Some are able to deal with persistent mets by mild continuous chemo modulated by mild drugs and high potency supplements as immunochemo. Various pieces are described in the literature. The resistance - mutational aspects are overcome additively by several (to many) mild or even beneficial adjuncts. The ADAPT backbone (xeloda+celecoxib) is a start, but other items can be added (and the results observed and measured) until various (extra) markers improve. Without enough modulation, the expression of various markers will increase until there are scannable mets. With good modulation, the side effects are lower too.
Current clinical practices are inadequate to do a thorough job tracking these changes in cancer mutation or expressions in real time. You may have be your own advocates and implement things yourselves. Part of the problem is that heavy chemo distorts many markers and panels; clinicians think various kinds of data are always unimportant or meaningless, when they destroyed yours. Nicer forms of immunochemo can have much more stable data with less noisy markers even while increasing the intensity of treatment, perhaps beyond the heaviest straight chemo.
This is "easiest" earlier than later, with fewer sites, less tumor burden, and fewer mutations. Ideally one keeps everything nice with zero preturbations; or only tracks 1-2 active problems at a time. Earlier one is fighting for cancer extinction and long remissions; later one is more likely fighting for some extra time.
Last edited by rp1954
on Sat Jan 20, 2018 4:33 pm, edited 2 times in total.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC