We met with her Oncologist this afternoon and the plan as of today is for Barbara to start the next Chemo cycle next Thursday. He wants to give her the same two drugs she had the last cycle, but reduce the dosage of the drug (5FU) that he believes caused the mouth sores in the hopes she does not have that problem again. Because these drugs were so effective against the cancer in the first three cycles, he (and the other experts he talked to) feel that if she can tolerate them, they will do the best job of getting any remaining cancer cells. Any change to another drug would be difference from the standard of care for stomach cancer and could potentially be less effective. One option if she has more trouble with this cycle would be to change to another drug that is used for the upper and lower intestines, so it should be effective, but there is no solid data to show that it is. It is generally only used when someone cannot tolerate the standard drugs. Barbara is very much not looking forward to starting this again, but at least we are getting closer to the end. Hopefully the lower dosage will not cause nearly as much discomfort as the last time. We will see.
We do meet with her surgeon next Tuesday for another post surgery checkup, and she will give a final approval for us to go forward. I have already checked with the surgeon via email and she is in agreement with going forward at this time. We also plan to keep the feeding tube in at least through the first cycle in case she cannot eat again because of mouth sores. We could at least get fluids and food into her even if she could not eat. Of course, she is not ready to get it out yet anyway since she is still not eating enough to stop the tube food.
If nothing happens before next week, I will do an update after her appointment with the surgeon and then start most likely daily posts once cycle 4 of Chemo begins.
Wayne
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