Family Letters

September 1998 January 1999 January 2000

March 1, 2000

To:  A long list of family and friends of The Bruyeres

Re: The next step in our cancer journey

Dear friends,

We are writing to share with you the next significant step in our cancer journey: Chris will undergo a major surgery at Memorial Sloan Kettering Cancer Center in New York on March 7th, 2000 (date will be confirmed on March 6). The two of us will be in New York for 2 to 4 weeks following the operation. We will be out of touch during that time, so we thought we would bring you up to date BEFORE and ask for your help DURING.

A little bit of background.
==================
Chris has not been feeling very well since early January. He lost his appetite, feels tired/exhausted all the time, has difficulty sleeping for more than a few hours at a time, and has a significant amount of discomfort in the abdominal area.  As most of you who have seen us recently understand, this is a significant and sudden deterioration in his health.

Starting in August 1999, our oncologist suggested we take a break from chemo. Summer and the back to school period were great. In October, we decided to go to Boston and start on a macrobiotic diet.  Although socially difficult, the diet went well. When we visited our oncologist again, he suggested we stay off chemo a while longer to give Chris' immune system a chance to recover, and he mentioned (again!) that there are "limited options". We thought this would be a good time to get a second opinion from Memorial Sloan Kettering (MSK) Cancer Center in New York, and he agreed.

The oncologist at MSK said he didn't think it was a small cell neuroendocrine cancer - it's often misdiagnosed, and it's a very aggressive cancer (i.e. twenty months later, Chris wouldn't normally still be around). So back home, we insisted on doing another biopsy (we had suggested this on a couple of occasions, but had been told that it was not necessary). The biopsy was done December 17 and sent to both Toronto and New York for analysis. New York called us in early February to let us know that it was, as they had suspected, a different cancer: Desmoplastic Small Round Cell Tumor (DSRCT).

Although we were happy to finally have a specific diagnosis, it is a very rare cancer and it means that Chris went through 20 months of sub-optimal chemo. You see, the chemo drugs used for Chris' treatment are similar to the ones normally used to treat DSRCT, however in different doses and cocktails. The tumors have now developed a resistance to these chemos, so four out of the five chemo drugs are no longer very effective. There is one chemo drug left to try.

New York strongly recommended an aggressive debulking surgery first, followed by chemotherapy. Our oncologists in Toronto had dismissed the surgery option twice in the past (too difficult, too many tumors, and not a good quality of life to follow). Their recommended plan was to begin a chemo treatment as if we had just found out about it (probably in lower doses than optimal, and with an expectation of reducing the tumors by about 20%). You can imagine our confusion and the difficulty in making a decision. As always in these cases, it is best to listen to your heart, or gut feel, and ours is pointing south of the border.

Our Strategy
=========
1. Remove 90-95% of the tumors with this debulking surgery in New York. Recovery will take 3 to 4 weeks.
2. Give high dose ifosfomide chemo (the only one Chris hasn't had yet) to get another 3-5% of the tumors.
3. Try an experimental treatment for the balance...

The overall goal is to beat all odds and write about our cancer journey with a happy ending!

How you can help (since most of you asked.)
================================
On March 7th at noon EST, we are asking each of our friends & family to take two minutes to say a prayer, think positive thoughts, or send healing energy to Chris. You see, we are very fortunate to have a large and supportive circle of friends & family and we are convinced that when all that positive energy is combined, miracles can happen. The operation will last 6 to 8 hours on that day. Following the operation, to help with the difficult recovery, please continue to send positive energy his way. We thank you in advance!

Many of you have offered us financial assistance and we are very grateful for this "safety net". However, we think we will be OK financially because the Ontario health care system will probably agree to cover the expenses for the operation in New York (that's another story, but it's a long one). If, for some reason, OHIP doesn't come through, then we would need to do some kind of a fund-raiser. But for now, we are keeping positive thoughts.

The two of us will be in New York for about four weeks. Gabriella's sister Kathy will become an instant mom (she has been a constant aunt since she moved back to Toronto) and we know the children will be in good hands.   We will be calling home every single night, so Kathy will have the latest news at any given time (at our home 416-444-8111). She volunteered to work on a web page and post daily updates: http://members.home.net/katherine.sahapoglu/ (still work in progress and accepting help!). We also formed a telephone chain for our close family & friends without email.

With love from our family to yours,

Gabriella & Chris                    Kathy
Cell: 416-346-0678                Cell: 416-579-6335
bruyerefamily@rogers.com       katherine.sahapoglu@rogers.com