My father is diagnosed with Stage 4 Lung Cancer



I think this is the first time I'm writing an article about my life on my blog. I never thought that my first blog post about my life would be about my father's cancer. I probably won't be able to control my tears, sometimes life can be so sad and painful.



My father was coughing very heavily. He said that his ribs hurt a lot. He continued to cough violently for months. We told him that we should go to the doctor, but he did not listen to us. His cough was getting worse day by day. He had not smoked for 11 years. He quit smoking in 2009. But he had smoked for 25 years in the past, so he had COPD and pneumonia in the past. He continued coughing for several more months. He searched for herbal solutions to stop his cough and drank herbal mixtures, but none of them stopped his severe cough.

On June 7, 2020, I spoke to my father and said that we needed to go to the hospital immediately because the severity of his cough was waking me up from my sleep. He finally agreed to go to the doctor. We went to the university hospital and the doctor directed us to the rheumatology department. My father also had FMF disease, so the doctor thought the cough was caused by FMF.



The doctor said that the blood values should be checked first, he gave my father a few tubes. A few hours later, the results were out. Most of my father's blood values were good, but the CRP value was quite high, a high CRP indicated that there was an inflammation in the body. After that, he had a CT scan of his ribs, but the results were good and there was no sign of disease.

We left the hospital and went home. A few more months passed, and now my father's cough was much, much more severe. On October 21, 2020, I told my father that we had to go to the doctor again. I said that this time we should have a chest CT scan. He said to me, "You are not a doctor, I will do whatever the doctor says". However, years ago, I went to the hospital because of a severe cough and I was diagnosed with asthma after chest CT scan. I told him we could find out the cause of his cough on a chest CT scan. After saying this, he agreed to go to the hospital.

On October 22, 2020, we went to the hospital and the doctor told us that we should have a chest CT scan. We had a CT scan and he told us to come for the result on October 26, 2020. When the result day came, my father did not want to go to the hospital, but we convinced him with my mother. It was 9 a.m. and we entered the doctor's room. The doctor was a very cheerful person, but when we entered the room, she was examining the paper in his hand very worriedly.



She didn't say anything to us for several minutes. She lifted his head and said to my father, "Your health condition is very serious, further examination is required. You need to go to the university hospital and have a PET CT scan immediately."

My mother asked the doctor these questions:
"What is our disease? Why is it so serious? Or is it cancer?"...

We were all shocked. I looked at the result sheet and in the diagnosis section "Lung CA?" was written...

At the bottom of the paper was written "Further examination required"

My mother and father were very worried, they were looking at me with fear. I was very worried too, but I did not show it and said that the result was not correct, there was a mistake on the results sheet.

We got home and I went into my room and closed my door. I searched the internet for the terms written in the result sheet. Yes, the doctor was right, my father really did have cancer. I was crying silently while reading about cancer on the internet. My father was only 54 years old. I had no siblings, our relatives were far away. I was just a student, I was only 21, it was so bad, it was just my mom and me, how were we going to fight for my dad's cancer? To be honest, I didn't know anything about cancer until my dad got lung cancer.

I left my room, my parents were talking quietly, they were very worried, I went to them and talked to them as if nothing had happened. My father said "Maybe I don't have cancer, that's what happened with pneumonia, maybe everything is fine." He consoled himself, but the truth was terrible...



A few days later we went to the university hospital and they told us that we should have a bronchoscopy. For this procedure, my father was given anesthesia and a tube with a camera and a needle was inserted through his mouth and nose.

The doctor told us the location and size of the cancer he saw with the camera. My father was not with us and was unaware of the cancer diagnosis. In addition, a few samples were taken from the cancer cell with the help of the needle at the end of the device and sent to pathology for examination of the cancer cell.

After bronchoscopy, they gave us an appointment for PET CT scan.



About 1.5 weeks later, on November 10, 2020, our pet ct results came out and the oncologist told us that my father had Stage 2B or Stage 3A lung cancer.

The cancer tumor was 4.8x3.7 mm in the upper lobe of the left lung and the cell type of the cancer was squamous cell carcinoma. The oncologist said that because the cancer cell was so close to his windpipe and heart, my father couldn't have surgery and he had to start chemotherapy.

Before coming to the hospital, I had read several articles about immunotherapy on the Internet and asked the doctor about it. The doctor told us that the drugs for immunotherapy are very expensive and they are not sent to our country. After this, I asked the doctor, "Maybe we had the chance to have surgery, can we talk to the thoracic surgeon?". The doctor said "I don't think so, but try your luck anyway." and wrote a few things about my father's cancer on a paper and said that we should go to the surgeon doctor with this paper.



The surgeon doctor told us that we could have surgery, but the entire left lung had to be surgically removed. He told us that most lung cancers are lobectomy (i.e. surgery to remove a small portion of the lung) but because the location of our cancer is life threatening, we should have pneumonectomy (i.e. surgery to remove one lung completely). He said that the cancer in the lung was located in the central station and was in the pulmonary artery, in addition, he also said that there was a 12 mm lymph node associated with cancer in the left lung.



The doctor said that we need to have an EBUS (EndoBronchial UltraSonography) test for surgery and that we can have surgery if the result is negative.

EBUS test was not available in our city. So we went to a city where there is an EBUS device. This test was quite expensive and they gave us an appointment for a few weeks later. The purpose of the EBUS test was to find out if there was metastasis (spread of cancer) in the lymph nodes in the lung.

We had the test and the doctor told us the results were good. There was no spread in the lymph nodes. We were very happy. We decided to have an operation in this hospital instead of in the hospital where the cancer was diagnosed.

The surgery date was given for December 5, 2020.

On November 26, 2020, the doctor said that the brain was not visible in the pet CT scan and that he should have a brain CT scan. My father had a brain CT scan and our doctor said the results were good and there was no cancer metastasis in the brain. After that doctor told him that he should get Covid-19 PCR Test here today.



We had a coronavirus test and went home. It was 10 p.m. and the phone rang, when we picked up the phone, the caller said that he was calling from the Ministry of Health and our coronavirus test was positive. They quarantined us for 14 days and our surgery was cancelled. Coronavirus was very dangerous and we were all crying. It was almost impossible for my father to beat coronavirus when he was cancer.



The next day, the employees of the Ministry of Health came and left 3 boxes of medicine at the door of our house. These drugs were malaria drugs and they told us to swallow 8 in the morning and 8 in the evening after meal.

In addition, they said that we should use coraspin, which is a blood thinner, because the coronavirus coagulates the blood in the veins.

I also had to take the drugs I take daily for my chronic diseases (Asthma, Hashimoto's Thyroiditis, Hypothyroidism, Allergic Rhinitis). When I got the coronavirus, I was swallowing more than 20 pills in a day.



Since I have so many chronic diseases, I was the one who had the worst of the coronavirus. I was completely out of breath while I slept almost every day, all my bones were aching and constantly crackling, I could not stand up, I had literally turned into a zombie.

I recovered in 10-15 days, my mother and father were recovered after 3 weeks.



After getting over the Coronavirus, we contacted the thoracic surgeon again and he gave us an appointment day for my father's lung cancer surgery on January 5, 2021.

We went to the hospital on January 3, 2021 and had the necessary tests done before the operation, they gave my father a room to stay the day before the operation and hospitalized him.

My father's relatives also came to the hospital. He was going to be hospitalized the day before the operation.

The results of all the tests were good and there was no problem for my father to have surgery. My mother stayed in the hospital to accompany my father.



On the morning of January 4th, we all went to the hospital, while talking to my father in the hospital room, a doctor came and asked my father, "Are you going to have an operation?".

My father said, "Yes, I will have lung cancer surgery tomorrow morning". The doctor took a deep breath and said, "You can't have surgery, there are 2 malignant brain metastases due to your lung cancer in your brain CT scan on November 26, 2020."

We were all shocked, all hope was gone. Now my father's cancer was stage 4B and there was no going back from this stage, we had come to the end of the road. My father was going to die because of the negligence of the thoracic surgeon.

My father was surprised: "But the thoracic surgeon said your CT scan is clean, everything is normal." He said, however, the doctor who came said that the disease had reached the final stage because of the metastases in his brain and that he could no longer have surgery.

A few minutes later the neurosurgeon came and said we should have an MRI for a 3D scan. They made an appointment for an MRI scan at midnight and hospitalized my father again. My father's relatives returned home and I got in the car to go to the house my father's friend had given us to stay.

I was driving the car without looking at the road... I was crying out loud, I'm crying right now as I write this, it was so bad, it was really, really, really bad...

That night... that night, for the first time in my life, I was alone in an unfamiliar place... It was winter and the weather was very cold, I had not eaten anything all day, I had not even drunk water.

I went to a corner of the house and cried and prayed until the morning, maybe, maybe the MRI result would be good, maybe those things were not metastases, I consoled myself by crying until the morning by saying these things to myself.



Stage 4B cancer was the last stage of a cancer. It was the worst and deadliest stage of cancer and it was almost impossible to get rid of this disease. When I read the articles about stage 4B lung cancer on the internet, I read that these patients had a 1 year survival rate of 14% and a 5 year survival rate of 1%, and I was crying nonstop. The average survival rate of stage 4 lung cancer patients with brain metastases was between 3 weeks and 8 weeks, it was all over...

My father was going to die because there were metastases in the brain CT scan requested by the thoracic surgeon on November 26, the thoracic surgeon said everything was normal on the brain CT scan...
I was very angry and very sad, I could never stop crying, as the hours passed, the weather was getting colder and I was crying and trembling with fear.



It was morning and the MRI scan was complete. It was confirmed by MRI scan that my father had 2 metastatic tumors in his brain due to lung cancer. Metastatic tumors were located close to the basal systems of the 4th ventricle of the brain and their dimensions were 12x11x10 mm and 6x8x9 mm.

They referred my father to radiation oncology for radiotherapy.
The doctor said my father couldn't have brain surgery because the metastatic tumors were so small.
He said that stereotactic radiosurgery should be performed for metastatic tumors. In addition, the doctor said that this treatment is a very expensive radiation therapy because it is not a standard treatment.



This treatment is SRS (Stereotactic RadioSurgery), also known as Cyberknife treatment, which is much more effective than the "Whole Brain Radiation Therapy" treatment called WBRT (classical radiotherapy).

They made a hospital appointment for 2 weeks later. While waiting for the treatment day in 2 weeks, my father's arms and feet started to go numb and he had difficulty walking, my father's health condition was getting worse day by day.



Then my father received Cyberknife radiation therapy (radiosurgery). The doctor said that we should come for a check-up after a few months and he referred us to the medical oncology department.



The medical oncology doctor recommended immunotherapy treatment to my father. This treatment does not have as severe side effects as chemotherapy, but it is a very very very expensive treatment.



He said we had to hurry because the cancer was at a very advanced stage. He said that since the cancer is in the last stage, we should take chemotherapy and immunotherapy together as a combined treatment. He said that instead of classical chemotherapy, Paclitaxel (taxane chemotherapy agent), which is a platinum-based chemotherapy mixture, and Carboplatin, which is also a platinum-based chemotherapy mixture, should be given together.



In addition to these, he said that we should receive the Keytruda immunotherapy treatment, which contains the active ingredient pembrolizumab during chemotherapy. Keytruda is a double dose immunotherapy taken each treatment day (100 mg / 4 mL (~$5000) + 100 mg / 4 mL (~$5000)). We need to take Keytruda (pembrolizumab) and paclitaxel + carboplatin combined chemotherapy every 21 days without interruption.



Keytruda immunotherapy costs about $10,000. My father is retired, my mother is not working and I am still a student. We have to take Keytruda treatment continuously for 2 years and this treatment costs about $15,000 per month. To continue with keytruda immunotherapy, we have to sell our house, our car and spend all our savings on this treatment. Even if we spend all our money on the Keytruda immunotherapy treatment, the treatment will be interrupted because what we have will not be enough to cover the cost.



The state does not pay for this treatment and does not provide any help, if we continue the treatment only with chemotherapy, probably my father will die soon, pembrolizumab active ingredient is the most effective immunotherapy injection and it is very effective for lung cancer. If primary lung cancer tumor and secondary brain metastases regressed, my father could have lung cancer surgery.

However, the oncologist said that he should continue the Keytruda immunotherapy treatment as a adjuvant treatment, even if he has surgery.

So even if my father had surgery, this cancer is not an early stage cancer. A cancer that has spread to the brain can spread to all parts of the body and if the immunotherapy does not trigger the immune system, the advanced cancer can kill the patient. So my dad has to continue immunotherapy treatment even if he has surgery.



I will write about my father's health as new things come out. Never lose hope and keep fighting. life is a struggle, never stop fighting cancer. Thank you for reading my article, I wish you and your family good health.

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