I got a big PSYCH when I went back to MD Anderson last week to meet with Dr. F. (medical oncologist). There was not wholesale agreement with the “tumor team” about the portal vein embolization. If I had proceeded in that direction it would have made me ineligible for two studies and kept me from surgery for six months to a year. Instead, I am starting a chemotherapy plan Monday. Dr A. (surgeon and member of the tumor team) still feels confident he only needs the tumor to shrink a small amount and he can remove it surgically (resect).
The chemo plan consists of taking Xeloda and Temozolomide in pill form. I’m on a plan that lasts approximately 15 days, then I take two weeks off. I’ll continue this for two or more rounds depending on my reaction to the drugs.
I think this is an unusual course of action, but we are going to give it a try. Dr. F. used these two drugs together in 2005 when he conducted a study at Columbia. The tumor team agrees with this direction as well.
Hopefully all will go well with this chemo, if not we’ll try something else. Dr. F. was sure it wouldn’t make the tumor bigger.
In other news, I believe we’ve cooled it on the testing for now. Still no sign of a primary tumor. My last test was a week ago Thursday. I participated in a small bowel function test. I thought long and hard before mentioning this test because I was afraid to put the word “bowel” in my blog and because it immediately conjures up images of a small team of judges in white coats with scorecards ready to rate my latest “deposit”. Not so. It was actually a test where they photographed barium as it traveled through my intestines and colon. Nice and somewhat aerobic.
I'll keep you posted on any new developments and how the chemo is coming along. I thank you for your kind thoughts and well wishes.
Jan K
Friday, March 21, 2008
Tuesday, March 11, 2008
Jan vs Tami Round One
Greetings,
At last Dr. F. has made a recommendation. It seems, after consulting with the tumor team, the best first course of action to try to shrink this tumor (nicknamed tami) will be a portal vein embolization. He's built in some additional options depending on the tumors response. If it actually grows because of this treatment, I'll be switched to a plan of chemo used in one of the current drug trials. If it shrinks, another PVE may be necessary before Dr. A. is able to resect the liver and tumor.
Portal vein embolization is used to cause the atrophy or shrinking of a part of the liver and the hypertrophy or extra growth of the remaining liver. Dr. F. warned me it is an unpleasant and painful procedure, but I'm not sure he's actually experienced one himself. I decided to stay in denial about that part of the conversation for many reasons. If I know something is going to be painful won't it be really painful and won't I fret and worry about it? YES. Can this "pain" he speaks of be worse than when emergency room Dr. Assh*le decided to press down on my liver and diaphragm to see if they would "spring" back which was followed by the only shrieking scream I can remember producing in the last 30 years? Besides, they have a really cool chart for pain in hospitals and when you rate yourself they bring you stuff. In my head the pain cannot be an issue, it just has to happen. I can already hear Beverly and Sobotik chanting "stay ahead of the pain Janni, stay ahead of the pain".
This procedure will require a few days stay at MDA in the lovely H-town. I'll keep you updated on a date, but I expect it will be within the next few days.
Thanks for all the inquiries and support you've shown for my family and me during this time. I feel like this is the first step in really starting the fight process, but we really started the day after that emergency room visit. I greatly appreciate the prayers, kind notes and emails. We (it may take the entire “village”) will kick this tumor's ass.
At last Dr. F. has made a recommendation. It seems, after consulting with the tumor team, the best first course of action to try to shrink this tumor (nicknamed tami) will be a portal vein embolization. He's built in some additional options depending on the tumors response. If it actually grows because of this treatment, I'll be switched to a plan of chemo used in one of the current drug trials. If it shrinks, another PVE may be necessary before Dr. A. is able to resect the liver and tumor.
Portal vein embolization is used to cause the atrophy or shrinking of a part of the liver and the hypertrophy or extra growth of the remaining liver. Dr. F. warned me it is an unpleasant and painful procedure, but I'm not sure he's actually experienced one himself. I decided to stay in denial about that part of the conversation for many reasons. If I know something is going to be painful won't it be really painful and won't I fret and worry about it? YES. Can this "pain" he speaks of be worse than when emergency room Dr. Assh*le decided to press down on my liver and diaphragm to see if they would "spring" back which was followed by the only shrieking scream I can remember producing in the last 30 years? Besides, they have a really cool chart for pain in hospitals and when you rate yourself they bring you stuff. In my head the pain cannot be an issue, it just has to happen. I can already hear Beverly and Sobotik chanting "stay ahead of the pain Janni, stay ahead of the pain".
This procedure will require a few days stay at MDA in the lovely H-town. I'll keep you updated on a date, but I expect it will be within the next few days.
Thanks for all the inquiries and support you've shown for my family and me during this time. I feel like this is the first step in really starting the fight process, but we really started the day after that emergency room visit. I greatly appreciate the prayers, kind notes and emails. We (it may take the entire “village”) will kick this tumor's ass.
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