Office visit 5/9/12 and an update from Doc H2 and Doc L

05/09 11:31
ANC 7526

Alan has done well returning to school after a two week absence due to chemo, the trip to MD Anderson and neutropenia. On our way to Doc P's office we got a phone call from Doc H2 with the results of the board on Alan's case. Doc L has convinced an Interventional Radiologist, Doc T, to take Alan's case. He warned us that the cryoablation would only take care of about 50% of the tumor. The component by the spine would need to be killed by radiation therapy. They will need to consult with a Radiation Oncologist and determine the physics of getting at Alan's tumor before they decide what kind of Radiation Therapy to use. We asked why they couldn't cut out part of the tumor so they cryoablation could be concentrated on a smaller amount of tumor cells, but apparently it has to be done on a whole, intact tumor.

The radiation had been ruled out before because they were concerned about the toxicity to Alan's bladder. They decided to use the cyroablation since Doc L will be in there at the same time protecting his bladder. Since just one treatment wouldn't kill the whole tumor they will combine them and hopefully that will knock it back.

Doc H2 also mentioned a Phase 1 trial that targeted an amino acid in the tumor. He needs to check if Alan's tumor contains the amino acid in question, but he can do that from the sample they have in storage. So now we wait. Alan's case has been moved to the office of Doc T and hopefully we will hear from her people soon.

It was too much to hope for Doc H2 to have called while we were in the exam room with Doc P, but at least we were able to share with him what we had found out. Of course Doc H2 will also be calling Doc P to go over things as plans solidify.

Alan's counts are high, probably due to the Neupogen, but we also noticed that scabbed-over blister at the end of his surgical incision had been bleeding. Doc P took a culture of the blood to be safe, but he went ahead and prescribed an antibiotic ointment and oral antibiotic. We will keep a close eye on it to see if a suture starts poking out. After we left the office we saw Alan scratching at it. Perhaps the scratching preceded the open wound - if that's the case, it's just a matter of protecting it from Alan's little hands until it heals.

Update - Doc L called us Thursday morning with a similar update. She confirmed that Alan's case was worked on by Doc T's office. Unfortunately, she had no idea of any timeline either.