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Med Onc Says Empty The Arsenal


Bill

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First, I want to thank all of you for the kind words and input re: my wife's situation. I haven't proven to be much good at doing likewise for most of you.

My wife has over 100 bone mets per her latest PET / CT. Her med onc says that, due to this, bringing in an interventional radiologist is a mute point and this is the bottom line. He can try to buy her some time as follows :

Tarceva / Gemzar / Navelbine / Zometa ( and pray for a synergistic effect ~ he tells me that so few patients live this long in this condition that he has seldom had to try this and doesn't know what to expect ) .... next, substitute in Alimta, next substitute some combination of Taxotere and maybe an Avastin combo ( note : FWIW, he is spooked by lung and brain bleeding reports with Avastin but he states that this is less likely with my wife's adenocarcinoma and most prevalent with squamous cell carcinoma. Anybody have any input on this ? ) Also, he said No ! to Taxol in her case. He offered no explanation so I didn't push it.

Here's his end of the line tx and it's brutal .... Samarium w/ multiple platelet & blood tranfusions.

It's my wife's life and I will respect her decision. She will let her med onc know next week whether or not she is willing to start this process.

Thanks again.

B

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P.S. As I mentioned in another post, my wife's quality of life is very poor. I can't see much more of this going on if she doesn't get at least some modest short term improvement. Laying on the couch all day sleeping and only getting up ocassionally to snack or take meds ( including enough oxy and vico to kill a horse ) is the extent of her daily activities. She does try to take our dog outside for a short walk daily and a lady friend drops by ocassionally and joins in. She's just plain miserable and burned out and getting more difficult to live with. I think that she might give the first line of chemo a try but I have my doubts that she will take it much further if that fails. BTW, she would be returning to her Tues. chemo group. A nice, upbeat, group of friendly people. Problem is my wife is the only one left from that group and that certainly doesn't help her spirits. All new faces.

B

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Oh Bill,

I am so sorry it has to come to this. I pray your wife has peace of mind in making her decision. Given that she has a lot of pain, have you looked into a morphine drip? It was the absolute best thing for my mom and I wish we had done it so much sooner. Once the drip got started, she said "for this first time, I feel like myself again" --

My mom opted to stop chemo and to be comfortable as she was so weak from it..it was the "right" decision for her. On the Avastin front, our oncologist wanted a brain scan to be sure that the brain was clear (which I guess lessens the chance of the bleeding?)

Please keep us posted. Praying that you both have some good days together ahead.

Holly

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Thanks to all for the kind words. My wife is willing to try the Gemzar / Navelbine / Tarceva ( with monthly Zometa ) regimen. She started this yesterday. She is already feeling poorly today. The Zometa alone always makes her feel ill for a day or two. Her respiratory function isn't very good and one of her docs thinks that she has pleuritis secondary to the thoracentesis that she had last Thursday. Realistically, this drug combo MUST work or she won't be well enough, at best, to try the remaining few drugs. Her med onc says that Taxotere then Alimta are next up but that they are more toxic which will be problematic in her current or a worsened condition. He says no to Taxol. He will " consider " Avastin in the mix enough though she has brain mets because her NSCLC sub-type is adenocarcinoma, not squamous cell. Samarium is strictly a last resort due to the extreme toxicity to bone marrow. Similar problems with some other last resort drugs. The drug(s) may work but the adverse effects are intolerable.

B

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