PeterG wrote:Thanks again, Karin. RP1954...
CAM means Complementary and Alternative Medicine, right? and mCRC is metastatic colorectal cancer... yes
"the Life Extension articles on surgery, colon cancer and cancer in general, targeted cimetidine separately."some LEF pages: colorectal cancer
specifically; cancer
generally; surgery
article and
special report There is a lot of discussion about cimetidine in the archives here. There are basically two kinds of papers and uses: cimetidine before and after surgery, and cimetidine for long term use, for years, effective in majority of advanced crc patients with specific biomarkers that identify who benefit should most from it.
But I am really interested in expanding my view of what to do. I am excited about the Chang-Nesselhut approach (the beyond the Magic Bullet/Cocktail/dendritic therapy etc.), We don't put all our chips on one treatment or technique, we trial, monitor and add successful ones together or in a sequence. We don't spend our budget on one shot, we make sure we've allocated around enough for multiple kinds of treatment.
...might be influencing me to grasp at straws.Critical thinking, reading and second, or outside, informed opinions are essential, for both CAM and "standard" offers.
Also, as I am still with Kaiser, if I should be pushing my oncologists to track specific biomarkersYes. In some cases they need to learn to improve their game, even if they may not do it now when you first ask. If they won't, you can order them online. Our first year, we skipped on some insurance arguments and delays; we paid cold, precious cash to gain time and options. Also better data can obtain more timely answers, more favorable treatment
or insured coverage. Or change doctors' "flat no" into a willing "yes".
..."Tracking biomarkers 1-2x month" makes sense to me in broad strokes, I have no idea what to do with (or how to interpret) "CEA, CA199, LDH, MCV, ESR (for monitoring and correcting longer term inflammation) and maybe hsCRP" . Nor do I know anything about "CA72-4, AFP, CA125, quantitative d-dimer, or fibrinogen." Are these all standard indices and metrics about which I should be learning ?
CEA, LDH (in Chem20), MCV (in CBC) and ESR or hsCRP are standard lab orders for various related medical reasons, not necessarily the cancer itself. In some cases, another biomarker, usually CA19-9, might be demonstrated to replace CEA, if CEA is obviously unsatisfactory and the other is/has been above normal range. CA72-4, AFP, CA125, quantitative d-dimer, or fibrinogen are baseline data that you might gather before/after surgery and once a year, unless they become more immediate. The biomarkers listed here are the short answer that I was looking for 5 years ago, back then effectively wishing for the tooth fairy.
And are they standard enough that I can get a factory-like HMO (Kaiser Permanente) to order and interpret these tests and analyses? On many parts, no. In some cases, not yet. Whether you keep KP long term, you'll probably need to find some additional support elsewhere. Outside consults and sources can clear up many questions.
Then, how will I know what to make of the results, and where to push.We often learn fastest by doing and asking questions, "on the job".
you have helped me note how ignorant I am...We were all born that way. It can be fixed faster than you may think. Read, the LEF articles, read some of the cancer books by Block, Quillin, Servan-Schreiber, Life Extension, and some of the archives here.
I suppose I would like to entrust my care to someone like Dr. Chang and rely on his or her expertise. In most cases, it takes more than one stop or doctor to achieve that. If you can pay the bills, travel included, Chang may be sufficiently knowledgeable to handle and accommodate more of that expectation. Often times, people structure their doctors for multiple support, like MSK (distant facility and special skills) with a local doctor, or an oncologist and an outside CAM doctor.
Seems you are advocating for a much more pro-active approach.Yes, but pro-active can save you a lot time and money. Time from guessing, not knowing but worrying. Time and money searching for answers in the wrong places, being told the same or unsatisfactory answers multiple times - like "No", "it's standard", "no one knows", "go home". Time being wretched or on this earth. Lack of success is the most expensive, insured or not. In my eyes, time invested up front and closest to an informed answer is the most valuable.