Yesterday Kirsten and I visited Dr. Devon Evans, an oncologist. He asked Kirsten about her maladies and how she was feeling. He already knew what was wrong. He asked her if her family has a history of cancer. Then, he dumped it on us. Kirsten has stage 4 neuroendocrine cancer. As the late Christopher Hitchens said after learning of his own cancer, “There is no stage 5.”
I had talked for a bit with Dr. David Agus at PopTech. Dr. Agus was Steve Jobs’ doctor, and is an expert of cancer. He said Kirsten is a zebra, not a horse, and she ought to be at Harvard where they treat lots of zebras. So, I asked Dr. Evans for a referral, which he understandably gave to us.
Kirsten has two tumors in her liver and another on her left hip bone. Her cancer is metastatic, most likely ACTH-secreting, neuroendocrine. The metastatic nature is what makes it a state four. Although there is no direct evidence that they are secreting ACTH, her ACTH levels are high, and it’s coming from somewhere. They do not yet know the source of the tumors, and therefore don’t know what course to take and in what order. Next is a biopsy of her iliac tumor. If it’s not a tumor, they will likely resect and ablate the liver lesions. Otherwise, Kirsten will start on a pill regimen.
The positive bit about all this is that neuroendocrine tumors are usually slow growing. Death comes from organ failure, as one would expect.
Below is a video I cobbled together from recent imaging studies. Kirsten has had them all. I’ve marked the tumors where I could do so confidently.