Monday, June 1, 2009

Dave's Story

This contains details about how Dave found out about his cancer. If you have any questions about anything in here, please message Kelly Palfreyman(Dave's daughter-in-law) on facebook. We will continue to post updates as we get them! Thanks for your love and support!

Before the Hospital

Dave has been sick for a few months. He has had respiratory problems (including pneumonia last year) and stomach problems (including vomiting). For a few weeks prior to being admitted to the hospital, Dave’s vomiting had gotten worse but was not in any kind of pain.

Dave had gone in to see his dermatologist, Dr. Jensen, about a lesion on his arm on Wednesday May 20. Dr. Jensen noticed that Dave had lost a significant amount of weight and wasn’t looking healthy so they started talking about it. (On a side note, Dr. Jensen is a long time personal friend who used to work in the ER.) So Dr. Jensen started making calls to get Dave in to have an ultrasound that afternoon.

They called Thursday with the results from the ultrasound. They showed that his gallbladder was not functioning properly and there was a mass the size of a baseball on the right lower lobe of his liver. That same day, Dave went in with Dr. Jensen to have his lungs x-rayed to see if the tumor had spread to his lungs.

Dave went in for a CT scan on Friday which confirmed the mass on the liver and that his gallbladder was not functioning. Then he scheduled a liver biopsy for Tuesday morning (due to Monday being Memorial Day). At this point Dave was still not feeling any pain just discomfort and nausea. Dr. Jensen had given Dave medication to help with the discomfort and to help him sleep.

By Sunday Dave was in a lot of pain (in the ribs next to his liver) and experienced severe vomiting. Dave also had a high fever so he was taken into the ER that night at 8 pm.

At Utah Valley Regional Medical Center (Sunday May 24-Monday June 1)

Dave’s wife Kaylene took him to the emergency room on Sunday night at 8 pm. They started I.V. fluids and gave him Dilloted for the pain. When the doctor came in he felt around Dave’s abdomen to find the location of the pain. For some reason Dave was feeling more pain in the lower part of his abdomen. As a result, the ER doctor was concerned about Dave’s appendix bursting. Another CT scan showed that Dave’s appendix had not burst and we were back to square one.

On Monday, Dave had a Hyda -test done on his gallbladder. This is a test where they inject the gallbladder with a dye and watch what the gallbladder does with it. This shows them how high the gallbladder is functioning. They continued to give him medication for pain and nausea. The liver biopsy was still scheduled for Tuesday when the doctors were back in town.

Typically when patients are in the hospital for an extended period of time, they are given blood thinners since they lay in bed all day. However, the liver is an organ that bleeds a lot. So doing a biopsy after he’d had blood thinners was not an option. The biopsy was postponed until Wednesday morning. (As a side note, his nurse was in tears and very apologetic.)
Wednesday morning, Dave had the biopsy done. The results general take 1-3 days to come back. Dave’s took two days. Wednesday at 4 pm, Dave’s doctor started him on antibiotics. Over the next few days his fever went down and his strength started to return.

The results came back on Friday. Dave had been prepped for surgery before the results came back. At that point the best option was to remove the gallbladder and the tumor. The right lower lobe of the liver could be taken out because that part of the liver will regenerate itself. The results came back that the tumor was cancerous and a better look at the tumor showed that it was actually the size of a softball. The doctors were concerned that the mass might be too big for them to take it out. If they take out too much of his liver it won’t be able to sustain his body. At this point on Friday the doctors explained the options were to operate and take out the mass (if they can without killing him) or to do a full liver transplant. They came in Friday evening and said that a transplant would no longer be an option. The national standard for a transplant includes a qualifier. The tumor on the liver can’t be larger than 8 cm. Dave’s tumor is 12 cm on one side. On another note, Dave has a swollen lymph node in or around the portal vein (the vein that leads to his liver). The doctors aren’t sure why it is swollen but they say it is most likely cancer. We aren’t sure what that means for Dave just yet, but that is a low priority compared to the tumor.

Dave stayed at the hospital until he could tolerate and keep his food down and his oxygen level went back up to the mid 90’s. They transitioned him onto oral antibiotics and oral pain medication. Dave came home this afternoon Monday June 1.

Options for Dave as of Monday June 1

At this point Dave has a few options. The best option is for him to have surgery. However, at this time he is not eligible for surgery because of the size of his tumor. There are medications that can shrink the tumor or freeze it so it won’t grow. If they can shrink it enough, they could take the tumor out. Or, if they can shrink it down to 8 cm then he would be eligible for a transplant. Shrinking the tumor to 8 cm is not impossible, but not likely. However, every person’s body is different.

The Huntsman Cancer Institute at the University of Utah has a Tumor Board that meets every Tuesday morning at 12:30. The Tumor Board is composed of a number of expert Oncologists and Cancer Surgeons who spend time looking through rare cases and try to come up with treatment options. Thanks to some of Dave’s close friends, the Tumor Board has agreed to review Dave’s medical records. Kaylene and Matt (Dave’s son) will be taking Dave’s medical records up first thing tomorrow morning and the board will meet at 12:30.

Dave has a rare form of liver cancer. Generally liver cancer is secondary which means that it starts somewhere else and spreads to the liver. Dave’s liver cancer is primary which means that it started in his liver. Fortunately it doesn’t seem to have spread. His organs (except the gallbladder) are fully functional. The doctors are surprised that the rest of Dave’s liver is also functioning at full capacity given the size of his tumor. They are also surprised that he has this kind of cancer at all. Generally this kind of cancer is found in third world countries in drug abusers, alcoholics, and people infected with hepatitis. They have no idea why he has it or where it came from. For those of you who live out of state or may be otherwise unaware, the University of Utah Huntsman Cancer Institute is a research school and is dedicated to making life saving discoveries. While they don’t know much about this type of cancer, we are confident that getting Dave in at the Huntsman Cancer Institute will be his best option. We are very interested to see what they do with the information.

If you have any questions please message Kelly Palfreyman on facebook. Also, Dave has a facebook group "Friends and Family for Dave Palfreyman". If you are not a member of that group and would like to be, please search and join or message Kelly Palfreyman and she will invite you.

Dave wants to express his thanks to the many friends and visitors who have helped out in any way, and he is happy to report that his spirits are high, most in part because of the great love and many prayers of you, his close friends and our incredible family.

Thanks for your continued prayers and support. We need our Utah miracle, and we can’t do it without all of you.


  1. Matty, did you write this? A lot of info here. Thank you. Almost like writing a paper, wasn't it?? You still have your gift for writing, I can see. Good Job. Tell Dad to check out my blog. (He knows it---but may have forgotten--so again it is:
    There are some really cute pictures of the grandsons on there that he will enjoy seeing, and some of Kelly's Graduation. Again...let me know if I can do ANYTHING. I am so glad I can help with the grandkids. (I have missed the little warts, anyway.) Hoping he can get into Huntsman very soon. Love you. Mom
    P.S. Just killing time till I can go get Juls.

  2. David: Our prayers are with you. Warmest regards, Russ, Ann and the Sewell Kids.

  3. Dave, we are thinking of you as well. We will pray for you and your family. Love, Josh, Leslie, Sydney, and Savannah Hatch.

  4. Hi Dave - Just wanted to let you know you are in our prayers. Much love - John, Danyelle & the rest of the Ferguson clan

  5. I am so sorry to have found out about this just a few days ago. And since that time, I have tried to find a phone number to call. My wife and I were in Minnesota when I first heard, and we are in Billings, Montana this morning, just on our way home. We are so sorry, and we just want you to know that you are in our prayers. I would drive to visit you if it is not too much to have visitors. My doctor told me in '05 that I only had two weeks to two months. Miracles happen, and we pray for one for you and your family at this time.