Friday, January 23, 2009

Time to Find a Hat

Today I met again with Dr. Amatruda to determine where we go from here. Previously I'd noted that the clinical trial which had been tentatively scheduled to begin on Monday was no longer an option. After revisiting the specifics of that, he told me that my recent MRI of the brain turned out okay.

And then we got into my options, which are:
  1. Do nothing now
  2. "Standard" chemotherapy
  3. IL-2
It's not that simple of course, but that is where I'll start. All three options maintain the option of pursuing the Hoag vaccine later on -- if all goes well and a vaccine can be developed and yada, yada, yada.

Dr. Amatruda explained in more detail the IL-2 (I think -- I forget some of the specifics, but I know what the intended meaning of that term as I use it is) treatment. It sounds pretty nasty. And from data available it seems less effective for liver cancers as opposed to tumors elsewhere. The tradeoff is that for the under 10% of people for which it is effective, its beneficial effects can be longer lasting.

The "standard" chemothreapy mentioned is carboplatin + taxol. This stuff has its side effects too, but they don't sound quite as hardcore as the IL-2. It might be more likely to get rid of the tumors, but its effects might not be as long-lasting ("durable" was a term I think he'd used).

So near the end of our discussion, it basically came down to picking one. He asked if I wanted to think about it over the weekend and/or talk it over with Angie or anything. After considering all I've come to understand, I told Dr. Amatruda that I was 90% confident that I'd choose #2. My reasons included the fact that I've got known smallish tumors, so let's take a whack at 'em. And the odds on the IL-2 didn't seem to be worth the physical toll exacted by the treatment. In all cases, all three options remain on the table, as does the Hoag vaccine.

So my appointment then got a little bit extended as I received some "chemo education". This is a bit of a Q&A session with a member of the staff about the particulars of side effects, conditions to watch for, and things to do to lessen the effects. This was followed by a seemingly obligatory blood donation, and I had to set up another abdominal CT -- this time at least I get to skip out on the barium!

Now, one of the side effects will be the hair loss and I've got a strong suspicion that I'm not one of those guys who can pull off the bald look. I've got my baseball caps, but I'd like to try something a little different. I may have to wander into a sporting goods store and see if anything catches my attention.