Monday, July 13, 2009

May I have the Envelope Please?!

"And the winner is....Dave Palfreyman."

After so many weeks of more and more bad news, we have heard back from the insurance company. They have agreed to pay for the TheraSphere treatment. We just found this out this morning. Dave is fortunate to have some very close friends in just the right places. Fortunately, one of those friends made a call and pushed this through for us. I don't know that I can express how much of a relief this is. We have been more and more concerned about Dave's quality of life. So this is especially good news given that the alternative treatment often has very horrible side effects. We are so grateful that this treatment is available for Dave. We are hopeful that it will lengthen and improve his quality of life.

Timeline for Treatments:
Dave will finish radiation next Wednesday July 22 and will start TheraSphere treatment on Wednesday July 29. I believe he just has to go in the one time for this. If they opt to do more treatments, (they may do 2 or 3) they will be space out a few weeks to months apart.

Thursday, July 9, 2009

Ready or not, here it comes!

Dave's first radiation treatment was yesterday. It didn't take very long. He was only there for about 15 minutes. He came home and just laid on the couch for most of the night. He had another treatment today and will continue this 9 more times. Dave is feeling alright after the treatments. He is really nauseated and a little tired after the radiation. His spirits are high and tonight he actually looks better today than he has in a few days. At the moment, he is visiting with friends and is very alert.

Tuesday, July 7, 2009

Dave's Golf Tournament

As you can tell, I am a little slow about getting things done lately. I apologize for that. I should have put these pictures up last Friday. At any rate, Dave’s golf tournament was a huge success . The weather was beautiful and participants were able to enjoy the quiet calm of Utah Lake views all morning. Talon’s Cove in Saratoga Springs hosted the event. It is a beautiful course and our family is grateful for their help and would encourage all of you Golfers to go out and enjoy that course.
Many of Dave’s friends and family came to show their support. More than 100 people played yesterday. Dave was able to attend the luncheon, catered by Talon’s Cove, and shared a few touching stories about old friends and his recent experiences with his family since the news of the cancer. He was full of energy and grateful to be with so many loved ones. He expressed his deep appreciation for the support of the players and donators, and expressed his firm commitment to give this cancer the best fight he has. Thank you to all of our friends, family, and members of the community who have shown their support! We also send a HUGE thank you to Steve Watts and the Talon’s Cove Golf Course crew for hosting the tournament.

These are pictures of the luncheon after the golf tournament.

Dave and Kaylene

Matt and Kelly Palfreyman, and Kris Coles

More of Dave's Family

On the left is his sister Annette, her grandson, daughter, son-in-law and his dad. On the right is Dave's father Kent, and his wife Janet.

These are some of Dave's friends and coworkers from Bank of Utah.

We are pleased to announce that Dave's still up for a good time!

More of Dave's friends

More of Dave's friends!

Thursday, July 2, 2009

Dave's Visit to the Doctor

I will post pictures and information about Dave's golf tournament tomorrow.

Dave had an appointment with Dr. Watson yesterday. He is the oncologist/radiologist that Dave will be seeing for treatment. At Dr. Watson’s request, our family went with Dave to his appointment. We met with the doctor so he could explain some things to us and answer any questions we had. This is, as I heard it, from the doctor. I hope you will forgive the frankness of this post. The nurse told us that most families find it easier to deal with this kind of a difficult situation if they are honest and talk about the hard stuff together. She said this includes talking about the treatments, side affects, and even how much longer he has on this earth.

First, let me say that the transplant is not an option as of right now but it is the only cure for Dave. Without a transplant he will have to battle the cancer for the rest of his life. According to Dr. Watson, his tumor would have to be no more than 5 or 6 cm for a transplant. (This is contrary to the 8 cm that we were told by Dr. Walentyne.) Dave’s tumor was 12 cm last time he was scanned. (Today the scan indicated that it has probably grown. That will be explained below.) Dr. Watson is confident that he can shrink the tumor. He said that it will be difficult to shrink it enough for Dave to have a transplant. He said, “Shrinking a tumor that much is a remote possibility. His chances are not zero, but not great.”

They did a CT scan today to pinpoint exactly where the lymph node tumors are so that they are ready for the radiation treatments to start next week. The CT did NOT show that the cancer is spreading to any of the organs near his liver. (YAY!) There are two lymph nodes that each have a tumor. The tumors are right next to each other and were measuring (last time they were checked) at 6 cm total. However, within the last month they have grown to a total of 8 cm. That is a VERY fast growing tumor, which also leads us to believe that the main tumor has grown as well.

So the radiation on the lymph nodes will begin next Wednesday at noon. He is scheduled to have the treatments every day for 11 days (business days) in a row. The side effects from that include nausea, cramps, and fatigue. He will take a pill every day about an hour before the treatment to help with the nausea.

Dave asked the doctor if it looked like the Nexavar (the pill to stop the growth) was working at all. The doctor said no and that he wants Dave to stop taking it. He is concerned about it affecting the blood vessels in the liver. If the medication weakens the blood vessels then he won’t be able to have the Therasphere treatment. So the Nexavar is out for now.

Dave’s mapping procedure showed that most of the dye went where it should have. About 9% ended up in his lungs. Usually they only see 2-3% in the lungs. They can do the procedure at 9%, but we need to pray that his blood vessels will stay as intact as they are. Unfortunately, Dave’s insurance has said that they will not cover the Therasphere treatment. It is a very expensive thousand treatment. Dave’s doctors are working tirelessly to explain to the insurance that Dave needs this procedure. They feel confident that the insurance will have to pay for this because it is medically necessary for Dave to have. It seems like it will take some work to educate the people at the insurance company. We are going to do everything we can to get our needs heard and addressed by the insurance company.

Until we have a ‘yes’ from the insurance company, Dr. Watson doesn’t feel comfortable with putting that financial burden on our family since there is another option. A treatment called TACE, Transarterial Chemoembolization. “TACE, a procedure in which the blood supply to a tumor is blocked (embolized) and chemotherapy is administered into the tumor.”

Dr. Watson would rather fight the insurance for Therasphere because the side affects are easier to deal with. Since TACE uses a form of chemotherapy, the side affects can be ugly. However, Dr. Watson did say that some patients react with very few side affects because every one is different. When I asked Dr. Watson how long we would wait for the insurance company before we decided to go on with the TACE procedure he said, that the radiation will start next week and he doesn’t want to start the other procedure until the radiation is done. We will want to know by the end of the radiation if the insurance will pay for it. Otherwise, he will start TACE procedure. (Dr. Watson said that the TACE procedure is more easily covered by the insurance since it isn’t as new.)

With either of those procedures, it is likely that he would have the treatment done a couple of times. They will be done 2-3 months apart. (If his liver function stays where it needs to be for the procedure.) The first scan they do after the procedure will not be useful. It will likely show that the tumor is worse than before. That is normal though. They will do a second scan later and it should show that the tumor is shrinking.

The median survival rate for a positive (meaning good) response to the TACE procedure is 16-19 months. (Meaning that on average patients live that much longer. 50% live less than that and 50% live longer than that.) The positive thing about Dave’s situation is that he is actually pretty healthy (other than those pesky tumors). Also, the Doctor said that the healthier a patient is going into the treatments, the better the patient will handle the effects, and the healthier the patient will be coming out of the treatments. Right now, tumor and its effects aside, Dave is reasonably healthy. He eats surprisingly well and keeps his food down, which is good because it will keep his body strong. His diabetes is mostly under control due to the major weight loss he has experienced and his liver is functioning very well for a tumor that size. Also, Dr. Watson says that the healthier a person is going into these procedures the better their chances are. In other words the procedures work better on healthier people.

This last month has been difficult, with the news, the waiting, etc. But, I know God loves us and will bring us comfort and support, come what may. Our family has decided to help Dave live the rest of his life with joy, love, and passion for life. If he eventually gets a transplant and lives a long life, then he will be able to look back on this difficult time and remember his family, his friends, and having the time of his life.

Dave would like to mention that his darling wife Kaylene has been such a blessing and support to him. She has worked so hard to take care of Dave and their home. Kaylene has also been a great blessing to Dave’s kids and family as well. We are very grateful for her strength, support, and wisdom during this experience. We are so blessed to have her in our family.

God Bless

Matt and Kelly