1/24 - Great News and then some Complications

Rae, Jane and I met with Dr. Kaseb of MD Anderson to get a report on the latest scans and findings.   Much of the news was positive.

Both the lesions of concern showed some shrinkage as a result of the chemo drug Nexavar. The thrombosis about the lesion that had extended into the IVC was significantly reduced indicating that the blood thinner, Lovonox, is working as well.  Both lesions now show signs of dead tissue from embolism (starving from blood).  Dr. Kaseb said that Nexavar acts to create an embolism as well as did the other treatments, radiation and the TACE.   The AFP marker is now 147.5 up from the 17 low and 49 in Dec.  Dr Kaseb was not concerned against all the other positive signs of progress.   

My observation is that the total size of the lesions now is within the criteria of a transplant.  If we continue to make progress of the lesion extending  the IVC then I might be a candidate.  We discussed this with Dr. Kaseb in the context of  liver function and the fact that I have cirrhosis.  The fighting of the cancer acts against the liver and thus must be watched closely.    He said most transplants are performed because of cirrhosis and not to fix cancer.  He again stated that active cancer is a big concern with a transplant because it tends to invade while the immune system is depressed to aid in acceptance of the new liver.   He did say that he has been successful in arguing for a transplant in a patient who has controlled the cancer for 9 months or so. 


Whats new as you would suspect if you were around me for the last two months is that I have a fluid buildup in my lungs.  This can be a sign of liver dysfunction or could be the sinus drainage I have been hacking against for 8 weeks.  Most of the drainage has stopped and the hacking has reduced.  Answer for the fluid buildup is more drugs, Lacix.  I will be glad to get this cleared up as it contributes to my fatigue and makes it hard to exercise for any duration of time. 


Also I am not winning the nutrition war.  I have lost another 4 lbs since our Dec visit and the nutrition indicators are down.  Fix is to eat more.   


All and all a very positive report.  Still showing progress against the cancer.  Transplant window is opening.  Liver function is still good under all the abuse. 


New goals:  Clear the fluids in my lungs.  Eat more.  Beat the cancer.  Start talking to Baylor College of Medicine about treatment of my cirrhosis problem hopefully leading to being a transplant candidate.  


Thanks for all the prayers.  I believe we have the cancer on the run.