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.

The colors of spring

This past week the weather was beautiful with temperatures reaching into the eighties. Everywhere I look there are splashes of color; purple wisteria, yellow daffodils, and white dogwood blossoms to name a few. I have really enjoyed watching the trees come to life this week as the buds have started to open, and everything is turning green, and I mean everything. Lots of pollen in the air leaving a greenish yellow film everywhere. Last weekend I finally put my bird feeder up opting for a spot near the bay window, so I could watch them from where I sit in the living room. It took the birds a few days to find it, and they are now happily munching on seeds. Well, I thought it was a good spot. Yesterday I moved the feeder to the side yard due to the unwanted bird #@*! on items in my front yard, mainly my car and the plastic lawn furniture. I hope this solves the problem. If not, the feeder will be moved again. Unfortunately, our wonderful spring weather has disappeared. Today will be rainy with temperatures in the mid thirties. It was nice while it lasted, and I'm looking forward to those eighty degree temperatures returning soon.

Awesome...

Someone pinch me!  I can't believe the drug company will be suppling us the Votrient for free. Thank you to Rachel, the financial assistance gal at the hospital. Dr. Rathmell, who might have had some pull with the drug company, and GSK!!!! You're Awesome!!! The drug will arrive tomorrow, so Dennis will only miss one day.

Dennis had labs on Monday, which were normal, and a visit with Mary, our NP. Boy, was she mad when we told her what was going on. She mentioned something about gouging out someone's eyes at the insurance company, but I told her she had to get in line behind me! Patricia, one of the trial nurses we had when Dennis was first diagnosed, stopped by to say hello as well. She's soooo nice, and always makes time for us.

I'm still waiting to hear about what happened with my insurance. We were offered two plans - gold and silver. We were told the gold plan was the same coverage we had. It's bad enough the deductible went up, and the cost increased about $100 a month, but to find out it didn't cover a drug anymore just about put me over the edge. Kathy from HR is doing her best to find out what happened, and has CC me on the emails to the insurance company. I hope we hear something soon, and that no one else has to go through this.

A place for me

I've started this blog so I'd have a place for my thoughts and feelings as our family deals with kidney cancer. We have a caringbridge page for Dennis that's used to update our family and friends on his condition. If you want, you can visit his page by clicking here. I write updates about his health, his treatments, when he has scans, side effects, etc. Most times I don't include my true feelings because I don't want to use his site as place for me to whine, vent and complain. It's not about me, it's about Dennis. Also, I don't want our family and friends to worry about me due to something I write on his site, and I know there's a few who will. Honestly, I don't want to deal with the phone calls and prying questions which will result from me offering too much info.

At the moment we're still waiting for information about assistance for Votrient. The last we heard was talk of 50% or free. Uh, free please! We need to know soon since Dennis only has enough pills to last through Tuesday. He has labs Monday so I hope to hear something during the visit.

I finally talked with someone in HR Thursday afternoon. She knew I was upset since I was on the verge of tears, but thankfully I kept it together. She talked with someone from the insurance company but she didn't sound hopeful. Unfortunately, I probably wont hear anything different than what I already know. To make matters worse there's another kidney cancer drug that's on the tier 4 list, Afinitor. I'm so pissed off about this. If we can't get assistance for either Votrient or Afinitor, that's two drugs he wont get to take unless it's in a trial. Sutent is a tier 3 so I'm guessing that would be the next drug if we can't get assistance.

Sucks to learn you're underinsured!