Back in Austin

We just got back from Houston and are glad to be home.  Maggie had CT scans early this morning to wrap up our visit at MD Anderson.  We return for our 8AM appointment on the 17th for the first part of our trial.

The CT scan went as it typically does at MD Anderson.  Get there early.  Drink the barium.  Throw it all up in the CT machine.  Ah, fond memories of the last times.  Maggie always warns them and yet techs always seem so surprised.

The trial we’ll be doing is called “A Phase I Study of Hepatic Arterial Infusion of Oxaliplatin in Combination With Systemic Fluorouracil, Leucovorin and Avastin for Patients with Advanced Solid Tumors Metastatic to the Liver.”  Obviously these folks need to invest in a good editor or marketing department because that name won’t sell many books.  Heck, I don’t know if it’ll even fit on the cover of a book.  Regardless, were you to be riveted by the name you can read more about it here.

Basically, they are going to load Maggie up with four different drugs at the same time, officially called The Whammy.  The oxaliplatin will go straight into her liver via a tube they will be inserting into her thigh.  Installing the tube, so they say, is a minor ordeal.  They’ll feed it up through the big blood vessel in her groin (the hepatic artery) using a CT machine to guide the effort until it reaches her liver.  They will do this each time we do an infusion.  I’m hoping they install a cork or something so they won’t need to cut open her leg each time.  I’ll suggest that to them, just in case.

They hope that the high doses of oxaliplatin straight to the liver will increase its effectiveness in killing off the tumors.  Dr. Kurzrock confirmed that, as we’ve been told before, the ones in the liver are of most concern in that if they begin to interfere with her liver functionality we will have a real problem.  So, smaller is better.  Nonexistent would be preferable.

But we can’t forget about the other tumors that are out and about, wreaking havoc.  Dr. Kruzrock says that while the liver will bare the brunt of the attack, the oxaliplatin will still make it out of the liver to offer up a good all-over-body scrub.  Additionally, she’ll be getting fluorouracil (5-FU), leucovorin and Avastin as a regular IV infusion.  None of the drugs are new to us but hopefully because of the new way they are infused they’ll be especially helpful this time around.

In case you are curious, here’s what each do, roughly:

  • Oxaliplatin interferes with the growth of cancer cells (which slows their growth and spreading), eventually destroying them.
  • 5-fluorouracil (5-FU) interferes with the growth of cells that reproduce rapidly.
  • Leucovorin strengthens the effect of 5-FU by reducing tumor cell resistance to the 5-FU
  • Avastin interferes with blood flow to the tumors, which may cause tumors to be “starved” of the oxygen and nutrients they need to grow.

The goal of this Phase I trial, like all Phase I trials, is to see how much of each drug they can pump into someone without killing them.  Ok, that’s a bit harsh but it’s about right.  A key part in a successful treatment is figuring out the proper dosage and though the use of clinical trials is how they figure it out.  Fortunately, I suspect we’ll be getting the most bang we can under the most watchful eye we can get.  Unfortunately, all this fun will likely come with some pretty strong side-effects.

Maggie’s liver has grown substantially over the last few weeks.  We can easily feel it outside her rib cage.  The pain Maggie’s feeling, from what we understand, is the stretching of the sack that covers the liver.  The liver itself feels no pain.  Apparently that sack sure does.  Yesterday was miserable.

Today Maggie’s feeling better.  She took an oxycodone around 10AM this morning in addition to her two fentanyl patches she’s wearing.  Riding in the car is tough with the jostling about and, of course, HW290 to Houston isn’t known for it’s glassy-smooth surface.  All I have to say is thank goodness for books on tape.  Maggie and I both listened to books on our iPhones on the way there and back.  Audible.com.  Love it!

But, for now, we are done with the car ride.  One quick soak in the bath and she’s happy again.  And now she’s on the phone to a few clients to help them solve their ever-present issues.  Always the helping hand, that one.

11 thoughts on “Back in Austin

  1. Good to hear they were able to lift the restriction on waiting four weeks out from the last radiation treatment. I’m sorry the both of you have to go through this. Do you plan on coming back to Austin every weekend during this trial?

  2. Kim and I check up on you several times a week… our thoughts and prayers are with you.
    Good luck with the new Quadruple Whammy treatment.

    Big hug to both of you.

  3. Glad to know you are home. Sounds like they are going to get after those tumors full force. My thoughts and prayers are with you both every minute of every day. Love you. Meme

  4. Whew! What a week+ you guys have had. (I hope you don’t get carpal tunnel from all the typing, Chris.)
    It must be satisfying (somewhat) to have picked a trial. For me, the anticipation of the unknown drives me crazy.
    Sweet Maggie, bless your little body! I’m praying for you right this moment. I prayed for God to show His love to you from unexpected sources. Whether it be from a nurse, a CT tech, or a stranger in a waiting room. Whether it be a sign on a billboard or a song on the radio… I prayed that you’ll hear the exact things you need to hear in any given moment you need to hear them… Words of comfort, words of hope, words of healing.
    May God touch your liver so it can withstand its current state and the drugs that will be coursing through it soon.

    Huge hugs,
    Shawna

  5. I love reading your posts 🙂 You guys are such fighters!

    I’m very interested to learn more about the clinical trail Maggie’s starting. I am currently looking for something similar, as 3 of these drugs I’ll be starting very soon anyway.

    I hope you’re both having a good day! 🙂

  6. Thank you for helping to further science and sign up for a Stage I trial. As a Stage IV colon cancer patient, I signed up for a Stage II trail in 2004 using FUDR for my HAI and Irinotecan for systemic chemo. It was successful for me and many others.

    I will keep you in my heart and prayers.

  7. Hello Blog Readers… Maggie’s mom here. Just wanted to let you know that Maggie went to the ER this morining with uncontrolled pain. She is currently (as of 1 PM on 11/13/08) resting comfortably on an IV pain killer, and will be admitted to the hospital this afternoon while they treat her for the pain. From what we can tell, it’s all in her liver where the largest tumors are located. Say an extra prayer for her today.

    Much Love,
    Mary

  8. Maggie,I hope you’re pain free and having sweet dreams. Chris, please let me know if I can bring you anything or do anything for you while you’re up at the hospital.

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