Angela's Chemo Support

 

We are raising funds to help us manage Angela’s journey through cancer and out to the other side of even better health! She starts FOLFIRINOX chemo on December 7 to finish her treatment for ampullary carcinoma. Here’s the backstory:

On August 18, 2021, as I was praying for Angela, I was led to pray that I would "see my wife." During our lunch date I noticed that Angela’s eyes were a tiny bit yellow, so I looked at her and said, "You're yellow!" She had been feeling nauseous and fatigued for a week or so, had itchiness in her forearms and calves a few days before, and had dark urine a couple of times. She knew that these symptoms pointed to liver distress, so she took herself to the Emergency Room at Banner Gateway hospital in Gilbert, Arizona. An ultrasound showed a “soft tissue” at the base of her bile duct, and then a CT scan confirmed that her bile duct and gall bladder were enlarged, most likely due to the blockage of the small mass. On August 19 she had an Endoscopic Retrograde Cholangiopancreatography (ERCP) in which the doctor took photos and biopsies of the small pebble-like mass in the ampulla area of her duodenum. Further ultrasound images showed no masses in her liver, pancreas, or gallbladder. The doctor was unable to open Angela’s bile duct, and recommended her for a Whipple surgery as soon as the biopsy results came in. Angela got to leave the hospital on Saturday, August 21. On Tuesday, August 24 she was informed that the mass was a malignant tumor – either ampullary carcinoma or duodenal adenocarcinoma. She did not have pancreatic or biliary tract cancer, which was good news. Her CA19-9 cancer markers were elevated but not high enough to signal either of those types of cancers. Her bilirubin count was climbing because her bile duct was blocked and bile was seeping into her bloodstream. Over the next three weeks she turned somewhat yellow as she waited for her Whipple surgery.

On September 13, Angela had the Whipple procedure surgery to cut out the tumor in the ampulla area of her duodenum. This procedure included the removal of her gall bladder, bile duct, part of her pancreas, part of her stomach, about 10 inches of her duodenum/small intestine, and 11 nearby lymph nodes. All the surgical margins were clear, and the surgery went very well. She was told she was not the typical Whipple patient due to her overall health, fitness, and age. In the 18 months before discovering the tumor in August, she had faithfully exercised 4-5 times per week and improved her strength and health. It made a big difference in how well her surgery and recovery went. The pathologies from the surgery confirmed ampullary carcinoma, and 3 of the 11 lymph nodes showed some cancer cells. The measurements of the tumor, its location, and the lymph nodes made the stage 3A.

 

She followed up with an oncologist at Banner MD Anderson in Gilbert (next door to Banner Gateway and only 2 miles from our home), and he recommended 12 rounds of FOLFIRINOX chemo given every two weeks because of the lymph node involvement. This type of chemo incudes 4 drugs: Folinic Acid, Flourouracil (5FU), Irinotecan, and Oxaliplatin, and is the same protocol that is used for pancreatic cancer. The oncologist’s reasoning for this recommendation was that some ampullary carcinomas act more like an intestinal cancer and some like a pancreatic cancer and some like a combination. There were some markers in the tumor that showed it was most likely a combination or mixed-type AC (ampullary cancer).

 

We also met with a naturopathic doctor who only works with cancer and chemo patients. She said to make sure we have a very sure diagnosis on the type of AC and to get a second opinion, preferably at MD Anderson Houston which has the largest GI cancer department in the U.S. Whatever we decided, she would be ready to support Angela with supplements and IVs to rebuild her system as she went through chemo.

 

We did decide to get the second opinion because AC is so rare, and literally every medical article Angela read on it said there was no standard protocol for it, categorization of the different types of AC have been inconsistent, there is not a lot of data on it, etc. Angela traveled to the MD Anderson Cancer Center in Houston for a second opinion on November 12. The oncologist there asked very good questions, and also proposed the same protocol of 12 rounds of FOLFIRINOX, though he said that most people don’t do all twelve—it’s just a really tough chemo. He did agree with the other oncologist and with the naturopath that Angela was in a good position and health to handle the chemo, and that theoretically, there could be zero AC left in her body. Since medical professionals cannot see or guarantee that there were no tiny colonies because of the 3 lymph nodes, they all recommended the chemo to finish the treatment that started with the Whipple surgery.

 

Four weeks after surgery, Angela’s CA19-9 and CEA cancer markers were in the normal, non-cancerous range. Eight weeks after surgery, they were again in the normal range and even lower. As of now, she feels well-recovered and has learned to eat differently to compensate for no gall bladder, less stomach surface area, and a decreased pancreas.

 

Angela and family took a lot of time to pray over every step and all her options. She does not look forward to chemo, but understands that it would be to finish what was started and prevent any recurrence of AC, and for the peace of mind of her loved ones. Angela is trusting her loving God to bring her all the way through this and into a satisfied old age (Psalm 91:15-16). She knows that she is in the best hands with her savior and healer Jesus, and has had such peace and confidence throughout this time. In the ER, back in August, she heard God tell her that this situation was “a pebble that He would flick out of her life,” and that He had her answers all the way through to even better health. She is so thankful for all the ways God took care of her through diagnosis, surgery, and recovery, and for the support of family and friends.

 

During the last few months Angela has taken time off from her business, and we have incurred some expenses to support her. We haven’t carried a credit card balance in about 17 years, but we did have to a couple of months ago. She will miss some more business income, and will have more expenses for supplemental IVs, medications, home medical supplies, and possibly wigs and hair accessories too. We would so appreciate any help and prayers from you. We love you! Thank you so much!