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Update on ablation


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Well after a full week and half of seeing doctors, test, discussions and waiting. The new team of doctors (medical oncologist, radiation oncologist, oncology orthopedic surgeon, interventional radiologist, and a pain management specialist) have arrived at a conclusion and comprehensive plan for Dad's treatment.

The ablation is being put "on hold" for now. They want to try a "mega dose" of radiation (10 treatments) to the shoulder in conjunction with chemo before they do the ablation since it and the reconstruction the shoulder will require afterwards, will be invasive. At this point with all the new findings, none of which were good, they prefer not to do an invasive procedure if something non-invasive will work. As the Dr. who does the ablation explained, if he needs the ablation after the chemo/radiation we have lost nothing, and if the radiation/chemo shrinks the tumors we have actually gained because the likelyhood of totally ablating smaller tumors is higher. Dad is very skeptical about the radition working since he had radiation(at a lower dose and only 5 treatments) in Nov and it only provided pain relief for a short time. However he feels that these Dr's have his best interest in mind and feels that he can trust their judgement,so he is willing to give it a try.

Dr. Roberts (medical oncologist) has suggested that Dad partipate in a clincial trial being conducted in his office to compare the use of Taxoprexin in combination with Carboplatin to the use of Paclitaxel in combination with Carboplatin. Depending on which drug Dad is randomized to, he will receive - a weekly one hour infusion of Taxoprexin in addition to (on weeks one and four) a 30 minute infusion of Carboplatin. This is a six week cycle(5 weeks of infusions and one week of rest). With Paclitaxel he would a 3 hour infusion of Paciltaxel once every three weeks and a 30 minute infusion of Carboplatin or the equivalent in weekly infusion, which Dr. Roberts believes he will torerlate better than the larger less frequent infusion. This is a three week cycle which can be repeated 6 times, as long as he continues to do well.

Dr. Roberts also expressed strong concerns about Dad not ever having had an MRI of the brain. He also suggested that Dad have infussion of Zometa to strenghen his bones (with the CT done last week we now know he has pathological fractures of the 7th, 8th and 9th left ribs)and to help prevent further bone mestateses. He also prescribe a Fentanyl patch to help better control the pain. Dad has had it on for almost full day now and it is seeming to make a lot of difference though he does have a slight rash. Suppose that may be the trade off for the pain relief, but we will watch it over the next couple days to be sure he is not having an allergic reaction.

Next week we have on the agenda: getting an MRI of the brain, bloodwork ,starting radiation of the shoulder(again), starting chemo and meeting with the pain management specialist. I am scheduled to go back home (to Ohio) on Saturday April 1 so I am hoping that they can get at least the first week of chemo done while I am here. I am a bit worried about how things will go and would appreciate hearing any comments or experiences anyone may have with the above drugs. Is there anything I should or can do/get for Dad before I go home to help make things easier for him and his wife once I go home on the 1st?

On a sad side note, we were also informed that the medical oncologist Dad had been seeing passed away on Tues. When Dad had the pain episode a couple weeks ago his office told him that this Dr. was "out sick" but we never dreamed it was this serious. When we first met with him in Oct he told Dad he had some "personal knowledge" of the pain he was in..but we never thought it was this personal. While we had differences in opinions on Dad's treatment, I am sure that his passing is a huge loss for the medical community, his patients, and most importantly his family. Our thoughts and prayers are with them all!

Thanks for any and all input, it means a lot!

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Hi Cindy,

I like so much about how your Dad is being cared for medically. It sounds as if his medical team is really a "team" and prepared to meet with all of your Dad's needs. Also, it sounds as if your Dad has alot of confidence in them. This means so much.

So sorry for the loss of his doctor. How sad for all.

Regarding what to expect or anticipate your Dad's needs when he starts chemo.

Truly this is difficult to know. Everyone seems to handle chemos a little differently. Speaking for myself, it was a good idea to stock up on drinks. They are heavy and were much easier to carry when I was full strength rather than a bit weaker.

I bought all kinds of juices and ensure or boost of all flavors for the times that I didn't feel like messing around in the kitchen.

As my limitations came along, I was able to make changes in my living to accomodate them. I lived alone and didn't have any help and was able to manage (get by). With the help of his wife, he should do all right. Is she in good health and mind?

Some people are very active through treatment. I needed batteries for the remote control...lol.

Will be keeping you and your Dad in thoughts and prayer.

Cindi o'h

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