So far, we have really only made one choice… to seek assistance and follow the advice of Doctors and Staff at Memorial Sloan Kettering Cancer Center. Now it is time to make a second choice. With the port going in tomorrow, we have one week to decide on the chemo regimen to follow of which we have been told that there is no wrong choice. However, one may prove to be more successful in Debbi’s particular instance and that is, of course, what we care about most.
Course #1, the standard, calls for 6 three week cycles of Gemcitabine & Cisplatin. Course #2 involves participation in a Phase II clinical research trial of Gemcitabine, Carboplatin, and Bevacizumab. [In case you were interested, Bevacizumab is more commonly referred to as Avastin]. Cisplatin is stronger and more invasive of the kidneys. Avastin is one of a new class of drugs that has been shown to be effective in other cancers and works by denying tumors blood, oxygen and other nutrients needed for their growth. The study is designed to find the effectiveness of Avastin in patients that can not tolerate the additional strength of Cisplatin. Since Debbi is very sensitive to drugs to begin with, we wanted to learn about this alternative.
We naturally listened carefully to the choices we were given and have been doing some research on line in order to learn more. Certainly, Dr. Bajorin did not pressure us either way. He only wanted to let us know the possibilities. Side effects vary widely. Tomorrow, while Debbi is having the port placed, I will try to contact some oncologists I have met over the years to try to gain some additional insights. Debbi’s comment while reading what I have written so far is… “OMG, this is really serious. Maybe I shouldn’t do anything” commenting on the deleterious nature of many of the side effects.
It is very scary looking forward so the best we can hope for is an immediate notification that the chemo process is working. That is what we have to pray for. That we choose a good chemo regimen and that it quickly works to measurably shrink the tumor in her kidney. I guess the tumor size will become the standard because we have not yet heard about any way to gauge effectiveness via blood tests or metrics away from the kidney.
With another invasive process tomorrow at 9:30, a bone scan and a CT scan on Monday, it still seems that there is much to accomplish, in addition to refining our decision on the chemo regimen, before chemo is to start on Thursday the 10th.