Initiation

Archer Kent Wagstaff will be 21 months old on Tuesday, August 26. On Monday, August 25, he begins chemotherapy for hepatoblastoma (liver cancer). He is such a good natured and strong child and we love him dearly!

History:

Archer has always had a difficult time when getting new teeth. They are usually accompanied by a fever and even vomiting. That's why when he started experiencing these symptoms some time early last week, we thought little of it. The symptoms lasted a couple days longer than usual, so Aubrey decided to take Archer to our pediatrician on Monday (8/18). Our normal pediatrician was out of the office, so Aubrey met with the other doctor in the same office, Dr. Douglas Hacking. After a quick examination, he discovered that little Archer's liver was "massive", and he ordered a blood test and ultrasound.

Tests:

Archer went in for blood work and didn't flinch the slightest bit when they inserted the needle into his arm. The nurses were impressed by his bravery and he even told the nurses "thank you" afterward. Following the ultrasound, we received a call from Dr. Hacking saying that the Radiologist hadn't had a chance to look at the ultrasound yet but the technician suggested a large mass on his liver. We slept little that night with the possibilities of what it could be occupying our thoughts. Tuesday morning (8/19), we were ordered a CT scan at Utah Valley Regional. Upon arrival, we were informed by the surgical oncologist, Dr. Rebecca Meyers, that UVRMC did not have the technology necessary to perform the triple phase CT scan that she needed. She sat down with us and went over all of the possibilities of what it could be and explained how they would determine it. She also informed us that at his age, hepatoblastoma was the most likely. She then had Primary Children's Hospital schedule the scan for the following day.

After another restless night, we drove up to PCH on Wednesday (8/20) and started the process up there. They let us know that if they suspected any form of cancerous tumor, they would perform a biopsy immediately following the CT scan, while Archer was still sedated. As it turns out, the mass was a tumor and it was suspected to be cancerous so they did conduct the biopsy as well. We were able to remain with him during the CT scan but had to wait out in the hallway for an incredibly long 30 minutes while they performed the biopsy.

The biopsy went very smoothly and they said that the results could take up to 5 days but we may know the following day. Archer then was admitted to the Rapid Treatment Unit and put on bed rest for 4 hours. It was heartbreaking to watch him lie there and cry because all he wanted was to be held, but couldn't. As we passed the nurse's desk on the way out, Archer had to say "Bye bye. Thank you!" to each of the 5 or 6 nurses there. Needless to say, he has won the hearts of all the nurses up there. We then went home for another sleepless night (sensing a pattern?) and were greeted in the morning with the news that he most certainly had hepatoblastoma in his liver!

Prognosis:

While we were at PCH on Wednesday, we met with a couple of the oncologists that will be helping Archer through his treatments, Dr. Anupam Verma and Dr. Allison Ast. They were very hopeful of the outcome and informed us that Dr. Meyers is one of the world's leading doctors in hepatoblastoma and is on the board that writes the treatment protocols for the disease. In other words, there is no one better that we could have as his primary oncologist. They proceeded to tell us how the treatment will work and the prognosis. The survival rate is very high and hepatoblastoma is particularly responsive to chemotherapy.

They also showed the scans that they took and we were able to see the tumor and just how large it is. The tumor itself is over twice the size of a normal liver for Archer's age. This means that his liver (and tumor) fill up almost the entire right half of his abdominal cavity. His left kidney is round and plump and his right kidney looks like it has been run over by a truck it is so smashed. His stomach and other organs are also having their space invaded by the giant tumor, hence the consistent vomiting. The cancer has started to spread to his lungs, as they found a couple of nodules but they are hopeful that the chemo treatments will take care of that.

Treatment:

Because the tumor is so large, surgical removal is out of the question without first going through chemotherapy to break down the tumor. Archer will have a port put in his chest on Monday (8/25) through which they will administer the chemotherapy. His first chemo treatment will immediately follow. The doctors are hoping that after 2 rounds of chemotherapy, the tumor will be small enough to operate on. If not, they will do two more rounds. If it is still too large to remove by means of surgery, they will have to perform a liver transplant. After the removal of the tumor, he will have to do two or four more rounds of chemotherapy in order to get rid of all existing cancer cells.

Each round of chemotherapy will be pretty tough on the little guy. As with all chemotherapy, he will require some recovery time between each round and his immune system will be very weak during this time period. He will be hospitalized for about 4 days after each treatment, during which time they will make sure that his body is getting rid of all the toxins released during the chemo process. He will then have 3 to 4 weeks to recover before starting the subsequent treatment. All in all, the process will take at least 7 or 8 months until he is fully recovered.

Big Sister:

Kaesia has been so sweet and helpful to us and to Archer the last week. I don't think that she really understands what is going on but she certainly knows that Archer needs extra love from her!





Thanks!

Since we have found out about all of this, we have received a tremendous amount of support. For the sake of space and privacy we don't want to list out all of the names of those to whom we are grateful but we do wish to thank you all tremendously! You know who you are. We are so blessed to have such great family and friends. There have even been a few other people involved who we don't even know.