Below is what
Mark wrote about our day yesterday and what we learned from the
oncologists. Today we will go to the temple and consider all our options
including the Gerson Therapy and other natural therapies along with the ones
below.
As for Rachel
we have decided that both Mark & I will fly to Ecuador on March 15 so that
he is there when we tell her. At that point we can tell others and not be
so concerned about anything getting back to her.
Yesterday was another interesting day. We met with two
Oncologists, both leaders in this area, and had an Echo cardiogram.
From the doctors we learned:
Diagnosis
1 I have stage 4b Metastatic Melanoma with innumerable nodules in both lungs,
one on the liver, one in the heart, one in the lower abdomen, one in the muscle
tissue of the back, thighs and hip. None are seen in the brain but they
want to do an MRI of the brain to be sure there are not small ones that don’t
show well on the PET scan. They also want an MRI on the heart.
Prognosis - MD Anderson Prognosis
Our Portland Oncologists, Dr. Smith and the one we went with Dr. Walter Urba prognosis:
2. A
few years ago our appointment would have been brief, "get your affairs in
order, sorry." Now, you should still get your affairs in order but
there are options and hope.
3. Given
my current state of health, which is pretty good, if we did nothing we are
probably looking at 6 months to a year. The average with this condition
is 6 months.
4.
The
latest option, only two years on the market is a drug called
Zelboraf. It
only works on melanoma with the BRAF mutation. So the first step is to send my
biopsy tissue sample to a special lab that will determine if I have that
mutation. About 50% of melanoma has this mutation. If so we will
start with this drug, which is just a pill with relatively minor side effects
and in most cases shrinks the tumors and extends life by 4-7 months. Then
the cancer figures out a way around the drug and starts growing again.
5.
The
next step, or the first one if we don’t have BRAF mutation, is
Proleukin or Interleukin-2.
It is an immune system accelerator. The process is one week in the
hospital that is kinda pukey
, then the
first week out kinda weak and then a week OK then
back in for a second pukey week, out a month and back for a third week.
They have a clinical trial going on right now that first radiates one of the
tumors before using the Proleukin, which is supposed to dramatically increase
the results. Currently 10% shrink tumors for awhile and 1 in 17 have no
disease for 3 months to 10+ years. With the radiation first pre-trials
showed 70% response instead of 10% and they don’t know about cure rates.
With the trial, if you don’t get in the part of the trial where you get the
radiation first you can get it before another treatment later. You can’t
get the radiation first unless you are part of the trial, or at least insurance
won’t cover it. This one has the potential of a home run cure on 1 in 17.
6.
The
next step is
Yervoy a new drug that stops the natural breaks in the immune
system so that it can fight the cancer with no limits. Tests have shown
15% have tumor shrinkage and a 5% cure rate. Several potential side
effects and overall extending life from 6 months to 10 months.
7. We
asked about the
t-cell therapy that Jorge’s friend used and found
successful. Dr. Urba told us that if we are interested he would call Dr.
Rosenburg in Bethesda, MD who developed it and uses it the most. Dr. Smith was concerned about this treatment because it takes time to grow the good
cells and there is a risk they won’t grow and in the mean time you are just
waiting. It is also very invasive as chemo is used. For some this
has been very successful.
I also had an
Echo cardiogram, Ultra Sound of the heart, and saw the inside of my heart
beating just fine. The tumor in the right ventricle, which leads to the
lungs, was growing there with four flat fingers hanging down flopping in the
breeze, or blood as the case may be, but didn’t look to be in the way at this
point. There is some concern about the “fingers” breaking loose and
floating to the lungs. Oncologists think that is unlikely.
So, in summary there is a lot going on in this field which
certainly gives hope. Cure is an option but rare (5%-10%).
Extensions of time seem likely, but are more in the month’s category than
years. While we were racing to the ER on Tuesday because they were
concerned about the “glob” in my heart Ane was thinking “at least months! not
today.” It all seems to be a matter of perspective. We very much
like the idea of many years but we will
prepare for less.