A Change in Treatment - November 22, 2009

When the CT results were not what we had hoped for, Dr K (MSKCC) offered her recommendation that Pete change to a different treatment. There were no new lesions, a good thing, but the results were again inconclusive with some lesions increasing and some decreasing in size. Because of how these new drugs are administered, we discussed the possibility of going to a local oncologist rather than driving up to MSKCC. She gave us the name of a practice about 1/2 hour from our home that she felt confident would handle Pete's care as they have worked with a number of her patients who live in south Jersey.

On Friday afternoon we had a first visit with Dr. W. He and all the staff were very gracious and the whole atmosphere was comfortable and calming. He took us on a tour of the facility and he and the others we met explained in detail the procedures and treatments Pete will be receiving. Although everyone that we've dealt with at MSKCC has been wonderful and very caring, the environment is that of a sterile hospital, and coupled with the stress of driving into and through the city to get there seems just a bit unnerving, for me at least.

Because of the change to the AIM protocol, Pete will need to have a port implanted and he will have to undergo a MUGA scan. I had never heard of it, but apparently it is a nuclear scan similar to an echo-cardiogram but it provides a much better assessment of the status of the left ventricle of the heart. One of the chemo drugs in this mix can do serious damage there and they need a baseline before the first infusion to make certain his heart is healthy enough to withstand the treatments, and then will repeat the scans at regular intervals to monitor for adverse effects. These 2 procedures will be done in the hospital (not sure whether Jersey Shore or Monmouth Medical) this week. Chemo will begin the week after Thanksgiving.

Though the new drugs Pete will be receiving (adiriamiacine aka doxorubicin, ifosfamide and mesna) are known to produce significantly more debilitating side effects than the initial drugs, it is hoped that the lesions will respond more favorably. Dr K indicated that she will be ordering a CT scan after the first cycle as opposed to the normal timing which would be after the 2nd cycle. One cycle, in this instance consists of 3 consecutive, 7-8 hr days of infusion and 2-3 weeks of follow-up monitoring, so the scan will probably be done just before Christmas. Based on those CT results, they will either proceed directly to surgery (if the lesions do not respond as hoped for) or continue on with the therapy.

That's about all there is right now. Since getting the disappointing results about a week ago I just needed to step away from the computer for a while. I didn't feel like tracking my food or water and though I logged on to SparkPeople a couple of times, I just didn't have the "oomph" to post or blog. I'm coming out of my "funk" and hope to get back in the swing of things starting today.