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The Big Plan

Posted Sep 11 2009 4:58pm
The big plan is chemo, chemo, and more chemo! No surgery, no biopsy, no delays.

Chemotherapy will start this coming Thursday. We're going to try the gold standard for leiomyosarcoma (Gem and Tax) and then take a peek after six weeks to see if it is working. If it is not working (if something grows) then we'll switch to one of the other three chemo drugs that are effective against sarcoma.

Ladies, I am going to need rides to and from Duke for the first three weeks -- after that, the doctor will let me decide whether I want to drive myself based on how I feel. Nice.

So, now that we have the big plan laid out for ya, how about some details?

What did the scan show? The tumor in the psoas looks exactly the same, no shrinkage, but that is totally fine and expected. There are actually six nodules in my lungs (not four as previously reported) but the extra two are super small and evidence of them can be seen if you look back to earlier scans. So it's not like there are any new ones, just that this was a better scan. As for the pancreas, there is a 4cm mass in the middle. I got to see it! Dr Reidel pulled up the scans and showed me everything, whichwas awesome. The mass is still unfortunately a mystery.

Why not biopsy the pancreas? The doc explained that there are three things that the mass could be. And then he went on to describe the approach for each -- and it always came back to chemo. So basically, there is little point in a biopsy because no matter what the results are, the answer is chemo. We are going to watch the mass and watch my sugar levels (which would be a good indication that my pancreas is not working properly). If everything else responds fabulously to the chemo (like shrinks) except for the pancreas mass, then we would probably biopsy the pancreas mass later on... Oh, plus, if it is another cancer typical in the pancreas then the Gem I will be getting is a good chemo to attack that.

I love Duke! And Dr Reidel is great because he takes the time to explain everything and convince me and even spell things for me (because I am of course taking notes). I have more details to share but will have to save them for another post because it's time to go to breakfast.

Lou and I are in the Outer Banks. We spent the late afternoon on the beach, getting thrown about by ginormous waves. It was so much fun!

How you have a fun day, too.
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