Post visit update

This morning we met with Dr. K and the visit went very well. She was very prepared, had reviewed my scans, and had a plan in mind but wanted to see how I was doing before she made her final decision.

She agrees with the radiologist that there is some growth, although with the nature of the scans it's impossible to say exactly how much. (The images are not always taken in exactly the same place, so it's difficult to measure mets with complete accuracy.) She agrees that there is measurable growth in the largest lung met (now 2.3 x 1.9 cm) and that Doxil is a failure for me. She considered sending me back to the thoracic surgeon to investigate surgery to remove the largest met, but since my health hasn't been that good and none of the mets are stable, she decided against it.

The new plan is to return to Gemcitabine (Gemzar) but to try a different infusion rate. The longer the infusion time, the higher the toxicity of the medication. A 90-minute infusion rate is "standard" for LMS patients, but I have not been able to tolerate a two-week on, one week off schedule at that rate because my white blood counts went below the 1.0 limit. Her suggestion is to reduce the infusion rate to 30 minutes, give me treatment once a week two weeks in a row with one week off, and see if my white counts recover in time. Otherwise, we'll try every other week at an infusion rate to be determined.

After I complete three cycles (one round or 9 weeks), I'll have scans again and we'll see what's happening. Her thought is that if the smaller mets are stable, she will send me to the thoracic surgeon to see about removing the largest met, whether or not that one is stable. That is not surgery I would look forward to, but it would decrease my tumor load and all of the largest tumors will have been treated or removed. That would be a good thing.

So, I'm back to Gemzar starting on February 19. I will also continue my monthly Zometa treatments and hopefully that will help strengthen my bones and help prevent any further bone mets. I will have another brain MRI and follow up with the radiation oncologist at the end of March, and will have CT scans in mid-April to check my lungs and the met that was in my pelvis.

I promised Ed and Dr. K that I would get an appointment with the ENT ASAP. So I'll be calling this afternoon. The bacterial infection seems to be gone. Keep your fingers crossed!!!

Before I close, I have to note how good it was to see everyone at MSKCC. I spent quite some time visiting with three of my favorite staff members in the chemo suite, and two of the staff in Dr. K's office. They are so caring and so interested in what's happening with their patients. It's a little weird to say that I miss my cancer "crew" but I do. I will actually look forward to seeing them again in April.

Thanks to all for your good wishes and for following this unending saga of mine.