Tuesday, January 4, 2011

So tired I almost forgot to write ...

For some reason I am exhausted. It is a strange phenomenon, actually - I am more tired at work and away from Kel than I am at home. What's up with that? Cancer is my caffeine? That is just messed up. Guess I picked the right field in which to work, but for some reason right now my research just seem too slow ... takes so long to develop a new drug and a new therapy. Less toxic seems like a good idea for new chemo's, but if toxic works then why mess with it, right? Toxic sux, but for Kel it (should/) will be curative so there should be something to that.

Sorry, really tired, not very insightful.

Kel had an ok day - showered again (thank goodness), even left the house for a while. It was to go to the primary care doc's office to get more percoset (otherwise had last dose today), but still - out is out. The pain is mostly from the tumor in his back by his kidney now, surgery and 'blockage' pain are better. For the blockage (and he is sooooo gonna hate me for this one), you know that scene in 'The Wedding Crashers' where they main characters put saline in the douchebag boyfriend's drink? The effect is exaggerated, but true. Saline will .... hmmm, how do I say this nicely ... enhance movement through the gastrointestinal tract? :)

I met Kel's will-be oncologist today too: Dr. Ahmann. Was visiting my friend and colleague Dan who is in the office next door, so Dan was nice enough to introduce us and I am very happy! Kel will meet him on Friday and learn more, but I find him reassuring, positive, and most importantly knowledgeable.

I know most MDs should be, and everyone we have dealt with for Kel's case has been great (minus one heme/onc fellow), but that is not always the case. The doc's for my mom sucked ... one even asked my father to not allow me back in the room. Guess my knowledge and ability to read scientific literature (you know ... half of my job) scared the old man? Good old dad told him to shove it. :) MDs who don't want to give their cancer patients the best care suck, but thankfully none of them are in Tucson.

I really am rambling tonight, and have to go get pain pills for Kel when he needs them tonight. So I will end with what I learned for his therapy to come:

We meet Dr. Ahmann Friday am for the initial appt. Kel will start with allopurinol to pre-emptively deal with any negative side effects of a tumor shrinking too fast which can lead to lysis (all of the intracellular contents released into the bloodstream).

Kel will be on a regimen of BEP: bleomycin, etoposide and cisPlatin with E and P being infused over 4h/day each day next week Monday-Friday. B will be given next Tuesday and the one after (I think). Lots of anti-nausea meds and hydration too. Might not be fun, but Kel can work light duty the off chemo weeks if he wants.

This cycle should be repeated 3-4 times.

I saw a post on some testicular cancer website about Vitamin E helping with the peripheral neuropathy caused by the chemo ... looked into it and the NCI actually ran a Phase III double blind clinical trial confirming this. So grabbed the right dose (400 mg/day in case you want some) and started Kel on it today. He will stay on that every day until 3 months post chemo.

Tumors so large they compress kidneys stomach, spine, etc really suck ... just ask Kel.

Thanks, and good night.


  1. Careful, Tracy. I see two smaller trials, one from Greece and one from Italy, showing improvement in neuropathy with Vitamin E, but a larger one from Mayo showing no difference.I also don't like that they don't report if there was a difference in response or outcome (to be sure that vitamin supplementation does not interfere with the main goals of treatment). Ask Dr. Ahmann about this. Take care.

  2. Dan: Saw the same trials (well, didn't look at the Greece one, just the Italy and the Mayo clinic) and one main difference is the taxane v platinum. Italian group focused only on cis, while only 4% of the Mayo study was cis. Doses of Vitamin E were the same. Will definitely discuss with Ahmann tomorrow, especially for concerns of anything else he will be on. Thanks!