Last night, I did have a fairly decent nights sleep, for me. At least I was able to sleep in bed, and not in a chair. The IV feeding ran during the night. However, today, the Boost Plus is not going down easily.
I had my visit with Dr. Flam yesterday afternoon. We had conversations with Dr. Nghiem and Dr. Lewis during this visit. Dr. Flam wants me to start chemotherapy again and made a compelling case for it. He wanted me to begin as soon as today and felt that that would open my esophagus so I could begin eating again. However it would take some time for this and I am in too much distress to wait for this. Dr. Nghiem suggested injecting the esophagus tumor with Beta Interferon endoscopically and then giving radiation to the area of 8 Gy. The second mass near the gastrohepatic ligament might also be treated in similar fashion. However, my esophagus has already had 56 Gy and this is getting close to the maximum. We decided to hold that approach for the time being. I did not want to have any more cisplatin as I want to preserve my hearing and my peripheral neuropathy has not improved and at times is quite uncomfortable.
The plan now is as follows.
Tomorrow, Dr. Lewis will insert a removable stent. Stent Review Article On Monday I will begin chemotherapy with a drug called Topotecan. Information about Topotecan
The drug will be administered by continuous infusion for 5 days, and repeated after 2 weeks off. I don't know how many cycles will be used, presumably this depends on the response.
The drug is available to be taken orally. Perhaps after the first cycle, if my swallowing function has improved, I will be able to do that. More on Topotecan
Nobody discussed the response rate with me, but it seems to be in the 25-40% range, with only rare complete remissions.
We are praying for you Doc Dave ... and if it is any consolation, Scott was on Topotecan ... I can't remember for how long because he had every chemo known to mankind while he fought MCC ... and it was one of the many chemos that he was on that wasn't harsh to his system. He is still MCC free after three years and seven months after a horrific prognosis. We will be praying for you and your family Dave. You had a good response in the beginning when you started chemo. Maybe they need to "tweek" the chemo meds a bit. I would be happy to send you a list of what they gave Scott to battle the beast. You can do this Dave !!
ReplyDeleteWith faith and hope and many prayers,
Diane and Scott
caringbridge: scotthammond (MCC survivor)
Hi. I'm glad to hear that Scott is doing well. I may need to call on you for that list. For the time being, I await the response to the Topo.
ReplyDeleteDave
Hi Doc Dave , I'm sorry you are battling this ugly cancer but glad you are being proactive in your treatment . My thoughts and prayers are with you .. Wanda , Alabama , MCC survivor ..
ReplyDelete