It’s been a busy few weeks, Rebecca got chemo on the 11th, and then Annabelle started her sophomore year of high school, then we brought Abigail up to Michigan Tech over this last weekend.

Rebecca got a scan done (CT of chest, abdomen, and pelvis – with contrast) on Thursday the 14th. We met with the doctor today to discuss the results, chatGPT sums it up well…

Overall Impression

• The biggest changes since March are:
  • Worsening lymph node involvement in the abdomen and pelvis (clear disease progression).
  • Gallbladder changes (thickened wall and distention) which could represent either local tumor involvement or severe inflammation.
• Good news: No spread to lungs, bones, or major organs (other than nodes and gallbladder changes).
• Concerning news: The cancer is spreading through the lymphatic system, with several nodal groups enlarging since the last scan. This usually indicates disease progression and may require a change in treatment strategy.

… so the plan is now to change drugs as the first-line chemo drugs don’t appear to be effective. He’s also having a couple sugeons review the CT scan to see if they think they can grab a new biopsy so that they can analyze it to know if it has mutated with the goal of being able to effectively pair a drug against that mutation. The plan now though is going to be to switch from FOLFOX to FOLFIRI, don’t know what that means, chatGPT to the rescue again…

What FOLFOX and FOLFIRI Are

• FOLFOX = FOLinic acid (leucovorin) + Fluorouracil (5-FU) + OXaliplatin
• FOLFIRI = FOLinic acid (leucovorin) + Fluorouracil (5-FU) + IRInotecan

Both are standard chemotherapy regimens for colorectal and related gastrointestinal cancers, including mucinous adenocarcinoma.

---

Why the Switch?

Doctors often switch from FOLFOX → FOLFIRI when:

• The cancer shows progression on scans (as in your wife’s case, with enlarging lymph nodes).
• Oxaliplatin (the “OX” in FOLFOX) has either stopped being effective or is causing too much side effect burden (like neuropathy/nerve damage).
• FOLFIRI offers a different mechanism of action (irinotecan works differently than oxaliplatin), so the cancer may respond better.

The good news is that this means no more cold sensitivity (that was a side effect of the FOLFOX). The doctor called off treatment next week, as Rebecca’s numbers are very low (even with all the shots they are giving her), and he also wants her to be in good shape in case they want to do a biopsy (surgery). He’s also in touch with our Chicago oncologist, and we are meeting with her next week to make sure that this makes sense to go in this direction.

So probably no update for another week or 2. Thank you all for your prayers and love.

Today we were set to see the doctor, then get blood/urine tests, then head to the hospital (adjacent building) to get chemo treatment number 6. But upon arriving to the hospital they told us we hadn’t made our numbers (white blood cell count) 😠

So that pushes us forward another week, and another week of no treatment, but there’s not much we can do about the white blood cell count other than taking the shots that she’s already doing.

So now next Monday will be treatment number 6, and on Wednesday (13th) we will do scans to see how things are going. Followed by doctor visit on 22nd to talk about what scans show.

I’m unsure what to hope for with the scans, as none of the scans in the past showed anything other than that her lymph nodes were enlarged, yet there was already stage 4 cancer stuff going on inside. So if this new one “shows” anything that means it’s even worse/spreading, but if it shows nothing we don’t really know what’s going on at all either – which doesn’t help at all for the the doctor to know if we should continue on this treatment or change treatment – so who knows what to hope for.

Rebecca and I had a really good time together for 4 days in San Antonio hanging out at the riverwalk (picture), so that was neat. Lots of relaxation, sleeping in, pool time, reading, talking, and much food. We both really enjoyed the time together just the 2 of us, and the girls had a nice time of no Dad and Mom in their hair also, so good times had by all I guess.

In 2 weeks we’ll be in Houghton moving Abigail into her dorm, so it’s a typical busy month for us.

Rebecca got pretty upset about not being able to get treatment for the second time, and what that means for things growing/spreading inside, so pray for her. It’s never easy to be not in control of things, and even more so when things are not going in a good direction. We continue to be thankful for our faith, family and friends.

July 7th we missed our numbers, so Rebecca had 2 weeks off and it felt really nice. Cold sensitivity went away, she felt normal, it was nice. But by the end stomach pain had started intensifying, so it was good, but there was a reminder at the end of what the chemo was helping hold back.

We had a really good time in Michigan for Abigail’s orientation visit. We were all shuttled between a lot of buildings, so we started getting the lay of the land much better, Abigail met some other incoming freshman, and got to feel more comfortable on campus. Beautiful weather, and we got to drive during the day for the first time up and back, so we got to see the scenery in a different way.

We met with oncology on Friday, and got labs. They want to start giving Rebecca injections to help with her white blood cell count. We did make counts for today’s treatment, but it was close, and she had 4 weeks since last treatment. So treatment was today, and now we are home with the pump, pump comes off wednesday, then she’ll go in for injections thursday, friday, and monday. We take off to San Antonio on Wednesday morning, and then back Saturday night. Then Monday (that’s the 4th) we will meet with the Oncologist early in the morning, and do labs, then over to treatment number 6 at 10a. So a busy next couple of weeks.

After treatment number 6 we will be getting scans, we’re still unsure what that means and what types of scans they will be. We don’t even know if it will show much (since none of her other scans really have). It’s strange because we don’t know whether to hope it shows something or not.

Man this year is moving fast, I can’t believe we are already past half way done. Rebecca and I have been spending a lot of time together, so that’s been real nice. We are so happy to have our faith in God, and for all of the good things that He has blessed us with. Despite the current stinky situation we are in, we are happy and in love, and I can’t ask for much more than that. Thank you for your continued prayers and well wishes. I hope you all are enjoying your summer as well, it’s going to be gone in what feels like a blink. Love you all.

Today should have been round 5, but Rebecca didn’t make her numbers, so they want us to skip this round. So a little bummed on having to skip, but excited at the same time to have 2 weeks of normality as well.

Abigail’s graduation party went well and we had a great time seeing family and friends. We then spent a lot of relaxation time the last few days, and saw some good fireworks last night.

We are off to orientation in the UP this weekend for a few days for at MTU for Abigail

We’ll have updates after our doctor’s appointment on the 18th

Sorry, I thought we took a normal photo, but I guess it was only a goofy one at the fireworks 🙂

Chemo treatment round 4 yesterday. Everything went well, some of Rebecca’s counts were a bit low from the blood test on Friday, so they needed to test again onsite but we were back up again and able to get treatment. So far things aren’t too different, she’s just tired.

Things have certainly been busy lately (I can’t believe it’s almost July). We have been preparing the house and finishing up things to be ready for the graduation party for Abigail this Saturday. The heat certainly doesn’t help.

Rebecca is trying a new drug that may help with sleeping and nausea. It’s an anti-psychotic, so I’m super thankful to the doctor for that fun nugget I get to rib her about now 🙂

We were able to get to a roller skating rink right by us for an 80s night skate time (picture). So that was fun. And we are very excited to see family and friends this weekend.

Sorry for the disjointed report, just wanted to get something out. Please continue to pray for our upcoming scans (probably around treatment 6) to show that these drugs are actually doing something. For her to be able to get better sleep at night, and for her nausea to stay low (or just go away).

Love you guys.

3rd round of chemo today. We were given this very nice blanket that was sewn by some kind people in DelWeb (retirement community out by us) for patients of the cancer center. It is very sweet and the patterns are pretty. It helped keep Rebecca warm, although that didn’t keep her from taking advantage of the nice warmed blankets that they provide her as well.

Last round of chemo seemed to affect Rebecca more than the first. She was pretty tired and a bit more nauseous then the first time, and the cold sensitivity was pretty bad, and never let up. So we are a little anxious (understandably) about how this time will go.

We are getting things ready for Abigail’s graduation party on the 28th, and looking forward to seeing a bunch of friends and family. Annabelle’s been in driving school, and I took her out on 90 for the first time Saturday to her dismay 🙂 Also we are looking forward to getting a new kitten friend added onto our family sometime in the next few weeks. So lots of activity here at the Suarez household.

We had a fun time in Lake Geneva Sunday/Monday. We ate lots of food, exercised our brains in an escape room, and exercised our bottoms on a horse ride. The weather was beautiful and we had a great time together.

Rebecca had round 2 of chemo yesterday (Tuesday). They said that her tests from Friday all looked great. Coldness/tingling in hands/fingers was much quicker this time and today seems more intense then last time. If things continue to ratchet up this much on subsequent treatments I don’t see going much more than 1 or 2 more as it’s uncomfortable and borderline painful for her hands. Other than that she’s just feeling pretty tired this time so far.

Not much else to report as things are just the normal suarez busyness:

• getting ready for abigail’s graduation party in june
• preparing for abigail to head to college in the fall
• annabelle got her drivers permit last week and is in driver’s education over the summer, so we are putting in the miles/hours that are needed for her to get her license in Jan
• we looked at kittens on saturday, so I’m thinking we’ll have another 4-footed friend soon in the suarez household
• work and home and church duties as always

I’ll update when there is more to update, but it may be a week or so if nothing new comes up.

Thank you all for your continued love/prayers/thoughts.

We met the Chicago oncologist today. The 2 hour plus drive in reminded us why we don’t like driving to Chicago 🙂

The doctor is a specialist on gastro oncology. She walked us visually through all of the scans that have been done over the last few months and the tests that have been done and explained what they show, why that does (or does not) matter, and why they then went in this direction or that direction based on that. Made lots of sense and was nice to be visually walked through.

We didn’t learn much new information, but a lot of confirmation of what we kinda half-knew, but hadn’t had an expert confirm. We are attacking this bluntly, so excuse mine, but I believe clarity is better than vagueness… The average lifespan for what Rebecca has is 2-3 years from diagnosis. The therapies will eventually not work, and so they will keep switching them until they either run out of therapies, or until they are just not doing anything to hold things off. We kinda knew these things, but the doctor confirming added a realness that hit different.

Despite this we are keeping a positive attitude. There’s no reason to waste a bunch of time crying in your pudding (what does that even mean?) when there’s a clock ticking. We are going to see how this round of chemo goes and see what effect is has on things, and meanwhile we are going to try to be more intentional about the time we are spending with each other and our girls as it appears to be diminishing much faster than we would have chosen.

Rebecca and I have a strong amazing marriage, and we have some insanely awesome kids that enjoy hanging out with us. We are both so thankful for this. We are also very blessed to have a very large support network of friends and family around us (like you guys). Keeping positive and exercising and keeping at it will help to eek out more time with Rebecca, so that’s the goal right now. We continue to appreciate prayers for us. God has given us so much, and he continues to do so.

We have tests and an appointment on Friday in preparation for chemo on Tuesday, and we are going to head up to Lake Geneva after church Sunday and stay the night and hang with the girls for Memorial Day. I’ll give an update after chemo Tuesday.

Abigail had her graduation on Saturday, and we were able to hang out and get a meal with family, so that was nice.

Rebecca has her first week of chemo in the books, so that’s good too. There was a little nausea, but not too much. The cold sensitivity was definitely a thing though, and it was weird. Things like touching glass, or metal were even “prickly” to her fingers, also after her hands would get cold they didn’t operate so well. We aren’t looking to that increasing as the dosses go on, but we understand now why the nurse said that almost no one makes it the full 6 treatments on that drug because they can’t handle the sensitivity to cold.

We are seeing the Chicago doctor team this week on Wednesday, and then into the local oncologist on Friday to start the the chemo process the following week again.

We did the first chemo treatment today.

We were at the cancer center for 5 hours

First they gave Bevacizumab ( Wikipedia ), which is a monoclonal, so not really chemo. She took that for about 30 minutes with saline. It works by inhibiting the growth of blood vessels which kinda works by choking the cancer from being able to grow

Then they gave her some anti-nausea (Zofran) and a steroid to prep for the next drug. They also gave some IV vitamins that help activate the first drug.

Then they started the Oxaliplatin ( Wikipedia ) with Leucovorin – this is another drug that has the job of trying to disrupt the way that cancer cells grow and multiply. The Oxaliplatin is the one that has some strange cold sensation things with it. Where she will have to wear gloves when handling cold things, not drink cold liquid and will have sensitivity problems in general with anything cold.

Right before leaving they gave us a “kicker” of Fluorouracil ( Wikipedia ) – also known as “5-FU” (which makes me giggle to say) – which will then continue to be administered via a portable pump that we take home with us – it’s done this way as they’ve found that it does best when administered over 48 hours, so it pumps a little in every hour. We have to go back to the hospital on Wednesday afternoon to have them take the pump back and remove the line from her port. The Flourouracil messes with the ways that cells make and repair DNA to (hopefully) screw up the way that the cancer makes and replicates itself.

Our conversation with the doctor on Friday was pretty normal, other than conceding that the cancer is terminal, it sounds like timelines are hard to nail down until we get through a first chemo regimen (3 months) and we can see her cancer is reacting to the treatments.