It's been awhile since I've posted. Normally I just read how everyone is doing. But it's time for an update.
I got transferred back to Houston from Paris for work. So my wife finished up 8th round of FOLFIRI Dec. 7, 2016, and had a final Avastin infusion on Dec. 19 before we actually left Paris.
We thanked our nurses and our Onc for all they did, but it was time to go home.
After spending Christmas in Germany, we arrived in Houston just before Dec. 31.
I previously made three different onc appointments to get various opinions etc.
We brought all our scans and reports, plus specimens from our time in France.
Good news: We got into MD Anderson and have a great doctor: Dr. Vilar Sanchez.
Not so good news: after each initial visit with each onc, they all said prognosis was 2 yrs, maybe 3, but could be 18 months. But it appeared based on Nov. 2016 PET scans that FOLFIRI was working, so recommendation was to go forward and do 4 more rounds and then see where we're at.
Only MD Anderson onc entertained possibility of surgery to retroperitoneal lymph nodes, though it was a small chance.
MD Anderson decided also to do a baseline CT Scan with contrast before we restart treatment.
Bad news: The scan found numerous, mostly sub-centimeter mets throughout both lungs. They didn't count because there were too many; some were at 1 x 1 cm mark.
Also, some growth in the lymph nodes in iliac region, others are stable but not shrinking.
The radiologist also went back to the Nov. 2016 PET scan and noticed that the Paris docs missed the lung mets, as they were present in Nov PET scan, though small and easy to miss. Based on measurements between Jan. and Nov scans, allowing for some technical differences, Lung Mets grew despite treatment.
Nothing in liver yet, though they noted tiny right hepatic hypodensity that is too small to characterize that can be followed.
So FOLFIRI is no longer working and surgery no longer an option at all (absent a miracle). And now we have 6-9 months if we stopped treatment all together and 12-15, maybe 18 if we restart treatment. Within a week our prognosis time frame was cut in half. That was rough.
Onc wants to finish 4 rounds with FOLFOX again and see if that helps, though it sounds he's a bit skeptical it will since we did FOLFOX first and had recurrence about at the 1 year mark post chemo.
Still, it doesn't hurt to try. So we begin FOLFOX tomorrow and get to experience treatments here in the US.
Otherwise we're looking at Lonsurf and/or Stivarga since EGFR targeted therapies are not an option.
Basically we've gone through two lines of treatment with few options left.
Physically, my wife still feels fine. But we know that won't last forever most likely.
Any one have any suggestions or been through this or similar?
What can you tell me about longsurf and stivarga side effects?
Thanks for help.
DH to wife 38, DX 12/14, Rt. clctmy Xmas
St. IIIB, pT3N2aM0, 4/27 nodes, mod. dif
KRAS (G12V), APC, TP53, MSS, vasc/lymph/perineural +
TX FOLFOX 1/15-6/15 (4 no oxi)
7/16 mets to retropertnl, iliac, supclavic. nodes
TX 9/16 FOLFIRI+Avast
1/17: Numerous bilateral lung mets; nodes stable/growth; FOLFIRI fail
TX 1/17 FOLFOX+Avast.
3/17: lung mets grow/new, nodes stable/growth, FOLFOX fail
no clinical trials
TX 9/17 Lonsurf
11/17 growth in lungs, nodes; mets to ovary, abdomen, and likely liver