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Jerry Earnhart

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The Journey

I have been told that colon cancer develops over a long period of time. Perhaps up to ten years or more. Consequently, I really dont know when my journey may have actually begun. I have always been fairly healthy with the exception of a bout with arthritis that manifest itself in my hipbone and socket. This became so sever that I had to have the hip replaced in 1983. This replacement lasted until 1996 at which time I had to have it replaced again. I only mention this to make a point about medical check-ups. Like so many folks I have known, as long as we feel good, we just dont take the time to bother with a doctor. Bad mistake! As part of the pre-operation procedure in 1996, my doctor insisted that I have a complete medical check up before he would perform the planned hip replacement in 1996. A physical exam detected a small trace of blood in my stool. In an effort to identify the source of this bleeding, I had an air barium contrast study and a sigmoidoscopy performed. These tests only revealed a condition known as diverticulosis and some small hemorrhoids. Diverticulosis is a condition of the large intestine (colon) where small pockets have formed and is not uncommon in folks over forty. This condition does not usually cause a person any problems. However, you are advised to not eat foods that do not digest easily. After reviewing the result of these test, the doctor decided that the blood in the stool was probably coming from the hemorrhoids. In hind site, this diagnosis may have signed my death warrant. As I noted above, colon cancer develops over a long period of time. So I can only assume that my tumors existed and were the cause of the internal bleeding. The reason the sigmoidoscopy did not detect these tumors is because the sig only looks at about 60% of the colon. That leaves 40% of the colon for cancer to grow undetected unless a colonoscopy is performed. You guessed it! My tumors were discovered in that 40%

Colon cancer is called the silent killer because it has very subtle symptoms. As I said before, I have generally enjoyed good health over the past years and didnt experience any problems until the spring of 1999. I had noticed some weight loss during the year. However, I attributed this to my new work schedule. In fact, I was quite pleased, since I have always had a problem with being overweight. In April of 1999, I began having some episodes of discomfort in the abdominal area. Some of my co-workers had some of the same symptoms due to a flu that was going around. I just assumed that I had the same thing. By August the discomfort had become much more severe and more frequent and I was having some problems with regular bowel movements. The weight loss increased to about two pounds per week, even though I was eating much in the same manner that I have always have eaten. In addition, I began to feel very tired most of the time. In September, the stomach pain (spasms) became so intense that I admitted myself to the emergency room for treatment. They x-rayed my chest and abdominal area and gave me a physical checkup. The ER doctor noted in my medical history that I had diverticuloses and promptly diagnosed this as being the source of my problems. He gave me a prescription for an antibiotic and sent me home. In October I attempted to schedule a visit to the primary care physician I had chosen when I changed employers in February, only to find out that he was no longer a part of my insurance program. This was the doctor that had ran me through all the test back in 1996 and the only doctor I had seen in the last ten years for anything. I finally found a new doctor and obtained an appointment for the first of October. He reviewed the x-rays taken in September, had blood test ran and gave me a physical exam. He concluded that I had an infection in my bladder and gave me some antibiotics. A follow up appointment was scheduled in three weeks. By the end of this period, the pain from the abdominal cramps had become much worse and more frequent. In addition, I had experienced some nausea and the constipation was almost constant. I also had some pain in my right hip. My doctor referred me to a gastrologist who scheduled me for another air-contrast barium test in mid-November. This test, as the one in 1996 only revealed the diverticula in the colon. However, the gastrologist suspected a blockage in the colon and recommended a colonoscopy. This procedure was scheduled for December 10th. In the interim, my primary care physician ordered a CT scan. The CT revealed multiple small lesions on my liver and a mass on the adrenal gland. In order to more clearly identify the nature of these lesions, I was scheduled for a MRI scan. Both scans indicated that these spots were probably simple benign cysts. At this point, I had lost over 75 pounds and couldnt eat any thing but soup. As scheduled, a colonoscopy was performed on the 10th of December. During this procedure, at least four polyps were removed ranging in size from 1cm to 3cm. Another much larger growth was found to be blocking the colon (cecum) and could not be removed. The pathology report diagnosed this mass to be Well differentiated adenocarcinoma of the colon (colon cancer). Surgery was scheduled for the 20th of December. Two sections of the colon were removed along with sixteen lymph nodes and one of the lesions (thought to be a cyst) on my liver. A biopsy of this material revealed that these were malignant tumors (including the material taken from the liver) that had spread (metastasized) from the colon cancer. (Note: There is still some question regarding the lesions on the liver since only two of these spots have shown any change in size since the initial scans performed in 1999 prior to surgery.) I was released from the hospital December 26th . By this time my employer advised me in a letter that due to company policy, I would have to return to work by January 5th or my position would be terminated. The pain in my hip had become so extreme that I could no longer walk and had to have support to even stand. The doctor prescribed some anti-inflammatory drugs that he felt might improve the inflammation in my right hip. Over the next two weeks this condition became worse rather than better. I was scheduled for a total body bone scan. The scan reflected tumors on the femoral (leg) bone and on the head of the femoral at the junction of the hip. I received twelve radiation treatments to resolve this condition. And it worked! By the end of these treatments I was walking, working and playing golf with no pain! By the way, I made the companys deadline of January 5th with the help of my wife. She drove and pushed me around to all of the locations under my supervision. (I manage apartment real estate)

Like so many folks, I insisted that the oncologists give me the best and worse case scenarios regarding treatment and prognosis. He hesitated for a moment and prefaced his remarks with the following statement Only God can tell anyone when they are going to die. He then went on to tell me that without treatment (chemotherapy) I could expect to live for six to eight months and with treatment the statistics indicated that the survival rate could be extend up to fourteen months. Survival beyond five years occurs in less than 8% of patients with stage IV colon caner.

I began the standard chemotherapy using fluorouracil (5-FU) and leucovorin on January 14, 2000. 5-FU was the only drug approved in the last forty years for colon cancer that had spread to distant organs (in my case the liver and bone). A new drug (Irinotecan or CPT-11) used in combination with 5-FU & LV was approved for use by the FDA in April 2000 and was added to my treatments in October 2000. Clinical trials have shown that this new drug can improve survival by four and one half months. I have been very fortunate to have no severe side effects from these drugs. I have continued to work and enjoy life in general. I am a little short of breath and my energy level has declined some but other than this I am very well for the shape I am in!

From time to time I will be adding some of my personnel experiences, thoughts and feelings in dealing with this disease. If you would like to be notified when this page is up dated please click on the link below.





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