Difficult news. Yesterday the lab results of Elaine's bile duct brushings revealed cancerous cells. This is evidence that the cancer that began in her peritoneum (abdominal lining) is spreading. It signals a new ominous phase of her disease.
At this point we have no idea where else the cancer may have invaded, how far it has progressed, or what any of this means for Elaine's prognosis. Undoubtedly we'll get more information over the next days and weeks.
The last month has been extremely unpleasant. Elaine has been hospitalized for the past six days. On Tuesday, she had her 4th procedure in 19 days, as an interventional radiology team removed more than half a liter of fluid from the pleural lining of her right lung. In the previous 36 hours, her fever rose and the pain in her chest, side and back intensified to a crescendo. Draining the fluid relieved her fever and pain, but left her exhausted.
The cytology report should help us understand whether the extracted fluid is the result of an infection or malignancy. At this point, Elaine is short of breath, and the fluid continues to gather, which could be long term problems. We’ve had conflicting counsel on this.
Elaine's physicians – Drs. Petersen and Corregidor (Gastroenterology), Huff (Emergency Medicine), Schoonover (Pulmonology), Kapoor (Infectious Disease), Shah and Bartfield (Hospital Medicine) and Spohr (Interventional Radiology) have been systematic, communicative and excellent, working together as a team, and we've been grateful for and gratified by this. All information flows to the hospitalists, who have also been in touch withElaine's primary care doctor, Rick Glock, and oncologist, Steve Buckley. It’s wonderful when you see medicine work like we know it can.
There is still much we don't know about her illness or the plan going forward, but those will be clarified in the next days and weeks.
Over the past 32 months, we have tried to face Elaine’s illness directly and optimistically. Times like these test our resolve, though.
Thanks for being there. You can reach Elaine at email@example.com.