PET-CT Results and New Treatment - October 26, 2010

There's been a change in the date for Dr R to move to NYU and neither he nor A are exactly sure of when the official move will take place, so until such time, Pete will continue going to Beth Israel.

The 10 AM appointment with Dr R was preceded by a quick check of Pete's vitals. With that finished, we went into the doctor's office where he was waiting with the scans already up on his computer screens. A was there with the written report in hand.

He began by asking Pete how he was feeling, did he have any pain. Pete responded that he's been feeling pretty well but still has some discomfort in the area of his left shoulder blade, but assured the doctor that it is minimal and that he has not needed any pain medication.

Dr R went over the scans with us very carefully, again pointing out various areas and explaining as he went through them. First the good news. The tumors in both legs are not only significantly smaller, but are also exhibiting considerably reduced activity levels, from numbers in the 20's now down to 3. With the exception of the large tumor in his left lung, all the others in his lungs appear to have diminished in both size and activity. There is no indication of anything in his brain, and his liver, kidney and other internal organs all appear clear.

Although that large tumor in his lung seems to have decreased slightly, the area seems to still be quite active. Dr R seems quite confident that this may actually be due to the fact that as the tumor is receding from the bone (ribs), those bones are going through a process of repairing themselves which would also be recorded as an area of heightened activity on the PET scan.

The one item of concern stems from the fact that the previous PET scan, though supposedly full-body, stopped at Pete's elbows. This latest scan went right to his finger tips and picked up a spot on his left arm just below his elbow in line with his thumb. The doctor mentioned that it may require an MRI of the area to examine it more closely. Having no other scan for comparison with this finding but with all other tumors reduced, the doctor feels that this may have already been present before the Ifosfomide infusions began.

Before leaving, Pete was directed to stop in at the lab to have blood work done because tomorrow morning we'll be back there by 8:30 AM to begin the next course of treatment. This time it will be Adriamycin and Cisplatin and what sounds like a whole lot of fluids to prevent dehydration. As I understood it, the two chemo agents will be delivered on the first day and then the next three or four days will require going back in for monitoring and to get hydration packs, which he'll be hooked up to and wear until we go back the next day and get another bolus.

Depending on how this next treatment goes, Pete may have a total of 2 or 3 rounds of these two drugs. I don't know how much time there will be between rounds, but so far things appear to be heading in a positive direction and Pete's tolerated everything pretty well. No reason to expect anything else this time.

While we were chatting with Dr R, waiting for A to come back with some copies, I asked him if he would be attending the CTOS conference in Paris during the second week in November. He seemed surprised that I knew about the upcoming meeting and asked where I had heard about it. I told him it was through the Sarcoma Alliance. He asked if it was through SA that I had learned of him. I answered yes, and told him it was E who suggested he might have more treatment options to offer Pete. He and A acknowledged that she has been a patient of his for several years. When I mentioned DM, he smiled and said, "He's the guy with the pony tail."