Whew!

Bill had his cystoscopy this morning and that bladder looked smooth and pink. No sign of tumors. So now he will have maintenance BCG treatments the next three Fridays and hopefully recover by Christmas. After the test we took a walk to calm ourselves down and then had a celebratory lunch. He will continue to be tested every three months and if nothing shows up, BCG treatments every six months. That is a three year program although we are not sure when the three years began. May or August perhaps. It was two years ago in early November that he was first diagnosed. It's a long haul!

Today Bill had his second of three treatments and all is going well. Both lab tests have come back with negative reports--negative as in no cancer cells found. One is a new test genetic test (FISH) for chromosome adnormalities that would indicate bladder cancer. So after next Friday's treatment he is free until the next cystoscopy early December. He has booked flights for us to Tupelo to visit his mother, sisters, brothers and friends October 7th. Yesterday we took a "field trip" to Santa Rosa to the Charles M. Schultz Museum (Peanuts) and then to Jack London State Park where we hiked to the ruins of Wolf House, his magnificent, state-of-the-art, "fireproof" home that burned up just prior to move-in day in 1913. Lots of stone and brickwork left but all the redwood logs burned. The chimney to his 4th floor bedroom/studio still stands. Both places were very interesting!

Good news! This morning's cystoscopy showed no visible tumors. Urine will be tested for cancer cells/markers. Three weekly maintenance BCG treatments will begin Friday. About as good as we could hope for today. Whew! Bill will be on the golf course in the morning.

Wow! This summer has been flying by. Bill has had a good summer with almost daily long walks, plenty of golf, the US Open at Pebble Beach, and time at Point Reyes National Seashore and San Francisco. Bill is on the golf course as I write!
Now we are beginning to get nervous. He has moved his next cystoscopy up a week to August 17 in hopes of being able to play in our club's invitational tournament with Greg in late September. If no new tumor growth has occurred, he will begin 3 weekly maintenance BCG treatments beginning on the 20th. That is what we hope for. He would be "out of commission" about a month. Then we hope to visit his mother and family in Mississippi in early October. Cross your fingers!
I will post the test results as soon as we know.

We have been looking forward to comning to the US Open at Pebble Beach for over a year and so far have not been disappointed.
Our fifth day has been great fun, just like the previous four! We were at the course by 7 am and in the grandstand at Hole No, 12 as soon as we could walk out there--a bit of a hike. This morning was cold, breezy and overcast, not at all like the 2 previous sunny days. Today the other half of the field had morning tee times so now we have seen everyone play, many we had never heard of. Yesterday was the Michelson, Watney, Barnes, Watson, Furyk day, today Tiger with Els and Westwood, leader McDowell, Stricker, Lehman, Mediate, etc. Early morning is the best time to be at the course as the crowds increase all day. Hoardes follow Tiger and Phil. This morning we came back from No. 12 to the Lodge (so glad we paid extra for Lodge tickets) to sit on a comfy sofa in front of the fire with hot coffee and thaw out while watching the action on TV! Then we went out the back door to the No. 18 grandstand which is out of the wind for a couple of hours.
By noon we decided that was enough and a nice lunch elsewhere appealed to us. Leaving is a long walk up and down hills and stairs, pushing our way through the crowd surging in. Then we boarded our Greyhound shuttle bus out to the beachside parking lots and our car. Only one other couple was leaving and they were staying in San Jose! We are just outside the forest in Pacific Grove in a cottage we booked a year ago after we learned we had been drawn for tickets in the lottery. We sat by the bus driver who lives just north of Sacramento and during the ride and chat learned that the drivers are all staying in dorms at CSU Monterey Bay and cannot get into the tournament. Since we were through for the day, we offered him our tickets. Then the real fun began. He was quickly on his radio rounding up Pete and Otis, drivers who were going on a 3 hour break, and stopped to pick them up and give them the tickets. They were to meet him at his break time to pass them back. We added quite some time to the trip but also 3 new friends! Hope to get one of them tomorrow to see how they liked it! The other couple on the bus was from Louisana--LSU caps ugh!--who were so sorry they couldn't give him their tickets too but they were saving all souvenirs to make a shadow box when they get home. We thoroughly enjoyed our wonderful hamburger lunch at Tarpy's Roadhouse--they make the best burgers we've ever eaten.
Tomorrow, Saturday, Greg will arrive early to spend the day at Pebble with Bill. A better Father's Day present cannot be found. Barbara is looking forward to a day off. We plan an early dinner together before Greg heads home.

Bill finished his sixth and last BCG treatment in this series on Friday. He is beginning to feel better today. The adverse reactions continue to please his doctor. So now he is free until the next cystoscopy in mid-August. We hope he is clear then. In the meantime we will play some golf, take some short trips and also go to the US Open at Pebble Beach on the 14th-21st of June. We hope the weather warms up soon so we can enjoy the summer!

Currently Bill is having six once-a-week BCG treatments to drive off those errant cancer cells in his bladder. He has 4 more to go. He had to skip a week after the first one because over-exuberance working in the yard before the kidney stent was removed last week caused a bit of a problem. Now all is better. He did have a reaction to the last treatment and Dr. Ferguson was really happy about that. "That means it is working," he said. Bill told him that he was glad that someone was enjoying his misery! The treatments end May 21 so he will have about 3 months to enjoy summer. Then he is scheduled for 3 more as regular maintenance in August if all looks good. We expect to be at the US Open at Pebble Beach in mid-June. Look for us in the TV coverage background!

Dr. Ferguson called with the pathology results. No cancer cells were found!!!! He called it preliminary since he will send the slides on to UCSF for analysis also. BCG treatments will begin in about two weeks and last for six weeks. So by later May he gets time off for good behavior! We are having beautiful Spring weather and he misses the golf course and taking money from and losing to his friends. He can start that in a couple of weeks.

Bill is feeling well and has to remind himself not to do too much so soon after surgery. Shorter, slower walks are okay. He will spend several weeks healing and then the plan is six weeks of BCG treatments again. We have tickets for the whole week of the US Open on the Monterey Peninsula and a suite with kitchen reserved (middle of June) and are really looking forward to that.

Today's surgery went well, lasted all of 30 minutes. The surgeon removed the one tumor and said the bladder looked really good. He put a stint in the left kidney ureter to keep it open--the tumor was very close and a buildup of scar tissue could block it. That will come out in a few weeks. In the meantime it can cause quite a bit of discomfort. We had the good news just before surgery. The pathologist at UCSF who reviewed the slides and report of high grade tumor from last month disagreed and classed it as low-grade papillary urothelial carcinoma. We all like that so much better! After the bladder has healed, Bill will have another 6-week round of BCG treatments without the interferon. That allows for a higher BCG dosage and the interferon can make one really sick. He had no reaction from the first BCG round last August/September. As Bill said this morning, maybe we are grasping for straws but we just might get to keep that damn bladder after all!

Bill will have more clean-out surgery on Wednesday, the 17th. Out-patient, we hope. Depending on what the doctor finds and does that day, the recovery will be about 4 weeks and then six weekly treatments of BCG plus interferon will be done. In the meantime he feels good--did major yard work yesterday and played golf today.

We have just returned to our hotel from consultation with the urological oncologist at UCSF. He concurred with Dr.
Ferguson's proposal to do more clean-out surgery followed by more BCG treatments perhaps with interferon, rather than remove the bladder at this time since the tumor is non-invasive. It is a beautiful sunny day in San
Francisco so we will go do something fun and then meet Greg and Alex for dinner at Town Hall. Home tomorrow after visiting Cousin Barry Smith in Berkeley.

Bill has a consultation appointment with oncologist/urologist Dr. Meng at University of California San Francisco Medical Center on March 4. We have been told he is internationally regarded to be among the best. So after that some decisions will be made. We will stay in SF for 2 nights, March 3 and 4. Greg and Alex will meet us for dinner.

The pathology report was a huge disappointment late yesterday. The biopsy showed a more aggressive cancer although it is not yet invasive. So big decisions have to be made. One option is to go back in and take out all remnants of tumor. One is very near the kidney duct and a temporary stint would have to inserted in the duct. This causes pain and irritation. Then do another round of the BCG treatments and cross our fingers, since that didn't work last time. In the meantime the cancer can become invasive and if it gets to the lymph nodes, not treatable. The other option is remove the bladder before the cancer travels. There are two ways to go with this. One is an exterior drain and bag. This can hard on the kidneys over the years. The other is to fashion a replacement pouch out of a section of small intestine. This is risky to the intestines and would require a much longer hospitilization and recovery. But urination would be somewhat normal if it all goes well.
Bill is being referred to UC San Francisco Urology Department and will see a urological oncologist there to discuss the next step. We do not yet have that appointment. In the meantime he is feeling relatively okay, up and about taking walks.

This morning Bill's surgery had no surprises. It lasted about 40 minutes, ending with a dose of chemo in his bladder. So it was almost noon when we came home due to a longer recovery room stay while the chemo did its job and then was flushed out. Three small tumors were removed. A special procedure to check his kidneys showed them to be in great shape. The path report will be in later this week. The doctor thinks that in about 3 weeks, Bill should begin another 6-week round of BCG treatments. This could delay our Southeast trip a bit. That would be a great disappointment because my cousin Robert Bentz has arranged for us all to go to the Wednesday practice round of the Masters! We will see!

Today was Bill's quarterly cystoscopy/check-up. It wasn't all good news like October, but not all bad either. It showed a tiny spot that the doctor wanted to biopsy, but due to its difficult location and the pain it would cause, he decided to do it in surgery with anesthetic and better access. He said it definitely looks low grade and very small. I could barely see it. After the biopsy he will give Bill a local dose of chemo to catch any possible floaters. In July 18 such spots were removed and the same dose of chemo was done so this is certainly an improvement. We had hoped, of course, that it would be totally clear. The surgery is scheduled for Feb. 8. We expect it to be short with very little recovery time needed.