Getting up to speed

Awesome game! UNC kicked Dukes butt 81 - 67 and won the ACC regular season title!! Woooo, hooo!

OK, back to Dennis' cancer journey...

On June 17, 2009 Dennis had a follow-up with Dr. Esther, and a consultation with Dr. Rosenmen to discuss having radiation to his femur. Well, they had an opening and started radiation that day. The following day we met with Dr. Rathmell and discussed how Dennis will proceed with treatment. Since Dennis was having radiation he had to delay the start of his systemic treatment, Nexavar, until after the radiation was complete. Also, after his last radiation treatment he will start his first intravenous infusion of Zometa. Zometa is a bisphosphonate that is used to reduce or delay complications from bone metastases or bone lesions.

June 25th was the last radiation treatment, and the first Zometa infusion. All was well until the next day...
We were leaving for New York and Dennis was sick. The Zometa gave him flu like symptoms, and somehow he pinched a nerve in his leg causing him a lot of pain. He was absolutely miserable. We're talking capital M miserable. It was so bad that I told him he needed to not make everyone else miserable for the 12+ hour ride. He ate pain pills like they were candy, and slept most of the trip. Thank you Lord!!

Dennis started Nexavar on July 6th. My insurance at the time was 30/70 and we still would not be able to afford the cost of the medication. I wrote a hardship letter and we were accepted to receive the Nexavar paying only 5% of the 30% I would normally have had to pay. I was floored by the cost of the cancer drug. I can't imagine having to decline treatment because you can't afford it. Thank God some drug companies offer no cost, or a reduced cost of their drugs. I have no idea how many patients are accepted into these programs, but at least for some it's an option and there's hope. Dennis had a few side effects from the drug; High blood pressure, weight loss, diarrhea, and tender feet. He was very lucky to not get HFS. Hand Foot Syndrome (HFS) is when you develop blisters and sores on your hands and feet. I've read about others having this, and to the extreme. Some couldn't even walk it was so bad.

Dennis continued having CT scans, and a Zometa infusion every 2 months. He also had another bone scan in August. All reports came back stable. He continued taking Nexavar until about the 3rd week in February of 2010. The medication was stopped due to his hernia surgery scheduled for March 1st. The hernia surgery went well, he healed nicely, and after his visit with the oncologist on March 22, 2010 he was aloud a hiatus from the systemic treatment. Taking a break from treatment was needed. Dennis lost quite a bit of weight while on the drug, and honestly, he looked awful. That night I read over his report and saw the T8 was stable in appearance. WHAT!!! This is why I ask for the reports, so I can go over them at home and compare the information from the previous reports. I can't stress enough how important it is to ask for copies of the reports. Of course the T8 was not mentioned on any other scan so I questioned it. The Dr. went back through Dennis' scans and did find the small spot on his vertebra and explained that some spots are so small that not every radiologist points out every spot when they write their findings.

The next scheduled CT in May included having his head scanned. He had a few really bad headaches, and of course the first thing I thought was it had spread to his brain. It's amazing with even the smallest ache and pain my mind thinks the worst. The scan revealed he does in fact have a brain, and it appeared normal. Are you sure? Awesome news! One less thing to worry about. No spread to his brain. He also had another bone scan with the results being stable. He was aloud to continue his hiatus from systemic treatment.

Dennis' July scan revealed another spot on his vertebra, this one at T7. It was listed as increased in size from prior study, but in the impression area it was listed as new. ??  Dennis was also having increased pain in one of bone mets. It was recommended that he have radiation to that area. While having radiation to the rib, the radiologist also zapped the T7 spot even though it wasn't bothering him. The radiation worked on the rib pain.

The September scan showed slight growth in his bone mets and in the lung mets. The growth was in millimeters and Dennis asked if he could continue to stay off the meds. The Dr. agreed, and Dennis was allowed to extend his hiatus for another 2 months.

December's scan showed more growth. The report impression was: 1. Interval development of innumerable new round densities throughout the axial skeleton which represent progression of osseous metastatic disease. Focal masses in the left pelvis and right anterior third rib have shown mild interval growth. 2. Minimal increased size of right upper lobe and right lower lobe nodules. Dr. Rathmell discussed Votrient  (pazopanib) as the next treatment drug for Dennis. Of course he was thrilled to start treatment again, NOT. Since it was deer season Dennis decided to start the drug in January. He was afraid of the side effects, so wanted to wait until the season ended. He started Votrient on January 15th. So far the side effects have been mild compared to Nexavar. His blood pressure increased so he went back on his second BP med, his hair is starting to come in white, and he has had vomiting. Although, he has now started to take anti nausea medication when he takes the Votrient, and that seems to be working.

On February 14th he went and had labs done, and had his infusion of Zometa. We met with a NP who was very nice. Dennis and I really liked her, and we will see her again on March 14th when he has his labs done again. We were lucky to get the Zen infusion area. It's the area that has less traffic and its very quiet.

We certainly hope this drug will shrink the tumors and help with the bone mets, too. Dennis has his next scan in April, and we're hoping for an awesome report!

Well, you're up to speed on the cancer journey...