CSTAR

DR. VOKES – MEDICAL ONCOLOGIST AT UoC

So off I go to see Dr. Vokes, the medical oncologist at the University of Chicago Hospital. It was very exciting, as Dr. Vokes is the pioneer and champion of combined modality therapy. Combined modality therapy is a range of treatments that utilize the synergy created from undergoing radiation and chemotherapy concurrently. Under Dr. Vokes at U of C, this usually means radiation twice a day, as well as chemotherapy on the same day, for five consecutive days, followed by nine days off. This cycle is usually repeated five times.

Here is Dr. Vokes: http://www.uchospitals.edu/physicians/everett-vokes.html

And combined modality therapy: http://www.uchospitals.edu/news/2000/20000413-vokes.html

Dr. Vokes was considerably more concerned about the situation. He agreed with the wait and see opinion of Dr. Agulnik, but suggested a shorter interval of 6 weeks before re-scanning. We decide to split the difference and schedule the scans for 8 weeks from the last set. The most important development of this appointment is that Dr. Vokes informs us that we should be consulting primarily with an ENT surgeon. He highly recommends Dr. Stenson, who we make an appointment with.

DR. STENSON – OTOLARYNGOLOGY SURGEON AT UoC

A few days later, we see Dr. Stenson. Our appointment with her was powerful. She has an aggressive outlook on cancer that is very compatible with mine. Instead of waiting, she prefers to biopsy immediately. A biopsy is when a small amount of tissue is taken and then tested for cancer cells. Her mindset appeals to me. “Why are we waiting” she says. According to Dr. Agulnik, the reason for not biopsying is that the affected tissue is so small that the risk of a false negative is high. A false negative result would be when the surgeon misses the affected area and takes tissue to be tested that is “good”. This tissue will be tested for cancer as negative, but is in fact false because it was taken from the wrong place. However, Dr. Stenson and I agree that a false negative result does us no harm, we would simply be in the same close monitoring situation as prior to the biopsy. So we should go for it.

Given this new aggressive diagnostic stance, a biopsy is scheduled with Dr. Stenson for the following week (last week). Dr. Stenson is planning to go in through my nose, as well as make an incision on the left side of my face to get to the affected area. We were so impressed with Dr. Stenson that we decided to utilize her as our primary physician for treatment going forward. I felt a tremendous kinship with her, she seemed genuinely personally motivated to make/keep me alive and healthy. Her intensity, honesty, and competence are qualities that are very valuable in the situations we are facing.

DR. HARRRAF – RADIOLOGY ONCOLOGIST AT UoC

We next met with Dr. Harraf, the person in charge of radiation treatments at UoC, for the first time. Dr. Harraf echoed Dr. Stenson’s aggressive stance on the situation. Pending the results of the biopsy, we discussed treatment options such as combined modality therapy, proton therapy, and others. The level of close cooperation between the doctors at UoC on post surgical treatments was very impressive.

DR. PELZER – OTOLARYNGOLOGY SURGEON AT NMH

The reasoning of Dr. Vokes to consult Dr. Stenson led me to schedule an appointment with Dr. Pelzer before the biopsy (still with me?). I have a tremendous respect for Dr. Pelzer, and it was very important to consult with him before proceeding. It took a few stressful days to get the appointment, but Maria did a wonderful job of getting us in to see him as soon as I was able to get a hold of her.

DR. CHANDRA – ENDOSCOPIC SURGEON AT NMH

After the appointment, prior to leaving the hospital, Dr. Pelzer called me on my cell phone and politely asked me if I could come back up to the 17th floor for a few minutes. “Absolutely” is my reply. Upon returning, Dr. Pelzer introduces us to Dr. Chandra, who was coincidentally in the area. Dr. Chandra wants to discuss my upcoming biopsy. He shows us several places where he wants Dr. Stenson to pay special attention, and outlines the reason for his concerns. I am trying to absorb all of the complicated information, when it occurs to me “why would I attempt to be the middleman in this exchange of information, and why would I have two different surgery teams (one for the biopsy, and for the surgery if necessary)? The right decision at this point is obvious. We are going to have Dr. Chandra, Chandler, and Pelzer do the biopsy endoscopically at NMH. It was hard to not go with Dr. Stenson, since she had been so impressive with her genuine commitment to my health, but the NMH team is the most appropriate capability for the situation.

What a ride!

OTHER INFORMATION

The only other bit of information was a PET scan, which is a nuclear medicine scan. They inject you with a mixture of sugar and radioactive chemicals. Cancer cells are greedy with food, so they look for places where more sugar is going than should be. The scan was completely negative, which is great, but it is not a definitive diagnostic in that it doesn’t show microscopic tumor.

I have also had an additional MRI of the cervical spine, as I have had some numbness in my right index finger in the past week. The MRI is precautionary, and will most likely show that nothing is wrong. I just did it so that I could have one less thing to worry about.

THANK YOU!

I know this has been a lot of information to digest at one sitting. I will try to update more frequently so as to make this more enjoyable (and shorter) to read. Thanks for everyone’s continued support.