Lab Reports

Dennis' labs were normal, and he will continue to take Votrient at full dose. After the awful side effects he had last weekend there was talk of possibly lowering his dosage. This was the first major episode of side effects since being on the medication. Dennis didn't feel too well on Saturday and skipped his meds Saturday night. He wasn't any better on Sunday, but did take his medication. Monday morning he couldn't eat, and couldn't keep water down. It was awful to see him so sick and not be able to help. He forced down water to stay hydrated, and by the end of the day was able to eat a little, very little. Dennis was able to eat more on Tuesday, and by Wednesday he was back to feeling "normal". The new "normal", you know, post cancer diagnosis normal. If Dennis has another episode like that, he's to call the nurse immediately.


Another area of concern is his eating. When he's on the meds food doesn't taste good and he doesn't eat enough. He also has a "full" feeling even when he's not full. He had the same issue with Nexevar. Dennis needs to pack on a few pounds. Well, more than a few. At this last checkup his weight was 148. Being sick right before his doctor visit didn't help, as I'm sure he lost 5 pounds over those few days! The nurse suggested making milkshakes using ensure or boost as the liquid. As long as it's chocolate, it shouldn't be a problem. Chocolate is his favorite food group!!!

Dennis' next CT scan, oncologist visit, and Zometa infusion will be in 6 weeks, on July 7th. We're certainly hoping and praying to hear more good news about shrinking spots!!!

As you enjoy this holiday weekend, please take the time to reflect on its true meaning. Memorial weekend is not about sales, a day off of work, or the start of summer. It's about those that made the ultimate sacrifice for our freedom.

Abstracts...

Sometimes I wonder about abstracts, or maybe I just don't understand them. A few days ago I read an abstract, Early experience with targeted therapy and dendritic cell vaccine in metastatic renal cell carcinoma after nephrectomy. Maybe it's just me, but I found the whole study questionable. For starters, the study only involved 2 male patients with metastatic RCC, and there was no mention as to where their metastatic disease was. How can only 2 people in a study be conclusive?


From the abstract: 
Sunitinib (50 mg per day) was given for 4 weeks, followed by radical nephrectomy after two weeks. DC vaccine was initiated immediately after surgery and repeated monthly. Sunitinib was restarted daily after 2 to 3 weeks of surgery with a 7-day interval every 4 weeks. 


Results: Follow-up in these patients at 9 and 10 months demonstrated a stable disease in both, as shown by imaging and clinical findings, with no further treatment required. 


Conclusion: The immune response obtained with DC vaccine combined with the antiangiogenic effect of sunitinib and the potential benefits of cytoreductive nephrectomy in advanced disease could represent a new option in the treatment of metastatic RCC. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice.


The abstract never mentions the length of the study. How long were they on Sunitinib after the radical nephrectomy? It only mentions they had a 7 day break every 4 weeks. The DC vaccine was given monthly. For how many months? The follow-up was at 9 and 10 months. They both were stable, with no further treatment required. And...  Sorry, but this abstract is lacking information.


I love the last line in the conclusion. Further prospective trials are needed not only to elucidate the ideal dosing and schedule, but also to better define the proof-of-concept proposed in this report and its role in clinical practice. 


Obviously!!


Update: I found the original abstract, and it did answer a few of my questions. Here's the link to the original.

Dick's Last Resort

While vacationing in Myrtle Beach this year we ate at Dick's Last Resort. This restaurant was sooo much fun. It's a dining experience like no other, and a must do if you ever get the chance. Check out Dick's Last Resort to find a location near you.

For those of you who can't read the hats - mine says I'm not wearing any panties, and Dennis' says I'm wearing her thong with an arrow pointing to me. Too funny!!!

Scan Report

The April report showed shrinkage in a few areas. Chest: There is improvement of the RUL subpleural groundglass opacity, measuring 6 mm, previously 9 mm. The 4 mm RLL subpleural nodule was unchanged. Bones: The right third rib measures 4.8 cm x 2.5 cm, previously 5.3 cm x 3.4 cm. The left pelvic lesion measures 4 to 3 x 2.2, previously 4.1 cm x 3 cm. The right 3rd rib and left pelvic reference lesions exhibit interval decrease of its soft tissue tumor component. Impression: 1. Osseous metastatis disease in the right third rib and the left pelvis which shows improvement compared to prior study. 2. Interval improvement of RUL ground glass opacity.

Okay, so there is shrinkage as listed, BUT what about the other areas of bone. No news about the 6th rib and no news on T7 or T8. It's a small improvement, and I consider his cancer stable with this latest report. Honestly, I was hoping for a better response from this drug. Hopefully, the next report shows even more shrinkage!

The side effects from this drug are mild, but he still has issues with eating. Food doesn't taste good, and sometimes just the smell makes it were he doesn't want to eat. He had the same thing happen when he was on Nexavar. I just hope he doesn't lose as much weight as he did when he was on that drug.