Busy Busy

The last couple of weeks have been busy with doctor appointments. And it’s not going to end for a while. It looks like I’m going to have another SIR Sphere treatment but I wanted to explore other possibilities first. The SIR Spheres may damage the liver and the procedure was not as effective as I had hoped the first time so I wanted to make sure there was not a better option out there. As I already reported I saw a radiologist about external beam radiation and he recommended that be left as the last option. Last week I saw Dr. Gannon, a surgeon, to discuss resection of the liver and radiofrequency ablation (RFA). He ruled out resection (surgically cutting the tumor out) because it would require that I be off chemo for an extended period. The surgery itself would weaken my immune system. He said that between the lack of chemo and the diminished immunity the cancer cells in my body would have an opportunity to run wild. He felt that surgery would shorten my life rather than extend it. Regarding the RFA he said it appeared from my most recent PET scan that the tumor was too large for that procedure. It’s hard to say for sure and he’ll know better when he sees the results of a CT scan which I’m having tomorrow. Dr. Gannon serves on a tumor board with Dr. Nosher, the interventional radiologist who does the SIR Spheres. He said they meet later this week and will discuss my case with the CT results in hand. Between the two of them, and I suppose anyone else on the board, they’ll decide the best approach. But it looks like it will be SIR Spheres. That of course depends on the tests I have to have done to make sure I’m fit for it, beginning with the CT scan tomorrow. I have an appointment early next week with the radiation oncologist who worked with Dr. Nosher on the last SIRT. She’s the one who determines dosage. She has to clear me for the next treatment. Today I started a new chemo regimen. It’s referred to as ECF which is epirubicin, cisplatin and fluorouracil (5FU). But Dr. George left out the cisplatin. Cisplatin is what causes the neuropathy and other nerve damage including hearing loss. She said that because I’ve been on it (or another platin such as Oxaliplatin) almost continuously for two years, it’s time to take a break from it. I think she’s right. The most common side effect of the epirubicin is mouth sores. I have experience with mouth sores from my very first treatments. It was a walk through hell. But I’ll do it if I have to. I have to go back there Wednesday for hydration and to be taken off the 5fu pump. I have yet another appointment next week with Dr. George’s office for an interim blood test to make sure my counts are OK with the new regimen. I asked Kelly, a chemo nurse, if they had any other patients who have been coming as long as I have. She said “while they’re living?” I said well they can’t come when they’re dead can they? She said only on Halloween. So I’m doing a lot of running around to doctors. Oscar had two vet appointments mixed in with another one on Friday so he’s going through it with me. Last week my brother Tim and I had the lunch we agreed to have. It was awesome. There was some serious discussion, some laughter and some emotion. It was a great step towards fixing things between us and I’m hoping for more. Please say some extra prayers for Robbie LaSalle. Rob is the patient who has two forms of cancer, adenocarcinoma and small cell, in his gastric system. He has reached a point where the doctors feel surgery may work for him. Tomorrow he goes for pre-ops and he’ll have the surgery later this week. They’ll remove his stomach, part of the esophagus, and perhaps more. This is very major surgery. He’ll have a very long recovery. His life will never be the same. But the hope is it will be a life. So we need prayers to get him through the surgery, have as easy a recovery as possible, and for success. It’s a tall order but God can handle it. Carry on Rob. --------------------------