Merry Christmas 2007

Merry Christmas everyone.


I (Jan) hope you are enjoying the day with your family and loved ones. Sister Terri had 44 of us for Christmas Eve last night and we had a wonderful time together. It was a blessing to have everyone there. We ate wonderful food, took the traditional family group pictures, exchanged gifts and enjoyed the company of the ones we love.


Christmas day is also sandwiched between doctors appointments for sister Kim. She had a CAT scan last Friday and will meet a radiologist this coming Friday. Two months ago, Kim's doctor found another tumor and she started treatment again. After last Friday's testing they discovered that the tumor is not responding to this type of treatment.


My niece, Becky is a nurse at UMC and was able to attend Kim's doctor's appointment. She did an excellent job of translating and explaining to us non-medical folks. I have copied Becky's notes below:


Becky Hoff wrote:


Dr. Remmenga explained to Kim that after 2 cycles of chemotherapy the avastin was not working. The larger of the two tumors that were seen on her CT scan had grown 31% from the previous scan. On pelvic exam he also felt “sandpaper” like areas which he felt was tumor. He told Kim that he would always be completely honest with her and he felt the need to change therapy. The biopsy of the recurrent tumor tested as estrogen receptor positive (ER positive). If a tumor is estrogen receptor positive it is more likely to grow in a high estrogen environment. Because her tumor is ER positive they are able to treat her with a drug called arimidex. This drug is used mostly in breast cancers. Arimidex reduces the amount of estrogen in the body. Kim’s tumors are feeding off of the estrogen in her body. For more information on the drug go to www.arimidex..com. They will follow up with a CT scan in 2 months. This drug takes a while to take affect and Dr. Remmenga fully expects some more tumor growth before the next scan.


Dr. Remmenga is also going to send tests to determine if the tumor is HER2 positive. If it is HER2 positive they would be able to add an additional drug called herceptin to her regimen. This would be given through her port once every 1-3 weeks. Herceptin is also called an immune treatment because it is made of an immune system–like antibody that blocks the HER2 protein in cancer cells. Blocking the protein helps stop the growth of HER2-positive cancer cells.


Kim asked him about other options they could look into. She has an appointment next Friday with a radiation oncologist Dr. Robert Thompson who specializes in gynecological cancers. He will evaluate her scans and tumor biopsies to see if radiation is an option for her. If so, this would be a daily treatment for Kim.


Kim also asked about surgery and Dr. Remmenga did not feel like this was a likely option due to the nature of the disease. Meaning, not only does Kim have solid tumors but she also most likely has small cancer cells in her body that are not able to be removed (or seen). With any surgical procedure they weigh the risks and benefits. The location of the tumor causes a risk to Kim’s other organs. Dr. Remmenga is consulting another surgeon to get a second opinion on the option of surgery.


The positives that I see out of this appointment are as follows:
1.Her tumor is ER positive and this allows for a different type of treatment. Had the tumor not been positive and the avastin was not working there might not have been another option.
2.Although her tumors have grown, the CT scan showed no evidence of tumor in any other organs.
3.She has a doctor who is determined to get her to an old age and is consulting with many different people to get her the best treatment possible.