Here we go...again.

The MRIs, MSIs, fiduciaries, blood tests, and the last round of chemo have all been taken care of today. Tomorrow, it's surgery time. The chemo was relatively benign as far as side effects are concerned. It does beg the question, "Is it doing anything?" But let's leave that for another time. For now, may the surgery succeed in removing the two growing areas, and may I recover rapidly and with no issues.

And a big shout out to my wonderful family and friends who are once again stepping forward to make this process tolerable, and occasionally enjoyable!

Let...the chemo...BEGIN!

Just had my first pill (and my 2nd, and 3rd, and 4th, and, yes, 5th) today after finally nailing down the date for the surgery. February 21st. No obvious side effects yet!

For this surgery I'll get to sleep in until...oh...8:00 before heading over there. My mom and first-born sister are coming out Sunday to take care of me. I still have some questions for the surgeon, and am hoping I'll actually get a chance to ask them before actually going under the knife.

Time flies when you're fighting cancer

Since the diagnosis on Wednesday, things have moved pretty quickly. There's an opening in a Phase II clinical trial for which I actually qualify! (Kinda feels like applying for a job). Since I did the vast majority of my research when the recent "quasi-tumor" image appeared, I know that there are several trials of the radical approach for which I do NOT qualify. ("I'm sorry, but we're looking for someone a little more....") Of course, as a scientist I do want to dot all the "i's" and cross all the "t's" (and annoy all the docs). But assuming my path continues in the direction of the UCSF clinical trial, I'll be starting the drug either Tuesday or Wednesday of the coming week, and diving into surgery 7 days later! The main concern about the surgery is that there's a chance that my vision will be slightly damaged, based on evidence acquired from the "awake surgery" I went through last September. Yes, there will be many more questions and discussions with the docs, but at this point they will likely influence the emotions more than the decisions....

3rd time wasn't a charm....

Unfortunately, I'm not really out of the woods. The results today were not so good. The "stable tumor" I'd previously mentioned looked like it grew a little bit more. Worse yet, a completely new tumor was discovered, and is likely growing fairly rapidly. So...what's next?

I basically have the choice between standard care and clinical trials. It appears that all of the standard care can be implemented if a clinical trial "fails", so of course I'm leaning towards starting with clinical. The other option is whether or not I go through another surgery, which seems to be a personal choice. And personally, while they are kind of miserable and definitely take a page out of my life, I still find myself attracted to them, my own special love/hate relationship.

There is a particular trial suggested by Dr. B that might be the best option with which I qualify. It is a Phase II study using PLX3397 as the chemo treatment. I am also checking with Dr. Rudnick for a 2nd opinion and to discover what other options might be available. That said, I did research several options for the "stable tumor" and found that I didn't qualify for most of the radical trials given its location. Since it hasn't moved as much as it's spread across the pond, I'm guessing I still don't qualify for those trials and so don't have a lot of searching to do.

I am unfortunately likely to miss out on the Huck Cancer ultimate tournament - and might even be in the hospital when it's happening on March 3rd - but still want people to sign up or donate for the cause if you can!

http://www.huckcancer.org

The "Official Result"

Sorry for the delay. I spoke with Dr. B a couple of days ago, and he said that the board confirmed that basically the changes are so minute as to not raise flags. Basically this means I will check it out again in another month. Good news? Works for me!

There is also another trial that I might qualify for, though I need to have my liver behave first. I'll be getting that blood test next week.

The "Unofficial Result"? Stable!

Basically the MRI today looked the same as the MRI taken a month ago. Basically. As in, if you don't look too carefully. Or if you add in the variables like "they were taken with a different MRI device" or "the alignment was slightly different". And really, who needs details?

Ok, maybe you need details. So here's where it really stands. Today's image did look oh-so-slightly bigger than the last image. Tomorrow Dr. B will be presenting my brain to the Tumor Board to see what they all have to say. Hopefully they will think that it hasn't grown significantly enough to do anything other than continue monitoring. That said, there was a fair amount of discussion surrounding future options. And no, they are not all that different from things I've already considered.

Good news? Yes, at this point I think of it as good news. As I've mentioned before, if this spot stays basically the same size for the rest of my life, I'll have no qualms with that. Of course, I'm guessing some of you are wondering...how does any of this make him "stable"?!?

Amazing paper on the complexity of cancer

This paper was written by my (genius) cousin. It really does frame the complexity of cancer treatment (among other diseases). It also made me appreciate the chemo I was just on, as its intent was to cut off several paths in the growth of a tumor, not just one - as simpler chemo treatments have always done.

Meanwhile, my next MRI is this afternoon, so I'll post more then.

Watch and wait

I did get my blood test results, and while they seem to be showing a flattening out of the liver enzymes, the numbers didn't drop enough to keep me on the trial. So I'm officially off. Where does that leave me? That's not entirely clear. For now, I will keep checking the liver status on a weekly basis. I'll also be getting another MRI in early January to see where things stand. Stay tuned.

Liver? Why I hardly....

Humor is always helpful when the news is not ideal. I had another blood test today, and just found out that my liver numbers are even higher than last week. Not to the point where I need to be worried about my liver (yet), but it definitely makes it more likely that I'll get kicked off the trial soon. I'm set up for another blood test on Monday as per request by Dr. B, though in my mind, if it didn't drop over the last week, then it's not likely to drop in that short of a time either (yes, my jaded opinion). He did mention that there have been patients in other trials who have had the same side effect and unfortunately it took them several months to drop back down. Of course, I was hoping to be one of those patients whose numbers dropped back to normal in a week or two.

As for other options, the current response from the team is that with a liver issue like this it is not quite a safe time to start Avastin or to have surgery (with anesthesia). The Avastin option was to make this "tumor" disappear, while the surgery was to determine whether it was a tumor after all. I wasn't really looking to do either of those unless there was a growing tumor, so if I do get kicked off this trial, my likely choice might just be to wait until my next MRI and see where we stand (readers' opinions are welcome).

Either way, there will be more discussion after the next blood draw. As he mentioned, it's a day to day process right now, with options and decisions all dependent on the liver numbers.

No change is good change!

Just came back from the latest MRI (which stands for "Most Reasonable Interpretation"). The white spot basically looks the same as the last time. There's still a little more information to gather, but for the most part, I felt good about the results. The next likely step is to get back onto the trial as soon as my liver cooperates. This will hopefully be confirmed tomorrow after Dr. B presents at the Tumor Board and my blood test returns negative. Of course, I'm still in "monitor mode" and will likely have another MRI in 4 weeks or so. However, it is possible that this "thing" will stay dormant for a long time, and I would be perfectly accepting of that as long as it doesn't impose itself!

Overall I guess it was not quite as good as I'd hoped for, but WAY better than I envisioned!