Tuesday, December 16, 2008

The Big Question

Today's visit with Dr. Amatruda was another of the warm and good-spirited talks much like we've had in the past. Our topic may have been less than ordinary, but we have good banter.

Given what I had learned in my grogginess following the partial hepatectomy and thereafter, I tried to cut to the quick a bit. So I asked the question, probably the real question that many folks would like to hear an answer to, and one that I have perhaps danced around a bit in the past: "I'm pretty well hosed, right?" Essentially the answer was to the affirmative. And with that biggie out of the way, we continued on discussing my current situation and the latest treatment plan.

Previously, the treatment planned was moreso toward adjuvant therapy, I believe. That is, things along the interferon and interleukin line. But since more "little seeds" of cancerous tumors were found on the liver, Dr. Amatruda has now suggested the chemotherapy route.

After some of the verbiage you will encounter further down, I tried to dumb things down a bit from the big words. I asked if the version I had been telling was a valid attempt:
The chemo is like roto-rooter, going through the system and killing stuff; the interferon is like a vitamin overdose, trying to get my body to kill the stuff but also having similar side effects.
He preferred to reword it something like this:
Let's say you've got moles ruining your yard. You choose one of two options poison (the chemo) or ferrets (the other). The poison may kill the moles, but it also may kill some of the grass; and after they're gone they may return again. The ferrets might also beat up the lawn a bit, but the may get rid of the moles too -- and potentially keep them gone longer.
But as it pertained to the big question earlier, either treatment is essentially to buy time. Stage IV is apparently not a happy place. Some of the treatments discussed were as follows.
  1. High-dose interleukin-2. This is apparently quite toxic and given in an ICU, but it effects may last longer.
  2. "Standard" chemotherapy with temozolomide. Or other chemotherapy types that may be better tolerated.
  3. Experimental chemotherapy with Taxol and STA-4783. This was the way Dr. Amatruda currently recommended.
But before hopping into #3, I first need to visit with Gretchen* to determine whatever we need to determine. And so we started setting up appointments, but it was a wonderful snowy day and my appointment was already scheduled for late in the day, so I'll need to get those things sorted out later.

But it will probably go something like this:
  • Get a new scan. This time a CT, not a PET/CT, of my abdomen and what-not. Shoot for the week between Christmas and NewYear's.
  • Consult with Gretchen in early January.
  • Consult with Dr. Amatruda about 2 days after Gretchen.
  • Start chemotherapy in mid-January.
  • In the meantime, try to keep up on top of the tissue samples that went to the Hoag study.
And also start seeing a shrink to talk about stuff. Maybe not so much me talking about me, but to also include how to talk to the girls. And family. And friends. So you don't end up hearing about his on some stupid blog or something. D'oh!

Anyways, I'm still pretty much the same as always at this point, a tribute to boring consistency like no other. And frankly, I'll be doing my best to maintain this -- oh, I'm planning on doing so for quite a while.

*I'll have to try to get more information later on.

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