August 19, 2024
We saw Dr. B this morning. He walked in asking why David did not have an appointment yet for the y90 procedure and wondered what the hold up was on Dr. K’s end. David told him he had the mapping done the previous Monday so Dr. B said he would call Dr. K after the appointment to see how soon we could get this moving. Discussing the PET scan report from Friday, Dr. B said it looked as if most everything was in David’s liver. He indicated the spots in his left lung were “insignificant” at this time. He talked again briefly about the Lonsurf chemo option but he said he was now more inclined to try a chemo protocol for neuroendocrine tumors to see how it responded. He bases this on the pathology of the two tumors that were resected in February. Being that they both had neuroendocrine features. He said the scans indicated that the tumor in his colon is still stable. We talked about the pain David is experiencing and that we scheduled an appointment to see Dr. J on 8/26 in person to discuss how the extended release pain medication was working. I asked about the larger cancers centers in the United States and what resources they may have to offer that we couldn’t get locally. He said basically they offered major surgeries when applicable and clinical trials. He explained clinical trails were options but that only a small percentage of the drugs ever receive FDA approval for treatment. He said so many just do not show enough promising benefits. He said a few places in the U.S. had started to bring back an old treatment from 25 years ago. Hepatic Artery Infusion (HAI) Pumps are being prescribed as treatment again. He said Memorial Sloan Kettering in New York was specializing in these and he had a patient that went there and had one implanted. He said a device is surgically installed near the liver and administers chemo directly to the liver. He said results following the first scan are usually very promising but subsequent scans reveal a downturn in progress and the cancer tends to reoccur. He said as was the case with his current patient. He said right now, he was just not impressed with the outcomes verses having to have something surgically placed in your body and then removed once the chemo was given. At least this gave us something to read about and consider. He said there was one doctor doing the HAI pumps at Emory. He said Emory also offers proton therapy but that wasn’t something you could do to the liver. I told David I was glad I did ask and that I was still interested in discussing MD Anderson in Texas. He said he would consider once we see how his liver does following the y90 treatment.
Before we made it to the car, David got a call from a Piedmont scheduler letting him know the y90 procedure had been set for Monday, 8/26 at 11. We would need to be at Piedmont Fayette by 9. Since this was the day we were to see Dr. J in Atlanta, we went ahead and rescheduled that appointment for 9/9 which was the next available date.
We headed home. We both felt pretty down. It wasn’t anything we didn’t already know liver wise, but it was really the first time we just didn’t get a good feeling from the visit or from Dr. B. It seems like there are lots of treatments options for cancers everywhere else except for liver mets.
David’s shirt today: Sometimes I get off on a tangent.
