My mother and I were standing on the front porch looking at her flower garden this past weekend. She was showing me a solitary marigold that she had picked up from the grocery store and planted. During our conversation, she mentioned that she regretted only getting one since it was so beautiful. Without thinking I started to tell her that when the flower fades, let it stay on the plant until it dries then she can collect the seeds. Before I could finish, she said “For next year.” My heart broke. It seems silly that an ordinary statement could cause such sadness until you understand why.
I’ll start in the Summer of 2014. I had spoken with my mom on Mother’s day. She was complaining that she was fatigued with minor activity and had right abdominal pain which she attributed to a recent laparascopic cholecystectomy (gallbladder removal). I encouraged her to visit her physician for evaluation. Less that a week later I get a call from my mom at 9 pm saying the hospital instructed her to go to the ED. Her hemoglobin was 3.7 (normal is 12-15 in females and deadly if it was due to an acute loss of blood). Fortunately for my mother, she had a slow, visibly undetectable gastrointestinal bleed. Because blood loss occurred over an extended period of time, her body was able to compensate to a point. She was in mild heart failure and received a few units of blood. As part of her workup, she had an EGD and a colonoscopy, which revealed a large tumor at the ileocecal junction. The biopsy came back as malignant. She was scheduled for bowel resection and anastamosis prior to discharge. Mom was released from the hospital a few days after surgery with an oncology follow up for stage 3 colorectal cancer with metastasis to local lymph nodes, no distant mets were noted.
The oncologist quickly scheduled placement of an implanted port and mom started on a six month course of FOLFOX at the beginning of July 2014. She had peripheral neuropathy but handled the chemo like a champ. Based on her labs and test results in December, it appeared that the tumor responded to the treatment. Her port was removed and she was scheduled for follow-up CT scan in March. Mom’s three month post chemo lab and test results were good.
Fast forward three and a half months. It’s now July 2015. I get a call at 1 am from my mother telling me that she went to the ED because she had lost her vision. The CT scan showed that she had a tumor in her occipital lobe with swelling which caused the temporary blindness. Her vision improved with steroids. She was again admitted to the hospital at which time we learned that her cancer was back with a vengeance. She now had a tumor in her brain, her lung, and multiple in her liver. Liver biopsy confirmed stage 4 metastatic colorectal cancer.
Initially mom was insistent on having the brain tumor removed and she had talked the neurosurgeon into doing the operation. Fortunately her oncologist explained to her that if she had the surgery, chemotherapy treatment would have to be postpone at least 4-6 weeks without complications which would be detrimental given the aggressive nature of her cancer. The tumor in mom’s brain was too large to do focused brain radiation therapy so she received whole brain radiation in an effort to shrink the tumor. A new port was placed and mom was started on FOLFIRI with Erbitux that had to be stopped because of a severe allergic reaction to the the adjuvant therapy and lack of response of the liver tumor to chemotherapy. The oncologist then started her on a recently approved oral chemotherapy agent for colorectal cancer called Lonsurf. During that time, mom’s tumor marker continue to rise and she started complaining of starbursts in her vision. Repeat CT scan showed that the liver and lung tumors was continuing to spread and the brain tumor was getting larger. She was again started on steroids and received palliative focused brain radiation therapy. As a last ditch effort, the oncologist recently prescribed Stivarga, an oral chemotherapy drug that can harm the liver along with lots of other horrible side effects. The doctor also discussed hospice care with mom, which she refused because she said she felt great and also believed that the focus of hospice care was to kill you if you don’t die fast enough. Privately the doctor told my father that she has less than six months to live. A conclusion that my sister and I had already cone to, me from my medical experience and my sister from her Google degree.
Mom recently finished her first round of Stivaga. She has sores on her feet which makes walking painful and continues to have right sided abdominal pain but is otherwise in good spirits and still very positive. It’s hard for me face the likelihood that mom won’t be around next summer to plant her marigold seeds. In the meantime, I am determined to spend as much positive quality time with her as possible while I can.
Don’t forget to tell the ones you love, how much you love them! God bless.