knowns and unknowns

Well, friends, here’s the info we’ve got so far today.

The CT scan shows disease progression. Almost all the “target lesions” (specific nodules of cancer they’ve been tracking) show some growth. There are now a few lesions in Val’s liver, as well. Evidently this is typical of non-small cell cancer evolution, so Dr. T said she was not surprised or particularly concerned about those growths for now.

This means the Navelbine is not working, so Val will stop taking it, which meant no chemo today and an early release to go check on Cynthia (in the midst of home antibiotic infusion) and have lunch. It also rendered moot the conundrum of how to get the drug into Val now that her port’s been removed.

Val wasn’t coughing much at the appointment, much in the way (I felt) that your car stops pinging once you get it to the mechanic. And also because she’s been coughing a bit less the last few days. Dr. T was not alarmed.

What she would recommend next is putting Val back on Carboplatin and Taxol, which is the drug regimen (paired with Avastin and Apomab) on which she did so well four years ago. However, in a month we are changing insurance from Kaiser to ODS and moving to the oncology department at OHSU. If the folks at OHSU have a trial for which Val is eligible, it could screw things up if she were to start a different chemo now at Kaiser.

One possibility would be for Val to use this kind of limbo time to try 2-3 weeks of radiation to reduce the size of some tumors that might be affecting her breathing. Dr. T will share her scan results with the radiologist and  we’ll await his thoughts on whether that would be useful at this time.

We’d like her to have a new biopsy done so the OHSU folks can try again to do the genetic mutation analysis. Dr. T is wiling to try to get permission to do this biopsy, but since Kaiser isn’t participating in that study, she’s not sure she can get another biopsy covered for us. She’s looking into it. If not, either I guess we’d have to pay for it, or we’d have to wait till January to have it done at OHSU.

So now we await updating phone calls from the doctor (these may take a few days). And the excellent Amy R, who made our Thai lunch happen, has heroically taken the dog for a much-needed grooming.