, since so many have expressed an interest in his recovery. It is easier to update this, instead of sending out 50 text messages every day. 

Thank you again!! Love, Josh, Lacey and Linc

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