October 12, 2010
The following update was written by my son after our doctors appointment . He says it best ….
Here’s the update after Mom’s appointment.
Dr. Gosewehr is good, he answered all of our questions and was knowledgeable of all the additional tests, treatments, etc that Mom wanted to ask about. For the additional scans and blood tests those are basically just things that will tell us what we already know – the cancer is back and growing. For things like tissue assay and targeted gene therapy -there isn’t really anything to do the tissue assay on no tumors no fluid, and the targeted gene therapy was more something for down the road as a possibility if necessary. For the Budwig diet, its fine for a “healthy eating/lifestyle” aspect because being healthy is important to fight this. He was familiar with it and has patients that use naturopathic approaches as well. It comes down to the fact that they don’t yet know what combination works for any individual to stimulate their immune system, etc and that is the goal of those approaches – to stimulate the body to fight off the disease on its own. The same goes for Chemo with some people – what works for what person isn’t always easily determined.
We got some details of the CAT scan result. They didn’t see any ascites/abnormal fluid build up in the abdomen. The Dr. did say there was a tiny bit of fluid but that is not abnormal. He saw some thickening on the lining of the bowel. He described it as looking like frosting on the bowel and that is a sign of active growing cancer and exactly where they would expect to see it and he was not surprised to see that given the symptoms Mom has explained she has been having. The symptoms are really the most compelling reason to do anything at this point. If she was feeling fine they might say lets wait a while if you want to, but that’s not the case now.
Decisions of how to treat from now on should be based on 2 things, effectiveness and toxicity (sideaffects).
For the initial treatment starting last March, Mom was getting a combination of carboplatin and taxol. Most of her unmanageable side affects (neuropathy, bone pain) can be attributed to the taxol, and most of the benefit can be attributed to the carboplatin. They do have added benefit used together but given Mom’s personal reaction and side affects to the taxol she would probably have much worse side affects and not an equal amount of benefit.
So for the treatment now. According to the Dr. there are 3 general Chemo options now: carboplatin only, carboplatin and taxol like before, or something new. As Mom said she had a great response to the prior treatment and so they are going to stick with carboplatin. According to the Dr. this is the drug best known to fight this and it has the least associated side affects with it, and we know Mom had a great response to it before. The something new, they discussed a few drugs Mom is knowledgeable of, could be something completely different and new or something new in combo with the carboplatin. There are 22 potential drugs to fight this, so far Mom has used 2. It goes back to what combo is effective for what individual. The Dr. expects the same result this time using carboplatin alone – put the cancer into remission. It could be as good of a response, a better response or not as good of a response. They should know after 2 treatments if it is still effective. If the response is not as good, or if she is not in remission as long as she had been this last time then they will look at adding one of the new drugs.
This treatment option seems like a really good one because we expect an excellent response like before, but without the taxol some of the side affects that were out of Moms control should not occur. there will still be side affects, but Mom has learned to be prepared to deal with some of them and knows how to minimize them. I just did a quick search on side affects and it even says that hair loss is rare with normal dose of carboplatin, so hopefully that will be the case for Mom too.
As the Dr put it “you’ve been to this rodeo before” and that is an asset because knowing what to expect is a big help in being prepared. Other positives are, Mom is not as sick this time as she was when initially diagnosed, she is in better health and additionally mentally prepared. I think she has a great attitude at this point, no “poor me”, just “let’s take care of it so I can get on with what I want to do”. She should be in good enough shape to have a good time on her trip.
I think that covers it.