CT scan on 3/25

3-25-2010

Dr Grossmann called about her CT scan today. It shows significant growth (double or more) in liver and bones of back and pelvis. Other areas are lessened. Maybe she can’t be called “stable” and enable her to continue with the study. He did ask radiologist to amend report to indicate bleeding as possible in liver. “I wish she could stay on the drug. She seems to be benefitting from it… I thought before it was worth it to wait on bones and continue study; now I don’t feel that way.” Two discs are compromised and there’s a compression fracture. We need to see with MRI if spinal column has soft tissue damage. He wants her admitted to hospital to get MRI of spine. I asked him to call Brad to tell him too.

[One concern I have is that her last CT scan was 1/27. She didn’t start the study drug until 3 weeks after that on 2/17, so tumors had time to grow quite a bit. That period was when she had big changes in how she felt. Even though this scan shows some tumors growing a lot, it could have been happening that long ago and now be slowing or stopping. We can’t know for sure.]

Liz should decide about the hospital. I asked if we could bring her in Saturday so she could have a normal birthday tomorrow – she had plans for dinner and visiting – he thinks that is too long to wait to get started. He said getting an MRI would be easier with medication to help with discomfort or maybe apprehension; MRI takes longer than a CT scan. It will be easier to have a radiation oncologist, surgeon, and osteo specialist involved if she is admitted.

She is likely to need surgery or radiation of bones asap. Surgery would mean 7-10 days in hospital. Radiation was not supposed to happen while on study drugs; it multiplies effects, at least on the skin.

Dr Grossmann called Dr Ribas for input – he still wants to see Liz next week (wed appt). IF B-raf study isn’t allowed due to cancer progressing, she may be able to get into another one: MEK (?) – similar mutation blocker. Dr G will email some still shots from scan. I will take disc of CT scan with me.

Liz wants another opinion. --We will get doctors from U of U hospital and perhaps from an IHC hospital too, to see scans and offer opinions.

Questions: Can we still do TIL cell treatment? Can tumor be harvested here instead? Start growing cells if possible. Can they freeze it or ship it fast enough?
Brad’s wish: stay on meds another cycle, still do TIL harvest and grow cells, THEN chemo & reinject.
Will do: Go in Friday morning for Air Med team to do IV, then MRI. Still go to Provo for bday stuff. See or hear results and go in Sat. afternoon if need to be admitted.