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Chemo

Friday, September 17, 2004 7:41 PM CDT

We met with Dr. Sacks yesterday. The options from UW don't look very good to us. Dr. Spence is recommending BCNU. BCNU is an IV chemo that has been around since 1972. It's not terribly effective IV, although it has shown some promise inserted into the tumor cavity at surgery in gliadel wafers. The side effects are many. First, all the classic chemo stuff, severe vomiting for hours after each dose, loss of hair and suppression of the bone marrow, meaning immune suppression. The usual dose is every six weeks, but due to the fact that Dave's been on chemo at such a high dose for so long, even though his counts have been good, Dr. Sacks doubts he'll be able to rebound very well, and every six weeks would be optimistic. The other side effect is pulmonary toxicity...basically, it causes infiltrating fibrous growths in the lungs and can lead to respiratory failure.

The other options are CCNU (an oral chemo) and PCV (an IV chemo), they all 3 have similar (dismal) success rates, and Dr. Sacks feels that the BCNU is the least toxic so that's where to start.

We're in the process of talking with Duke. They have some promising trials. Gleevec is a chemo that attaches to a genetic marker in certain tumors, Dave's could be tested to see if he's a responder. There is also a monoclonal antibody treatment which involves using the DNA of the tumor cells and injecting a radioactive substance that would specifically attack the tumor DNA. It is very experimental, but we know of some people who tested it in the early stages 4-5 years ago and are still around to tell the tale. It would also mean that Dave would be radioactive in North Carolina for 6 weeks in isolation. Not fun.

Guess we'll see if Dr. Friedman thinks Dave is a candidate for any of the newer treatments available at Duke.

Please pray for wisdom for Dr. Friedman, and pray he will have something to offer us.

You can read about the different treatments at www.virtualtrials.com

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