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ESPN: Washington's Ron Rivera says he has cancer, plans to continue coaching - NOW CANCER FREE!


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10 hours ago, Burgundy Yoda said:

Can we realistically expect him to coach going through chemotherapy? I know he wants to, and I respect the hell out of him for it because he's a warrior, but it will be draining on his body.

I work with a guy who had a different type of cancer (I think some form of prostate cancer), went through some type of daily outpatient treatment, and didn't miss a beat. Didn't miss a day of work. I have no idea if it's the same type of treatment or not, but it took a couple months and he was cancer free.  The biggest issue is he had to travel to the clinic and receive treatment which took 2 hours a day.  

 

So the answer is, maybe?  I have no idea if what Ron has to go through is similar or not, but if it is, then he should be able to continue working.

 

My guess the biggest issues, at least short term are going to be inconvenience and also you are significantly more immune compromised if you are on chemo.  Which of course puts you at a higher risk if you contract COVID.  My colleague was told essentially to quarantine regardless of COVID.  So it will be interesting to see how Ron approaches this.  Maybe he should wear a darth vader type helmet/breathing device. 

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11 hours ago, Burgundy Yoda said:

Can we realistically expect him to coach going through chemotherapy? I know he wants to, and I respect the hell out of him for it because he's a warrior, but it will be draining on his body.

It depends, it's not a one size fits all approach to treatment and everyone's body reacts differently but if he's getting chemo his white blood cell count will shoot down for days after each chemo treatment and that's when he's susceptible to infection.   A normal white blood cell count is between 4.2 and 8.5 and when you go through chemo about 5 days after each treatment your white cell count can be very low, its expected.

 

The biggest thing to worry about with chemo is infection when you become neutropenic, when that white cell count is below 1.0 your body cant fight off infection and you could get sepsis.

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5 hours ago, JSSkinz said:

It depends, it's not a one size fits all approach to treatment and everyone's body reacts differently but if he's getting chemo his white blood cell count will shoot down for days after each chemo treatment and that's when he's susceptible to infection.   A normal white blood cell count is between 4.2 and 8.5 and when you go through chemo about 5 days after each treatment your white cell count can be very low, its expected.

 

The biggest thing to worry about with chemo is infection when you become neutropenic, when that white cell count is below 1.0 your body cant fight off infection and you could get sepsis.

In his interview with Julie D he states he will be getting seven weeks of Proton therapy. This is radiation.  NOT CHEMO. 

 

https://www.cancer.net/navigating-cancer-care/how-cancer-treated/radiation-therapy/proton-therapy

Proton therapy, also called proton beam therapy, is a type of radiation therapy. It uses protons rather than x-rays to treat cancer.

 

proton.jpg.b1cf3f6dac3ac4f822edcbfe1407c205.jpg

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Staging SCC

 

Cancer types are confusing and to understand where Coach Ron might be with what has been divulged thus far, her you go...

 

First the type is dependent on it's origination location.  Squamous cell carcinoma means originating in the dermis or skin. This is specific as it didn't start in the lymph node. 

 

Second, in his interview with Julie D as he described how he found it, he touches the left side of his neck above the clavicle.  This location is at the supraclavicular lymp bundle. 

 

This leads to a normal staging criteria as a Stage 3 SCC. 

 

What is misleading here is we don't know more.  No reference to the diameter or size (which matters).  We know that treatment regimen is to start with 7 weeks of radiation,  not chemotherapy.  Normally you start with the least invasive and kind of save your ammo for any treatment failure or detected extension into another organ system.  An extension into another organ would move the staging to a 4.

 

If I were to read into this I'd assume that the original SCC is not greater than 2mm.  That he has undergone a full PET Scan and there's no detectable extension into another organ system and extension is limited to the local supraclavicular lymph node.  

 

Concerning is the fact that the SCC got into the lymphatic system.  As good as cancer detection is, the ability of a systemic PET scan is limited by the size of the cells it can detect.  Meaning, a negative scan cannot rule out extension into another organ.  The science just isn't good enough yet.  They have to stage and treat what is presented. There's a possibility he already has a growing CA in another organ and it's just not big enough yet to show up on the scan.  He can take treatment via proton therapy  for weeks and get another scan that shows no cancer cells but in reality he could have it extended to another system making him end stage or stage 4. 

With any further extension the last resort available would be chemo.  Stage 4 SCC has very high morbidity rate.  Chances of survival are best case 39% for 1-2 years.  Coach Ron has not been diagnosed with Stage 4.  For all intents and purposes, given the information that has been shared, he is a Stage 3.  This carries a long road of not knowing what might happen until he's cancer free past 5 years.  Mean survival rate for Stage 3 SCC is 1068 days (or 3 years). 

 

My conclusion is that what is being reported and said is Positive Thinking.  The facts show that Coach Ron more than likely will not be coaching football in a year or two unless he gets lucky.  This is an extremely serious condition. 

 

Giv'em hell Coach!!!

 

lymph.jpg.ca2c557800b1d42e037454a2e626ba90.jpg

Squamous cell carcinoma stages

There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage squamous cell carcinomas. These include:

  • Greater than 2 mm in thickness
  • Invasion into the lower dermis or subcutis layers of the skin
  • Invasion into the tiny nerves in the skin
  • Location on the ear or on a hair-bearing lip

After the TNM components and risk factors have been established, the cancer is assigned to one of the five squamous cell carcinoma stages, which are labeled 0 to 4. The characteristics and stages of squamous cell cancer are:

Stage 0: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis (upper layer of the skin) and has not spread deeper to the dermis.

Stage I (stage 1 squamous cell carcinoma): The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.

Stage II (stage 2 squamous cell carcinoma): The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high risk features.

Stage III (stage 3 squamous cell carcinoma): The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.

Stage IV (stage 4 squamous cell carcinoma): The cancer can be any size and has spread (metastasized) to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.

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Let the treatment process play out and we will see if Ron will be able to coach long term.  If not, Jack Del Rio would be the interim coach and Snyder will go thru the process of finding a new permanent coach.  Let's hope we don't have to entertain that option but also realize that is something that could happen.

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17 minutes ago, Malapropismic Depository said:

Is this going to affect his ability to yell at players ?

Probably.

 

In general, common side effects of proton therapy include:
  • Fatigue.
  • Mouth, eating and digestion problems.
  • Headaches.
  • Hair loss around the part of your body being treated.
  • Skin redness around the part of your body being treated.
  • Soreness around the part of your body being treated.
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1 minute ago, TheShredder said:

Probably.

 

In general, common side effects of proton therapy include:
  • Fatigue.
  • Mouth, eating and digestion problems.
  • Headaches.
  • Hair loss around the part of your body being treated.
  • Skin redness around the part of your body being treated.
  • Soreness around the part of your body being treated.

If it's skin cancer but is now showing in the lymph nodes is it wrong to think it's already metastasized?

 

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5 minutes ago, JSSkinz said:

If it's skin cancer but is now showing in the lymph nodes is it wrong to think it's already metastasized?

 

Yes.

 

It extends into a lymph node and has not metastasized into another organ system to the degree that is detectable via PET Scan.  

He wouldn't be coaching with Stage 4 SCC. 

 

Stage 4 CA's are total disability.  Time to gt your affairs in order.

Edited by TheShredder
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33 minutes ago, KWilliamsAWinfield said:

He should retire to focus on his health, that is just my opinion 

From my experience you're right. 

 

However, most patients entering into a treatment plan struggle with depression and that's magnified by idle time and feelings of uselessness. All this happens at once, getting blindsided out of nowhere feeling perfectly fine. Keeping a sense of normal, at least in the beginning is good medicine.  Really he won't have a huge issue with radiation side effects.  Mostly just annoying because these are compounding treatments.  Imagine feeling a little worse each day for 2 months. 

 

He will pull the plug on coaching if it spreads at all.  He won't have a choice really. 

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Coach Rivera , I hope you will conquer this insidious disease. I wish you a quick and speedy recovery, and may your family and your self find strength and courage from all the thoughts and prayers from the fans, the franchise and from the general public.Stay Washington Strong.

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  • Renegade7 changed the title to ESPN: Washington's Ron Rivera says he has cancer, plans to continue coaching - NOW CANCER FREE!

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