The appointment with Dr. W was for 1:45 today. Pete had decided that it would be prudent to resume the DTIC, but administer Doxil along with it, so that was one of the first things that was discussed. Dr. W felt that this was a reasonable thing to do because multiple agents are generally more effective than a single agent, which is something I had read in much of the research that I had done.
Pete and I asked questions of Dr. W and he graciously, patiently and thoroughly explained every one and then asked us if we understood or had any additional questions. He epitomizes, in my opinion, the way every physician should treat a patient.
I had made a list of chemo drugs, some approved by the FDA for treatment of various cancers, but not sarcoma and others are "investigational" drugs. However, all were suggestioned by people in various sarcoma and other cancer communities as having shown, in some instances, to be effective in reducing or stabilizing soft tissue sarcoma.
Those that are FDA approved can be prescribed by a physician for treatment of sarcoma, but the problem arises if the insurance company refuses to pay for them because they're not approved specifically for sarcoma.
Those that are "investigational" drugs are in clinical trials. They have not yet been approved by the FDA for use in the treatment of any cancer. However, if the drug, in the course of the clinical trial, shows that it may be an effective treatment, a doctor may petition that it be provided to a patient for whom all existing therapies have failed. This would allow the drug to be provided for compassionate use. It's not an easy thing to do; it takes quite a bit of time, a whole lot of paperwork and it can be very frustrating. And since the drug is still in trials, it has not yet been documented how well it works, or if it works at all. How to pay for the drugs, if they are approved for compassionate use, is a whole other story.
Along with my "chemo list" I had come prepared with a series of other questions. One of them involved Doxil, the drug that is going to be combined with the DTIC. Doxil is a derivative of Adriamycin (aka Doxorubicin). Adriamycin is cardiotoxic, meaning it damages the heart muscle, and therefore has a lifetime maximum dose. Doxil apparently has a less toxic effect on the heart, but Dr. W did say that Pete will have to have periodic echocardiograms or mugascans to check on heart function.
The bottom line is that Pete has an appointment next Wednesday, August 18, for his first infusion of the DTIC + Doxil combination. He'll have to have an echocardiogram done before then.
That's about it for now.
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