The Vague Plan

I know that some of you have been itching for an update. Each day I thought about posting one but there have been so many possible permutations of the possibilities, I didn't want to try to put it down until some of it had come together more solidly. And the plan that we have isn't even nailed down. This is just our current version of the plan.

David and I have visited with an oncologist at UC Davis (Dr. Semrad) and also one at Stanford (Dr. Fisher). We saw both of these people on Monday November 25th. The oncologist at UC Davis was very nice. He mostly does research now but has clinic hours on Monday. He went through all of the treatment options for us and talked about clinical trials a little. He didn't have anything for me, really, in that aspect. He did say that if Stanford is doing an immune therapy trial to try to get on it. We asked Dr. Fisher at Stanford about that later the same day and he said that there has been an immune therapy trial but it has stopped for now. It may start back up though. I asked him to keep me informed. While talking with Dr. Fisher we decided that a multi-targeted approach is what we should go for, and my oncologist, Dr. Dormady, agrees. This would involve doing a procedure called "radioembolization" which is similar to the chemoembolization that I have alredy had but uses radioactive microspheres instead of chemotherapy drugs. Follow the link for more information. These doctors have told me that that the 4 tumors in my liver (and the one near my left kidney) are just the tip of the iceberg and there are likely more that just aren't visible yet on the scans. Hopefully radioembolization would take care of the visible ones as well as the invisible ones.

To deal with the one near my left kidney (in the muscle there), Cyberknife would be a good approach. (Remember Charlie?)

After those two procedures, systemic chemotherapy would again be on the menu. My tumor cells have demonstrated that they have developed a resistance to the drugs I've already been given so Dr. Dormady is trying to get insurance to approve a drug called Pemetrexed. This is actually a lung cancer drug but an assay called "Target Now" has indicated that it might be effective. Also there is a drug being used in Canada that is very similar to this drug and it has been shown to be effective against colon cancer. We should find out this week if the insurance will authorize this drug.

On Tuesday this week we will go to UCSF to speak with an oncologist there to find out if there is anything else we should consider and also to see if they have any clinical trials.

On Thursday this week we will return to Stanford and speak with an interventional radiologist and find out for sure if the radioembolization is a good option for me.

The following week we will meet with my oncologist again to put all of this information together into a final plan. Well, final until a clinical trial pops up.