UVA Update

Hello Prayer Warriors!

I'm so glad you are here, because prayers for Patrick & Emily are very necessary at this time.

As suspected, today was a big day.  It was a day of procedures, of overwhelming information, and of tears.  Per Patrick's request, I am going to be forthright with the new information obtained at UVA.

*   *   *

Early this morning, Patrick underwent his follow-up colonoscopy.  His gastroenterologist, Dr. Shami, also performed a tumor ultrasound while Patrick was sedated.  Additionally, the colorectal surgeon who will eventually perform Patrick's operation, Dr. Friel, attended the scope and physically examined the tumor.

The colonoscopy itself did not reveal a great deal of surprises as most of the information remained unchanged since the original colonoscopy.  Dr. Shami's report did indicate the "stage" of Patrick's rectal tumor:

Tumor Stage:  uT3 uN2

Medical Translation:

uT3:  Cancer infiltrating the rectal wall through serosa or perirectal fat

uN2:  >3 malignant perirectal lymph nodes 

In a nut shell:

Stage 3 cancer with cancer found in the surrounding lymph nodes.

(a photo Patrick asked me to share of him recovering from the procedure)

*   *   *

Immediately after the colonoscopy, Patrick & Emily met with Dr. Friel to discuss future plans and possible outcomes.  Unfortunately, he did not have much good news.

Due to the size and location of Patrick's tumor, Dr. Friel feels it is highly likely Patrick will require a permanent colonostomy (a stoma (hole) formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body).

Furthermore, Dr. Friel expressed a concern about the location of the tumor within Patrick's rectum.  He was troubled to find that the tumor is on the front of the bowel (against the prostate) rather than at the back of the bowel (against the tailbone).  Due to the depth of Patrick's tumor, Dr. Friel has concerns that the prostate and bladder may also be affected by the cancer.  Although uncertain, he mentioned the possible need to remove these organs (prostate and bladder) as well during the surgery if he is unable to separate them from the tumor.  This would result in an additional urostomy (a stoma for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible.)

In the midst of this devastating news, Emily inquired about their future desire to start a family.  Dr. Friel also expressed concerns about nerve damage, impotence, and infertility.  He suggested that Patrick & Emily consider sperm banking prior to surgery and genetic counseling afterwards.

*   *   *

Earlier today, a friend of Patrick's referred to him as a "spiritual tough guy."  What an excellent description of him!  On the journey to UVA today, Patrick mentioned several times that:  "me and God are still okay."  His faith and reliance on the Almighty remain unshaken and exemplary.

Nevertheless, Patrick & Emily are also at a place of brokenness.  They are walking through the valley.

They are in desperate need of earnest and relentless prayer and uplifting.

*   *   *

Even in this deep valley, there is great hope.  Dr. Friel told Patrick & Emily that prior to surgery he will begin radiation and oral chemotherapy for 5-6 weeks.  This combination has the potential to shrink Patrick's tumor and separate it from the prostate/bladder.  This would mean avoiding the urostomy and potential infertility.  Best case scenario, it could also mean avoiding the colostomy as well.

Do we serve a big God?

I think so.

Want to pray specifically?

Please pray for Patrick's body to respond incredibly well to chemo and radiation.  Pray that the tumor shrinks drastically.  Pray that the prostate and bladder are unaffected by cancer.  Pray that Patrick is able to avoid these unwanted outcomes of his surgery.

(They are still smiling)