Update #6: The second treatement cycle was supposed to start yesterday but my mom recently developed rapid heart rate (110+ resting), shortness of breath and extreme fatigue, with visibly swollen legs and sudden increase in ascites. The treatment was delayed. Doctors suspected deep vein thrombosis in her legs (which is closely related to pulmonary embolism) but ultrasound showed no blood clots in the legs. Only a CT scan can let the doctors truly determine the cause but my mom's breathing difficulties prevented her from going through a scan. Out of options, she has been put on blood thinner for 2 days and we can see the heart rate slowly improving. Doctor's said if there is significant improvement in the coming days, they can be quite sure that there is a blood clot somewhere, but a true diagnosis requires a CT scan.
Onc said blood thinner normally does not counteract the efficacy of immunotherapy. When and whether to start the next cycle of treatment now depends on my mom's recovery from this unconfirmed blood clot. He would rule out the possibility of a tumour-induced blood clot if blood thinner works.
It just happened so unexpectedly when she was taking a break and was supposed to get better and feel better...
Supporter to my mom (64 yr); KRAS wild type; MSS
2012: DX Stage I, rectal cancer; resection and colostomy, no chemo
5/16: DX Stage III, mets found; right groin lymph node and soft tissue nodules
5-6/16: Radiation + Xeloda
7/16: DX Stage IV, pleural effusion; cancer cells found in fluid
7-12/16: Xelox + Avastin X 6
1/17: Clean PET scan, NED
2/17: Pleural effusion; recurrence
4/17: Iri + Erb X 3
5/17: Ascites; Chemo failed
6/17: Keytruda X 1
7/17: TECENTRIQ (atezolizumab) + COTELLIC (cobimetinib)