Well...yesterday I went in for my second round of chemo. First, usual blood & urine tests and a new xrays this morning. Then met with Dr Einhorn. Started with side effects discussion - particularly those that landed me in the hospital. He explained that most of the side effects were caused by the Taxol but some were also impacted by the Carboplatin. Talked about changes in my chemo drugs. Changing the Taxol to Gemcitabine. He feels that it will be equally effective but should result in fewer of the specific side effects that I had. Obviously, Gemcitabine has its own set of side effects - so we'll see how it goes. Also changing the Carboplatin to Platinol - both are platinum-based chemo drugs and accomplish the same thing. But, apparently the Platinol infusion takes a little longer and might negatively impact my white blood count a little less - meaning perhaps less chance for infection and high temps. My BP has continued to run low while on my BP med (just 90/60 on this visit) and Dr E wants me to stop taking the BP med and work with Dr Forkin on a lower dose once I am off and monitor BP for a while with no BP med.
After the various chemo/meds discussions, Dr E moved on to the really good news. The xray seems to have shown very clear progress. He explained and drew pics showing the nature of the cancer spread in my right lung and reiterated that the left lung appears completely clear. He identified one specific tumor that he thinks is the likely primary tumor - though it was still relatively small. On today's xray he said that this primary tumor has faded to being almost transparent. And, the xray shadowing from the other multiple small tumors has reduced considerably since the last xrays. Dr E says that he is now questioning whether we are really limited to the standard approach for stage IV adenocarcinoma. As I said in an earlier blog, stage IV typically means a focus on control and simply trying to extend survival. He now thinks that we need to re-evaluate the possibility of surgical options. I am still quite nervous about that - but surgery being an option is actually a much more optomistic outlook. Surgery might mean that at least some of the tumors might be able to be removed - not just controlled. Obviously, I am trying to avoid letting this cause me to be overly optomistic since it is always possible that it will not come to pass. However, he will consult with the thoracic surgeons around 6/13.
Timeline for now: The new chemo routine included 7 hours of med/chemo infusion yesterday and now includes another short infusion this coming Thursday. Dr E has given us the go-ahead to attend Jill's niece's wedding in the Dominican Repbulic in early June - as long as we could rearrange our plans to get back a little earlier than planned so he can begin other tests and get the surgery consult. Our travel agent was able to make the changes in our plans and we will be coming home a day early. On 6/13, I will get a PET scan. That one is new for me but is apparently yet another step up from a CT and MRI. I think it will also allow them to further determine possible spread to other organs. After the PET scan, Dr E will consult with the thoracic surgeons and other pulmonologists to discuss other more aggressive directions including surgery. 6/14 will be my meeting with Dr E and next chemo infusion.
So far today (day one after chemo), I haven't started any significant side effects other than simple low energy.
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