Thursday, November 13, 2014

Follow up from the follow up visit Nov 12

The surgeon and I agreed that I was not ready to go back to work and should defer my return until Dec 1. More importantly, he informed me he wants to start chemotherapy next Tuesday Nov 18. That is several weeks sooner than I anticipated and I will have to scramble to find some folks who can drive me back and forth to Gainesville for chem on Tuesdays and again on Fridays for labs since i can't drive myself yet. the chemo will consist of 2 IV drugs that are the same or very similar to the 2 that formed the back bone of my treatment before, Carboplatin and Taxol. The total course will consist of 6 cycles each 3 weeks in duration. But the new thing is that because this was one isolated recurrence with all the other biopsies completely clean, he wants to consider throwing in a 5 week course of radiation therapy after the 3rd cycle of chemo. This is not standard but is occasionally done. the risk is that radiation of the gut which is hard to avoid if you irradiate the abdomen can lead to long term complications resulting in diarrhea, nausea, vomiting and malnutrition after 10 or more years (or did in the early days). But RT has improved over the decades and can now target better and minimize side effects. The potential pay off is the possibility that you may totally ablate the tumor cells, leading essentially to cure. I am leerly of RT but leaning toward thinking the possibility of outcome may justify the risk. My doc presented this proposal to his local tumor board today and apparently they favored it. He wants to also consult colleagues at MD Anderson and Cleveland clinic. I apprecaite his caution and am intersted to hear what those consultants advise. Stay tuned. Anyone planning to come this way who wants to drive me to a chemo in Gainesville on a Tuesday or a lab draw on Friday just call me with the date and I will put you on the calendar! Louisa

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