Update on my dad

I just got a phone call this morning from my sister that my dad has been admitted to Duke because his back had been hurting him the past few days.  I just now got another phone call that my dad’s left lung has collapsed on account of fluid building up from possible pneumonia.   The cancer treatment makes his immune system really weak.  I will update when I get more information.  I hate this.

The following is a recent email received from my mom about my dad and his fight against Renal cell carcinoma (RCC):

Our daughter Beth has been going with us to Duke for the past few months and taking notes. We are keeping a log of sorts about the appointments, questions and etc. We were there Monday and she just sent me the additions and etc. for our appointment with Dr. George. I think it gives all the information on what is happening so I decided to save time and sent a copy to you. If you have questions please feel free to e-mail me and I will try to answer (pgnc@mindspring.com).

The only addition is we have scheduled the appointment for the ‘port’ to be inserted on August 17th, he will return on August 31st to visit Dr. George for evaluation and if strong enough will go to chemo suite and receive the IV

Will keep you advised…….

Love and best wishes to you and family

Linda and Pat

Appointment Notes:

Dr. George asked about Dr. Wetzel’s appointment.

Info. We Shared–Appt. with Dr. Wetzel:
Swallowing tests showed no aspiration. Muscles for throat and tongue are weak but functional. I received tips to aid swallowing liquids and foods and Rx for chronically treating the yeast.

Further Updates Shared:

  • July 12th tapered off Dexamethasone.
  • July 17th symptoms: nausea, dry heaving, vomiting, increased fatigue, and confusion.
  • Symptoms continued through July 20th.
  • July 19th returned to 1mg Dexamethasone.

Dr. George would be comfortable beginning the Sutent (chemotherapy drug) now, but there are other options available that may be better tolerated.

The CT showed minimal change with the tumors in the lungs, perhaps a 1-2mm increase. “Time is on your side.” By the end of the month the FDA will approve a second drug for Kidney Cancer, Avastin®:
“Avastin® (bevacizumab) is the first U.S. Food and Drug Administration (FDA) approved therapy designed to inhibit angiogenesis, the process by which new blood vessels develop and carry vital nutrients to a tumor.
Avastin is approved, in combination with intravenous 5-fluorouracil-based (5-FU) chemotherapy, for first- or second-line treatment of patients with metastatic carcinoma of the colon or rectum and in combination with carboplatin and paclitaxel for the first-line treatment of patients with unresectable, locally advanced, recurrent or metastatic non-squamous non-small cell lung cancer (NSCLC).” http://www.gene.com/gene/products/information/oncology/avastin/
Avastin® has a long half-life, meaning that infections can take longer to heal while on the medication. Therefore, Dr. George suggests waiting until all active infections (i.e., yeast infection and open wounds) completely heal before beginning Avastin®.

Primarily we are approaching this as a lung-based cancer. The Avastin® IV therapy is a good choice to attack the cancer. It is an IV medication given once every 2-3 weeks.

Dr. George suggested a power port as a good idea.
“ . . . a port (or portacath) is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical ‘needle stick’.

. . .The port is usually inserted in the upper chest, just below the clavicle or collar bone, leaving the patient’s hands free.”
Dr. George encouraged the following before continuing treatment:

  1. Clear up the chronic yeast infection.
  2. Be consistent with hydration and gaining strength.
  3. Reduce the Dexamethasone gradually. When ready: 1 every 2 days, then 1 every 3 days, next 1 every 3-4 days-none.

Next Appointments:

  • Schedule the outpatient procedure for the power port.
  • Schedule the first Avastin® infusion in four weeks. This appointment can always be moved if you are not ready to begin. The first infusion will take approximately 1-1/2 hours.
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