To begin, my two daughters and I fully and thankfully believe that Dr. Alan Kramer and his wonderful staff saved my wife's life!
Very rare, killer cancers seem to hide themselves, striking the unwary with deceiving symptoms, leaving none or only mysterious clues. In my wife's case, her voice became deeper, throat and swallowing congested at times. Her ENT Doctor took a needle biopsy of her thyroid - negative results; two further needle biopsies were performed over several weeks prolonging treatment. By this time, the skin on her chin had begun to darken, and faint, red spider veins began appearing on her jaw and upper neck. The new evidence could only be called a 'mystery' - but 'something' was going on.
Finally, her ENT, confronted with a series of unproductive needle biopsies, decided on surgery to remove half her thyroid in order to enable a full pathology evaluation. This proved to be a timely and crucial decision, given as we learned later, her disease spreads rapidly. The surgery took more than twice as long to perform because her thyroid was surrounded by thick tissue, painstaking to cut through (later we found out it was diseased tissue). Meanwhile I researched thyroid cancer on an AMA Encyclopedia of Medicine. The first in the list, 'Anaplastic Carcinoma', was referred to as always quickly fatal, but very rare - I chose to dismiss this one and focused on three of the most common, hoping for the most benign.
Scheduling difficulties created a two part Tumor Board review: the first, on a Friday, presented the findings of the pathology report. My wife could see from the face of the Pathologist (as I did) that it wasn't good news. She had the dreaded one! A plan to schedule immediate surgery and 2 a day radiation treatments was outlined by the Surgeon who removed the thyroid sample and the Radiologist.
But then the plan was rejected at the follow up Tumor Board meeting with Dr Kramer the Oncologist and nationally famed Cancer Surgeon Dr. Singer, in favor of conjunctive radiation/chemo treatment, followed by chemo only. The reason - this cancer travels rapidly through the skin as evidenced somewhat by the red spider veins and discolorations it creates. (The biopsy surgeon, who proposed first surgery, was probably following the official position of the American College of Surgeons-dictating surgery first. He called me latter to tell me he didn't know the behavior of this rare disease; very few MDs do.)
Radiation once a day went on 5 days a week with conjunctive chemo one day per week. It proved physically grueling for my wife. Yet she was buoyed up by the friendly staff in the CMPC Radiation group and especially by the personable staff of SF Oncology Associates who provided her chemo treatment. Their pleasant, relaxed environment left my wife relaxed and comforted.
Yet the wear and tear on my wife's body took its toll. The radiation wounds to the skin of her neck reflected internally in her throat making it impossible to keep up her nutrition regimen, making her weaker every day. Worried, I brought her in to see Dr. Kramer on a Friday after barely able to get her to eat all week - he calmly and persuasively talked her through her reluctance to hospitalization. A feeding tube was installed to feed her stomach directly. We turned an important corner that weekend and through the following week in the hospital where Dr. Kramer visited every day in her room (and one evening down in the cold surgery area hallway, she on a gurney, waiting for a minor surgery procedure). After the feeding tube stomach implant, she went home far stronger, determined and prepared to finish out her treatment.
One day while she was having her Chemo treatment, one of the staff introduced us to an older couple who had brought their adult daughter in to start her chemo treatment for a very rare nasal cancer. I explained to the father the severity of my wife's disease and how happy we were to experience the care SFOA provided and how well my wife was doing. He told me he is an MD and could have brought his daughter to any one of the Bay Area's Doctors and medical facilities. But in his opinion his daughter needed a good "Quarter Back" to manage her treatment, and in his opinion, Dr. Allan Kramer was the best!
I also must mention the wonderful, personable SFOA staff, who maintain a calming atmosphere despite however busy the waiting room, and patient activity of the day. Today, under the care of Dr. Kramer and his group at SF Oncology Associates, going on nearly three years from when her symptoms first arose, my wife is exercising daily, traveling, and by all indications, thriving. And her very recent pathology tests status report, giving her an 'all clear', proves it!
Sincerely,
Jeffrey Allan Grote - the very happy Husband of The Patient, Jessie Grote read more