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.
Showing posts with label tumor growth. Show all posts
Showing posts with label tumor growth. Show all posts
Monday, March 29, 2010
Friday, January 29, 2010
1-29-10 Cancer has spread
Liz had a chest, abdomen, and pelvis CT scan Wed the 27th, difficult in part because she couldn't keep the barium whatever contrast down. She drank the clear kind and did fine.
Today the 29th we met with Dr Grossmann to hear results. He said and showed us that cancer has increased, in many areas. The interleukin-2 did not work for her. No more treatments will be done - that is the good news.
The existing lung tumors have grown, the second from 9mm to 25 mm.
New tumors are evident in many areas:
She has a tumor in her spine in vertebra T11, 12.4 mm, about 10 mm from the spinal cord. She had noticed back pain the last 3-4 days. She also has two smaller tumors in the right femoral neck, the part that goes in her hip socket area. These bones can become weakened and can cause a pathologic fracture - if she stepped off a curb wrong they could collapse suddenly. Radiation to these bones will start on Monday Feb 1st. There is also a small tumor in disc L4 in the lumbar region, smaller at this point.
She also has a 25 mm (1 inch) tumor in her spleen and a 16 mm tumor in her liver, and several smaller ones both places. Thus far no problems and she mentioned only sporadic pain on the spleen side, "like a stitch in the side from running" but when she is sitting still. He did not indicate treatment for these multiple tumors in soft tissues.
She has an MRI for her brain Sat the 30th at 9:45am. We hope skull cancer is at least limited to the area it was before. [side note: this week she has lost nearly all the hair in that spot on her right side of the skull, about a 2 1/2 inch circle) and her upper hair covers it from view. It is sensitive skin there.]
Liz also noticed a bump on her back, near the spine, that can be felt through the skin.
Dr Grossmann has called the National Institute of Health (NIH) in Maryland to see how quickly they can get her in to their study with harvesting TIL cells from tumors, then growing them to reinject to fight cancer. He predicts she can get in within about 14 days. Harvesting from either of the two lung tumors or the bump near the surface on her back should not be too difficult. It may take a few days to recover from lung surgery. Then Liz would come home. They try to grow the TIL cells (to billions) and it takes about 3 weeks. They would call to tell us if it worked (50% success rate), then she would return for a strong dose of chemo (the kind that makes you lose your hair) and the injection of TIL cells. She'd be in the hospital for about a week in intensive care. TIL cell treatment is 50% effective, so overall that has a 25% chance of helping her. Brad tells me that if her MRI shows cancer in the brain it would exclude her from this TIL cell treatment study.
Other radiation to deal with tumors in soft tissues would follow. Brad feels strongly this could be done sooner to halt growth and we are considering working with different doctors who would treat more aggressively. We also hope to get antibodies treatment.
Meanwhile, we worry about Liz's drop in weight and appetite, and will try some medications to help that.
None of this was expected, and it is hard to hear and to understand. We want so much for our lovely Liz to have opportunities to grow and enjoy her life. We so appreciate the prayers and support we receive from friends and family and total strangers, near and far. We don't know God's plan for us. We trust Him to lead us along. We hope we learn what we need to learn quickly. We want to do the important things. Thanks for your help, everybody.
Tracy/Mom
Today the 29th we met with Dr Grossmann to hear results. He said and showed us that cancer has increased, in many areas. The interleukin-2 did not work for her. No more treatments will be done - that is the good news.
The existing lung tumors have grown, the second from 9mm to 25 mm.
New tumors are evident in many areas:
She has a tumor in her spine in vertebra T11, 12.4 mm, about 10 mm from the spinal cord. She had noticed back pain the last 3-4 days. She also has two smaller tumors in the right femoral neck, the part that goes in her hip socket area. These bones can become weakened and can cause a pathologic fracture - if she stepped off a curb wrong they could collapse suddenly. Radiation to these bones will start on Monday Feb 1st. There is also a small tumor in disc L4 in the lumbar region, smaller at this point.
She also has a 25 mm (1 inch) tumor in her spleen and a 16 mm tumor in her liver, and several smaller ones both places. Thus far no problems and she mentioned only sporadic pain on the spleen side, "like a stitch in the side from running" but when she is sitting still. He did not indicate treatment for these multiple tumors in soft tissues.
She has an MRI for her brain Sat the 30th at 9:45am. We hope skull cancer is at least limited to the area it was before. [side note: this week she has lost nearly all the hair in that spot on her right side of the skull, about a 2 1/2 inch circle) and her upper hair covers it from view. It is sensitive skin there.]
Liz also noticed a bump on her back, near the spine, that can be felt through the skin.
Dr Grossmann has called the National Institute of Health (NIH) in Maryland to see how quickly they can get her in to their study with harvesting TIL cells from tumors, then growing them to reinject to fight cancer. He predicts she can get in within about 14 days. Harvesting from either of the two lung tumors or the bump near the surface on her back should not be too difficult. It may take a few days to recover from lung surgery. Then Liz would come home. They try to grow the TIL cells (to billions) and it takes about 3 weeks. They would call to tell us if it worked (50% success rate), then she would return for a strong dose of chemo (the kind that makes you lose your hair) and the injection of TIL cells. She'd be in the hospital for about a week in intensive care. TIL cell treatment is 50% effective, so overall that has a 25% chance of helping her. Brad tells me that if her MRI shows cancer in the brain it would exclude her from this TIL cell treatment study.
Other radiation to deal with tumors in soft tissues would follow. Brad feels strongly this could be done sooner to halt growth and we are considering working with different doctors who would treat more aggressively. We also hope to get antibodies treatment.
Meanwhile, we worry about Liz's drop in weight and appetite, and will try some medications to help that.
None of this was expected, and it is hard to hear and to understand. We want so much for our lovely Liz to have opportunities to grow and enjoy her life. We so appreciate the prayers and support we receive from friends and family and total strangers, near and far. We don't know God's plan for us. We trust Him to lead us along. We hope we learn what we need to learn quickly. We want to do the important things. Thanks for your help, everybody.
Tracy/Mom
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