Friday, December 19, 2008

Fox Chase and Thomas Jefferson

Today we visited Doctors at Fox Chase and Thomas Jefferson and they basically both gave us the same information.  The treatment for the first round of chemotherapy is very standard and consists of cisplatin and etopside.  On day 1 both cisplatin and etopside will be given, then on day 2 and 3 only etopside will be given, followed by 18 days of rest.  So the total 21 days will count for one cycle of therapy and the doctors suggested doing 6 cycles.  They said that after the 6 cycles often the tumors are so reduced in size you can often not even see them. The disease needs to be treated systemically throughout the body through chemo and not just focusing on specific areas such as radio ablation or surgery.  After the 6 cycles, there will be a break usually 2-3 (maybe 8-9) months before the tumors start coming back.  They highly suggest during this point in time to do 3 weeks of prophylactic brain irradiation, even if there are no tumors in the brain because it has been shown to help patient outcome.  Every 2-3 cycles mom will scans to see if the tumors are shrinking and when they start to grow back.  During the second round of chemotherapy is when there are some more options available, but most of them are experimental and part of clinical trials.  It really depends where the tumors come back that will determine the treatment plan.
However all the doctors were very clear that we need to start treatment right away.  Also the doctors were very encouraged about how healthy Mom looked and that she has practically no symptoms.  We decided that we will see the Doctors at Fox Chase but the actual treatments at Reading Hospital.  Whenever Mom gets a scan, we'll make an appointment at Fox Chase and we'll discuss the results with them and from there determine our future treatment plans.  I think this is the best situation because driving back and forth to Philly 3 days in a row would be very tiresome, but I feel much better having the expertise of the Fox Chase Doctors.  
Thankfully we were able to get a hold of the Doctor at Reading who had luckily already scheduled time for Mom's treatment the following week, so we did not have to admit her to get treatment.  Her chemotherapy will start Monday and she will have treatments on Tuesday and Christmas Eve (Wed) as well.