Food for Thought

When I posted Friday night, it was to give everyone a brief overview of our appointment because I know many people were waiting to hear about it. I thought I would share a few more details as I sit down to look over my notes and prepare to call Dr. D tomorrow.

Mom has really made up her mind to do the chemo. Radiation is not an option (some have asked) because that sort of treatment is very localized, and often used just as much before surgery to reduce a tumor's size, as well as eradicate residual cancer tissue that may have been left over after surgery. Funny you bring up Europe, Margot, because our DFCI doc, Dr. C, has good colleagues in Italy and England whom he wrote his most recent article with, and I immediately said, "So should we go to Europe?" He said they're very much in the same boat we are in terms of successful studies in this area. There is currently one clinical trial with about 400 patients, which in the clinical trial world isn't a whole heck of a lot. We're not at the clinical trial point yet, and although the medical world doesn't have a ton of evidence based ideas for Mom, I think it is best to stick to what we do know.

The two kinds of chemotherapy being offered are very common, frequently used in transitional cell cancers, and tolerated well. Since this is considered adjunctive therapy (meaning, after the surgery), she would only need four cycles total. It would go something like this:

Week 1: cisplatin & Gemzar
Week 2: Gemzar
Week 3: Off

Four complete totals would be approximately 12 weeks, but sometimes symptoms or low blood counts can force us to put off chemo for an extra week, but this is just to give you a sense of the schedule Mom would have.

It's the cisplatin that is known for being rough on the kidneys, so before each treatment, certain labs that measure kidney function would be assessed. If Lil Lefty can't tolerate the cisplatin, then they just won't give it to her. They can also replace it with a chemo drug from the same family called carboplatin.

I can hear the question in my head now..."Then why don't they just give her the carboplatin to begin with?"

Cisplatin is believe to be more effective in renal cancers, which makes it the ideal chemo drug of choice for Mom. Carboplatin is just a back up, but not our first choice.

There is no way of knowing, but Mom could just sail through these four cycles and Lil Lefty will behave herself, and we can feel assured that we used all the tools in our toolbox. But if we run into bumps along the way, we will deal with them as they come.

In order for these chemo to be most effective, Mom must begin treatment within two to three months of her surgery, so between February 3 and March 3. We delivered another stool sample Friday (in your standard brown lunch bag with SPECIMEN written all over it), so hopefully we'll get another negative on the c.diff front.

Overall, Mom is doing worlds better. Her appetite has certainly perked up, her energy improves every day, and she's starting to take on little projects around the house. She's even ventured out for a few meals. We went to Toshi Thursday and I really had guard my plate from her wandering chopsticks. All excellent signs that she is ready to tackle what is ahead.

Not sure if Dr. D will be in the office tomorrow or not, but as soon as she, Mom, and I have a little brainstorm session, I'll let everyone know what we've come up with.

Susan and Marilyn D. have been hard at work preparing for the commencement of the meal deliveries on Tuesday. We went through countless cookbooks of delicious cancer fighting recipes and it certainly got Mom's taste buds revved. Making herself food, especially when she's on her own, has never been a priority (hence her steady diet of peanuts). Thank you to all those wonderful cooks who've volunteered their resources! Maybe the cooks can comment on what they're creating so we can all salivate together.