An Unexpected Diagnosis What started as acute back pain has led us down a path no one ever saw coming. Following a routine physical, some abnormal bloodwork prompted additional testing. Paul was admitted through the ER at Glenbrook Hospital, where a CT scan and abdominal ultrasound revealed a mass on his kidney. Later that evening, he was transferred to Evanston Hospital, where doctors performed an MRI and biopsy. The biopsy confirmed renal cell carcinoma (kidney cancer). While the biopsy was not able to determine the exact subtype, stage, or grade, Paul's medical team has shared some concerning findings. The tumor is very large—approximately the size of the entire kidney—and the cancer cells appear to be aggressive and fast-growing. His oncologic surgeon and medical oncologist believe the cancer is at least Stage 3 and very possibly Stage 4. Further testing has shown that what was initially thought to be blood clots are actually tumor growths within several veins. While all of these findings are serious, the greatest concern is involvement of the vena cava, the large vein that carries blood back to the heart. Doctors also believe the cancer has spread to nearby lymph nodes. In addition, Paul's adrenal gland appears enlarged and will be evaluated further during surgery. The good news is that, at this time, there is no evidence of cancer in his liver, lungs, or heart, though those areas will be carefully assessed during surgery. He is also awaiting an MRI of his brain to rule out any spread there. We are currently waiting for a surgery date and hope to receive that information very soon. The operation is expected to last 4–6 hours and is considered highly complex because of the tumor's size and involvement with major veins. It will take place in the cardiovascular institute with multiple surgeons working together to give Paul the best possible outcome. Following surgery, Paul is expected to remain in the hospital for 4–7 days, with a recovery period of approximately 4–6 weeks. This is understandably frightening news for all of us, but we are focusing on one step at a time and placing our trust in the expertise of Paul's medical team. We are doing our best to keep spirits high while we wait for the next steps and learn more. Thank you to everyone who has reached out with support, prayers, and encouragement. Your kindness means more than we can express right now. We will continue to share updates as we learn more. All our love, The Bottcher Family
I created this GiveinKind page to keep everyone informed and connected throughout Paul's cancer journey. I will do my best to post frequent updates so that family and friends can stay informed without relying on secondhand information. As needs arise, I will also use this space to coordinate support, whether that's meals, groceries, help around the house, or other practical ways to lend a hand. Thank you for keeping Paul, Rachel and their family in your thoughts and prayers and for being part of the incredible community surrounding him with strength, hope, and love. Best, Emily