Monday: Appointment with Dr. James Cusack (surgeon) at MassGeneral. He said there was still too much disease for him to be confident in removing all of it. He called in Dr. Jeff Clark (oncologist) to consult. Left with treatment plan to continue with FOLFIRI, adding Cetuxamab. We agreed to ramp up my treatment to be a bit more aggressive. I would do four rounds (2 months), scan, and return to see both of them at the end of September. Dr. Clark would call Dr. Singh to confer.
Friday: Appointment with Dr. Singh (oncologist, newly hired at my local center). A great first impression. He had spoken with Dr. Clark; told him he needed to review my history. He discovered that I had two biopsies - one during a colonoscopy and one needle-core for the mass outside the colon. The first was KRAS mutated. The second showed KRAS wild. He faxed over the two different results to Dr. Clark on Thursday. At the appointment he explained people could indeed have both types, and I expressed concern over that, asking lots of questions. At end of appointment we had agreed I would skip next week's treatment and have a biopsy repeated on the mass outside the colon. If this new biopsy also came back wild, I would add Cetuxamab. If not, we'd discuss options. Biopsy is sent for next Friday, with appointment with Dr. Singh the Friday following. Next treatment would be Monday after that. I needed to decide if I wanted to add the new drug or wait until the results of the biopsy. Chances are the results will take longer than a week to return.
At 5pm today, my phone rings. It's Dr. Clark calling me. He had not reached anyone at my home cancer center, so he called me. (WOW!) He told me he had receive the information from Dr. Singh, so it meant I was not a candidate for the drug, telling me other options. I told him about my appointment this morning, and we both agreed the best approach would be to continue with the treatment (FOLFIRI only) until the results are back. He would prefer I did not take the drug if I am indeed not wild.
I am seriously impressed with today. I have a new oncologist here who is not only staying for the long term, but who is willing to communicate with outside doctors, and who treats me like an equal in my own care plan. I have an oncologist in another state who not only takes the time to respond to my local doctor, but who takes the time to contact me on a Friday evening.
Now if it wasn't so hot and humid right now. Everyone please enjoy your weekend.
PS: We stayed in Manchester, NH. Took bus down to South Station. Took Red Line to Charles/MGH. Yawkey Building is literally at the T-stop. Could not have been simpler. Thanks go to my in-laws for driving to/from Exit 5 for the bus. <3
06/2018 KRAS negative for mutation; PDL1 negative, CEA 22.7
07/11 (ONC#1) FOLFOX started; 07/25/2018 FOLFOX+Avastin started
09/05 (ONC#2) Avastin discontinued
10/03 CT-scan showed no improvement
10/04 Appt w/ONC for 2nd opinion, change to FOLRFIRI due to increase in small nodules in abdomen
10/16 FOLFIRI+Avastin; Neulasta; Savaysa (Lovenox) treatment started
02/11 (ONC#3) Avastin discontinued
04/29 CT-scan showed both masses decrease to 8cm (from approx 12cm in June 2018)
05/06 CEA 3.7