Thursday, December 1, 2011

Who wants to LIVE on chemo? "Not me", says T

Cycle 2, day 8 of chemo
by sherry

Yesterday we went in to have Terence's PICC line flushed (a weekly event now), and to meet with his oncologist Dr. Montogomery to review how chemo is working; he also received his 12 week Lupron injection (for you PCa'ers: yup, he's still getting it even though he's hormone resistant).
Annie checks out the chunk of hair from Terence's head!

His PICC line is doing good; (that's the peripherally inserted central catheter. It is a tube that is inserted into vein in his upper arm, and advances until the catheter tip goes  in a large vein near his heart to obtain intravenous access.  If he's too active with that arm, it could pull out and they'll need to ex-ray it prior to the next chemo). I asked about surgically placing a port in his chest, but Dr M. said UW standard is the PICC line in the arm. It's a daily hassle (needs to remain sterile) but it has the least amount of serious & permanent side effects if there is an infection.

His Blood counts were good- exactly where they need to be on day 8. Decently low WBC/RBC & that means the chemo is in killing mode!  He has a lot more nausea this round, so they changed his nausea medication, hopefully it will work. He's lost 10 pounds since chemo started.  Not a bad thing.

Dr. M's main determination as to whether the chemo is 'working' is based on the decreased level of Terence's pain  (he has had no cancer related pain since he started chemo).  One concern is that Terence started having to catheterize every day (again) - which is an indicator that the cancerous tissue that was removed during surgery Oct. 4 has grown back).  Dr. M wants to give chemo more time he thinks it will have an effect on it.

So yesterday's decision is that the chemo is most likely working and that he should stay on chemo for an indefinite amount of time (i.e. as longs as it seems to be "working").

Here's the definition of "working"-
1. for as long as he can tolerate it (the side
   effects of chemo),
2. As long as it continues to decrease the
    cancer related pain,
3. As long as he can continue to keep cathing
    at a minimum.

Dr. M. is hoping that Terence can continue to tolerate chemo at least 3-4 more months because he is the Principle investigator for a new clinical trial involving Abiraterone (A.K.A. Zytiga- the drug that was recently FDA approved for post chemo treatment but cost $5 K month).  He is running a new trial to see Abiraterone's effect on tissue and Dr. M feels that it would be good to get Terence on it because the timing for post chemo may perfect, and it will be free.

Hairless in Seattle!
We'll see what happens. But if the chemo is still working, Dr. M wants him to stay on it as long as possible (he has one patient that has been on it for 22 months). That means if Terence is doing well on chemo Dr. M. probably won't even try to enroll him on the trial because T can go on Zytiga at anytime (it just won't be free).

Looking at being on chemo for an indefinite amount of time certainly is daunting- it has it's pros and cons.  
The pros are obvious: staying alive longer and being pain-free. The cons?  Living on chemo, (certainly not a lifestyle of choice)!

Any ways- the good news is that other than having cancer, Terence is really healthy!  

Still praying for that miracle though.  
Who wants to LIVE on chemo?  "Not Me", says T.

P.S. Thanks to Kelsey & Collin, Travis & Stacy for sending Terence those awesome Cowboy Joe beanies! 

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