Today's news was mixed. The good news - there is less cancer overall. The bad news - there is more activity in some of the lymph nodes.
His head and neck area looked good. The lymph nodes in a couple of chains around the chest are the ones in trouble. His main lesion has stopped growing. The liver, spleen, gallbladder, abdomen and belly look good. There was a little activity in a spot on his lower back and pelvis that will be watched closely. There's still a little bone activity.
We're happy about the good news, but Dr. Thompson focused on what we need to do about those poor lymph nodes and anyplace showing "activity". Activity is not a good thing when talking about cancer cells.
Rudy will be on a different chemo protocol for the next 6 weeks. He'll continue carboplatin. The abraxane is being dropped. Gemzar will be used instead. That starts today.
Gemzar will be easy to remember. I just picture a czar named Jim in control of rubies, diamonds, and other precious gems. Rudy's lymph nodes are the gems and our czar is going to go in there with his bodyguards and tell them all to settle down.
Gemzar's main side effect we'll keep an eye on is that it's a challenge to blood counts. We'll be doing everything we can to help those numbers. But, I guess we'll still have to be careful about exposure to germs, not getting cut or hurt and things like that. Most chemo patients need to watch those things. CTCA will monitor his numbers closely.
A while back, Rudy had a biopsy that was sent off to find the actual type of small cell cancer and to check for genetic mutations. They did find a couple of mutations. There are a number of possible Phase I clinical trials for cancers with similar mutations, but nothing for his specific mutation. Dr. Thompson went over the possible trials, but since they weren't a perfect match, we're not going to jump into any of those at this point.
In 6 weeks, Rudy will have another scan. This time it will be a CAT scan. Not just any PET will do. It has to be the CAT. (Ha Ha)
It's very possible that at that point, Rudy may change to immunotherapy. This is a fairly new type of therapy that uses the body's immune system to fight cancer. There are some hoops you have to jump thru to be able to have immunotherapy and Dr Thompson is doing a few things to work towards it so if we do make a change, there won't be much of a wait.