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


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21 hours ago, TheShredder said:

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

Thanks for your knowledge. My mom is a nurse and with both of us crying our eyes out, she had to explain the Sean Taylor (femoral artery issue) to me. 

Again, thanks. 

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On 8/21/2020 at 6:07 PM, TheShredder said:

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!!!

 

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.

 

Am I reading this wrong, that he has, in the average case, less than 3 years or so to live?  The figures you quoted here I find in a 2002 paper based on data collected from 93-97, has the treat-ability changed any since then?

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I guess the big concern for me is about chemo. From what I understand, chemo weakens the immune system in a pretty big way. That's not a good thing during a pandemic. Rivera better think doubly if not triply hard on how he goes forward. I'm sure (or at least hope) he's consulted with his doctors about that though so he has much better advice than a layman like me can offer.

 

If it does weaken his immune system, I hope for his sake, he hands the reins to Del Rio and quarantines until he gets his strength back.

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5 minutes ago, Vanguard said:

I thought I heard that he was getting some kind of new advanced laser treatment that isn’t as hard on the immune system.  I don’t want to put false info out.

 

Are you talking about proton therapy?  I think he mentioned that, but I'm 100% sure I saw it reported that he said that.

 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/proton-therapy#

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20 minutes ago, NewCliche21 said:

 

Are you talking about proton therapy?  I think he mentioned that, but I'm 100% sure I saw it reported that he said that.

 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/proton-therapy#


Yea.  I just looked it up too.  Says that it usually causes some fatigue, but I don’t think it’s as taxing as chemo.  But I think Ron said in a quote he will be mixing in some chemo.

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3 hours ago, Burgold said:

I guess the big concern for me is about chemo.

 

54 minutes ago, Vanguard said:

But I think Ron said in a quote he will be mixing in some chemo.

Nowhere in his interview disclosure statement he now refers the media to does he state anything about chemotherapy. 

 

That doesn't mean he won't be getting chemo or that they're not planning on it.  However anyone mentioning chemotherapy is making assumptions. 

Standard Moffit protocol is the most respected and for his type and stage does call for chemo after radiation.  For stage 4 its life dose radiation and chemo simultaneously administered  in otherwise healthy patients. 

 

Normally Oncologists Assistants are RN's who essentially breakdown the patients treatment protocol for them and give them their treatment options.  Some patients refuse chemo. Honestly if i get Stage 3 or worse CA I'm not taking chemo.  It just wrecks you permanently and I'd choose differently.  However, these assistants help patients work through the process...all the way to cure or death.  It's likely that Coach Ron decided to do proton/radiation first then reassess.  But there's no protocol for 'mixing in some chemo'.  That just doesn't exist. 

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19 hours ago, Bifflog said:

 

Am I reading this wrong, that he has, in the average case, less than 3 years or so to live?  The figures you quoted here I find in a 2002 paper based on data collected from 93-97, has the treat-ability changed any since then?

 

@TheShredder I'm interested in the answer to this, as well. As I can see how one could deduce that it could be an average of 3 years to live in this situation, considering this quote.

 

Mean survival rate for Stage 3 SCC is 1068 days (or 3 years).

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19 hours ago, Bifflog said:

 

Am I reading this wrong, that he has, in the average case, less than 3 years or so to live?  The figures you quoted here I find in a 2002 paper based on data collected from 93-97, has the treat-ability changed any since then?

I was very detailed in my post. The statistics are current as of May 2020. 

 

Like I said it's complicated because we don't have the full patient assessment.  We were given enough info to Stage it as a 3 however. 

There's plenty of reasons you'd put Ron Riveria outside the mean.  I think all would agree. I would assume his odds of survival past the 5 yr recovery window to be better than the normal patient. 

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10 minutes ago, TheShredder said:

 

Nowhere in his interview disclosure statement he now refers the media to does he state anything about chemotherapy. 

 

That doesn't mean he won't be getting chemo or that they're not planning on it.  However anyone mentioning chemotherapy is making assumptions. 

Standard Moffit protocol is the most respected and for his type and stage does call for chemo after radiation.  For stage 4 its life dose radiation and chemo simultaneously administered  in otherwise healthy patients. 

 

Normally Oncologists Assistants are RN's who essentially breakdown the patients treatment protocol for them and give them their treatment options.  Some patients refuse chemo. Honestly if i get Stage 3 or worse CA I'm not taking chemo.  It just wrecks you permanently and I'd choose differently.  However, these assistants help patients work through the process...all the way to cure or death.  It's likely that Coach Ron decided to do proton/radiation first then reassess.  But there's no protocol for 'mixing in some chemo'.  That just doesn't exist. 


Don’t come in correcting everyone like you know.  Because you don’t. 
 

https://profootballtalk.nbcsports.com/2020/08/22/ron-rivera-will-undergo-chemotherapy-proton-therapy-for-seven-weeks/

 

That is where I got the information I’m speaking of.  Unless you’ve had cancer and first hand knowledge of the treatment.  You need to amend what you said.  Check yourself, and whatever knowledge you thought you had on the subject.

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3 minutes ago, Malapropismic Depository said:

 

@TheShredder I'm interested in the answer to this, as well. As I can see how one could deduce that it could be an average of 3 years to live in this situation, considering this quote.

 

 

 

I just posted a reply and that should be enough about survival rates.  All non medical people get wrapped up in 'What are the chances of survival', but it doesn't really apply.  Everyone isn't created equal.  Those statistics are  comparing same situations.  That's virtually impossible.  

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2 minutes ago, Vanguard said:


Don’t come in correcting everyone like you know.  Because you don’t. 
 

https://profootballtalk.nbcsports.com/2020/08/22/ron-rivera-will-undergo-chemotherapy-proton-therapy-for-seven-weeks/

 

That is where I got the information I’m speaking of.  Unless you’ve had cancer and first hand knowledge of the treatment.  You need to amend what you said.  Check yourself, and whatever knowledge you thought you had on the subject.

 

Really.  I said that he didn't state that in his interview and you can't assume that. 

So go attack someone else and I'm fine taking my professional knowledge and experience and keeping it to myself.  You can guess about whatever you wish. 

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4 minutes ago, TheShredder said:

I just posted a reply and that should be enough about survival rates.  All non medical people get wrapped up in 'What are the chances of survival', but it doesn't really apply.  Everyone isn't created equal.  Those statistics are  comparing same situations.  That's virtually impossible.  

 

So, to sum this up : Coach Rivera is not your average patient :)

He's not your average coach, either. Or average at anything.

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38 minutes ago, JSSkinz said:

I'm curious do you work there?  I've never heard anyone refer to a specific protocol using their name.

I'm a little skeptical. If I remember, Moffit was the name of Boxey's pet on the original Battlestar Gallactica and while I do support pet therapy I'm not sure it's the standard approach.

 

Muffit - Battlestar Wiki

 

On a serious note, I appreciate the breakdown. Expert knowledge is always useful.

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1 hour ago, TheShredder said:

I was very detailed in my post. The statistics are current as of May 2020. 

 

Like I said it's complicated because we don't have the full patient assessment.  We were given enough info to Stage it as a 3 however. 

There's plenty of reasons you'd put Ron Riveria outside the mean.  I think all would agree. I would assume his odds of survival past the 5 yr recovery window to be better than the normal patient. 

 

I didn't mean to imply otherwise, I was just alarmed reading the assessment (and rightfully so, it seems).

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To be completely honest, the cancer is not the scariest thing to me at this point. I am confident he will receive the best care and do what is necessary to pull through.

 

What worries me is our current pandemic. Many treatment practices for cancer weaken the immune system. That means Coach would find it even harder to fight it off if he got sick. I’m glad he has been taking the Covid protocols so seriously. He may benefit more than anyone.

 

On the bright side, his situation will likely cause all of the players to double down and be even stricter about safe practices as well.

 

Gotta find the positives sometimes. Similar to how being a zombie means endless amounts of cardio workouts. Great for the quads. Stay healthy people.

 

Edited by FootballZombie
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21 minutes ago, FootballZombie said:

To be completely honest, the cancer is not the scariest thing to me at this point. I am confident he will receive the best care and do what is necessary to pull through.

 

What worries me is our current pandemic. Many treatment practices for cancer weaken the immune system. That means Coach would find it even harder to fight it off if he got sick. I’m glad he has been taking the Covid protocols so seriously. He may benefit more than anyone.

 

On the bright side, his situation will likely cause all of the players to double down and be even stricter about safe practices as well.

 

Gotta find the positives sometimes. Similar to how being a zombie means endless amounts of cardio workouts. Great for the quads. Stay healthy people.

 

I'm listening to white zombie right now totally **** faced if that means anything?

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7 hours ago, TheShredder said:

 

Really.  I said that he didn't state that in his interview and you can't assume that. 

So go attack someone else and I'm fine taking my professional knowledge and experience and keeping it to myself.  You can guess about whatever you wish. 

 

 

The poster you responded to represents a minority position.

 

Those of us that have thoughtfully read your posts are impressed with your knowledge and sobered by your conclusions.

 

Personally, if I am ever in a life threatening health situation I want a straight shooter like yourself to tell me the unvarnished truth. So that I can make critical decisions that aren’t based solely on hope and best case outcomes. 

 

Please continue to keep us informed. It is definitely appreciated.

Edited by TrancesWithWolves
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On 8/21/2020 at 6:42 AM, Ashburn Dave said:

Cancer is the worst.  Even when your chemo puts it in remission the cancer is always lurking and trying to mutate so it can come back.

 

Lost too many family and friends to cancer.

 

Good luck Ron and hope this isn't part of the teams curse that hovers above us now.


I agree.  Lost my spouse 4 months ago after being diagnosed with cancer in October.  
 

Best wishes to RON.

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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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