Progression??

The visit to the doctor this week went fairly well, though we departed with some challenging news. Judy was kind enough to take off time and come along. We had a ton of questions about appetite, weight loss, digestion and stamina. I’ve been experiencing bloating and gas that needed answers.

At Dr. Chang’s office all those issues became secondary. It turns out that for the first time, there are signs that cancerous cells have progressed beyond the liver, taking up residence in the lymph nodes most near. Dr. Chang’s recommendation was a fairly new drug, called “Avastin” coupled with my old enemy oxaliplatin on a bi-weekly regimen through the summer. Rats!!

Had I been originally diagnosed later than 2006, Avastin would have been included in my first line chemotherapy, as it is now the drug of choice for stopping the spread of disease after surgery. However, it wasn’t yet approved for that. Here’s the official description of what it does:

“Avastin is a therapeutic antibody that is believed to work by targeting and inhibiting the function of a natural protein called "vascular endothelial growth factor" (VEGF) that stimulates new blood vessel formation, a process known as angiogenesis. Researchers have shown in preclinical models that anti-VEGF agents like Avastin may work by causing the following changes to occur in the blood vessels supporting tumor growth (tumor vasculature):
Regression of existing microvessels — helps arrest tumor growth and reduce tumor size
"Normalization" of surviving mature vasculature — makes the tumor vasculature more conducive to effective anti-cancer therapy
Inhibition of vessel growth and neovascularization (e.g., the sprouting of new micro-vasculature from existing vessels)”

I argued that the targeted use of chemotherapy drugs into my liver last year seemed to prohibit expansion, and asked why we weren’t going to do that. Dr. Chang explained that we should be a little more worried about the lymph nodes, now, and go after things with this "systemic" approach.

I then argued that life with oxaliplatin in my system is completely uncomfortable. It was what made my balance poor with numbness in my fingertips and toes. One is not allowed to have very hot, or very cold, drinks. (Or, for that matter, stand in a really cold stream and fish, because the body simply can’t tolerate extreme temps.)

We compromised. No targeted infusions, but yes I’d take Avastin. No other additives for now. I begin with two hours of infusion tomorrow, then do the same thing every two weeks. I guess I’ll watch the World Cup on my phone, while getting the infusions. There shouldn’t be any hair or energy loss, or any of the other issues that accompanied the previous chemotherapy infusions….that’s one of the benefits of this new drug.

I still feel pretty well….a little less than great because of the digestion issues. I was given a prescription to help smooth the digestive process and relieve “tension” in my small intestine—that has worked really well in two days. On the positive side, Nate and I played golf with Alex Cruz Monday, in the sunshine, and I toured the course in 79. We expect 80 degree weather this weekend.

Love to all. Thanks for your kind thoughts and prayers, it takes far more than a village to assist with my journey and I appreciate every little call, thought, note and giggle.