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More Good News from Houston

Kathy and I are hanging out at Houston Hobby airport waiting for our flight home. We’ve been here since Monday for a routine visit three months after my final round of PRRT. I had several follow-up tests and exams at Excel Diagnostics including a MUGA scan, renogram, bone scan, MRI, CT, and octreoscans. I also had the gamut of lab work last week. All of the results are good. The imaging shows continued tumor death in my liver and other areas. Some areas of tumors in my lymph nodes and diaphragm are stable. There is no evidence of disease in my bones. My kidney function is normal, and there is no sign of toxicity in my kidneys from the PRRT.

A couple of the most dramatic findings are that the overall tumor bulk in my liver is down to about 25%. A few years ago as much as 40% of my liver was involved with cancerous lesions. The doctor showed us the MRI of my liver and the difference from then to now is amazing. Also great is the fact that my neuroendocrine tumor markers are all the lowest they’ve ever been. These include cga, neurokinin a, serotonin and 5HIAA. That last indicator is the one that surprised us the most because it’s what helped to diagnose me with carcinoid back in 2005. At that time my 5-HIAA level was 87. The highest that indicator has been in the last six months was 55. My test last week showed it at only 15.

The hope now is that this therapy will continue to work over the next several months to further reduce tumors, and that I can enjoy up to five years (or maybe more?) of tumor free progression. I will continue to have follow-up scans and tests on a regular basis. We still have to work out the details but I should be able to have the majority of that work done at Cedars-Sinai in LA rather that having to return to Houston.

We’re so thankful AGAIN to our wonderful friends Mary and Russ who opened their home to us this week. We feel like part of the family and really enjoy our visits with them. While we won’t miss the humidity here, we will miss the people and the great care. I feel so fortunate to have had the opportunity to receive this therapy.

Good Report

Kathy and I met with the doctor today at Excel Diagnostics and the news was good. The various scans show that my tumors are responding to the therapy, with some of them shrinking and some stable. There are no signs of new tumors. My bone scan was negative. My kidney and liver function are fine. My blood markers that indicate various levels of cancer related junk are trending in the right direction.

All of this will help to slightly soften the blow of tomorrow’s therapy, which I unfortunately know is going to make me miserable. Right now I’m just looking forward to getting this done and getting back home. Kathy, as always, has been a trooper and continues to support me and tolerate all of my nonsense. With a little radiation these next few days I’m certain to light up her life.

More to follow post-therapy…

Visit with My Oncologist

I just met with my oncologist today. This was a regularly scheduled follow-up to my first two PRRT treatments. I’ll come back and see him again when all four treatments are complete, probably in late February. He is pleased with how things are progressing, and confident that I’ll see substantial benefit from this therapy, particularly after all four doses are administered.

It’s been two weeks since my trip to Houston, and I’m still feeling wrung out, sick to my stomach, and having to make way too many trips to the bathroom. If this is anything like the first round I should start feeling quite a bit better in another week or so. I was hoping that this time would be easier on me, but no such luck. My doctor today said that I can take more “rescue injections” of octreotide at home to help ease some of the symptoms.

I’m back at the office on a regular basis, working as many hours as I can tolerate. At home Kathy is a saint – putting up with my issues while dealing with her own (including a sprained ankle right now). I’m looking forward to feeling significantly better by Thanksgiving so I can enjoy our big family celebration.

I’ll post again soon. Thanks for stopping by.

Doctor’s Report

Well I’m glad it’s Friday and that I had my fourth and final nuclear scan this morning, so there’s nothing more for me to do before flying back home tomorrow. I really miss my family. After this morning’s scan I drove to another office and met with the doctor to review my results.

The news is essentially this: stable disease. That’s good news because it means that there are no new tumors and nothing is growing or spreading. Not to get too technical, but the MRI report states, “Stable to slightly decreased size of bilobar hepatic lesions.” Again good news which means that my largest tumors in my liver have actually decreased in size ever so slightly. The largest of those tumors measured 4.7 x 4.3 cm before my first therapy in August, and it’s down to 4.5 x 4.2 cm as measured Tuesday, just prior to my second therapy. That’s only a modest gain but progress nonetheless. I’m very pleased that the therapy is working and really looking forward to more dramatic results after the second, third and fourth rounds.

In general I’m feeling somewhat better this time than I felt after the first round. I’m still pretty tired though. Plenty of time to rest this afternoon, then looking forward to heading home tomorrow.

Doctor Visit

We said goodbye to Mary, Russ and their sons today. We had such a great time with them that the week went by too quickly. Incredibly gracious hosts – thank you!

The meeting this afternoon with Dr. Delpassand went well. He first took my history, then discussed PRRT in general terms and explained why he felt it was a good option for someone like me because of the potential for positive results with relatively few side effects.

He then went over my various test results in detail. Everything was basically as we expected with regard to my tumors and their  locations (liver, diaphragm, lymph nodes, lung, etc.) No real surprises there. He then discussed the PET scan and said mine was negative. This is a good thing because it means my tumors are not taking in a lot of glucose and are therefore not aggressive. This is both good in general terms and also because it makes me a better candidate for positive results with the PRRT. Then Kathy asked him about the bone scan. He said that was negative as well, which means that they didn’t find any bone mets: more good news. All things considered Dr. Delpassand said I’m a good candidate for this therapy so we’re very hopeful that it will be effective.

The greatest potential for harm from this therapy is to your kidneys. To counteract that they give you amino acids to help protect your kidneys. Taking the amino acids reduces the possibility of kidney damage to just 1%. When I show up Wednesday morning they will start a 4-hour IV with those amino acids. About 30 minutes into the amino acid drip they start the actual lutetium (radioactive) drip, which will only go for about 30 minutes total. I’ll sit for 3 more hours while the amino acids keep going. They’ll do some scans during and after all of this to make sure the lutetium is being taken up by my tumors as they expect. It’s actually the amino acids that can make you nauseous, but that should pass after the first day.

This picture is of some of the Excel Diagnostics staff as we were giving them a garlic braid. Cathie, Bouchra and Susan are all great and have been very helpful. As soon as the photo-op was over they started cutting up the braid right away and were handing out garlic to everyone in the office.

Tomorrow we’re probably going to visit Johnson Space Center, and maybe head down to the coast before the big day on Wednesday. I’ll post more then. Take care.