CHEMOTHERAPY VISITS SEPTEMBER 8, 2015 - DECEMBER 28, 2015

Tuesday, September 8, 2015

Cycle #5.  Tolerating the dose reduction.  Tolerating chemotherapy well.  Liver enzymes continue to improve.  He has mild nausea from the chemotherapy which is being controlled with Zofran.  Return in 2 weeks for cycle #6.


Monday, September 21, 2015

Cycle #6.  Tolerating chemotherapy well.   He was advised to remain active and continue his routine medications.  Mike had a 5 mm ulcer on the left side of his tongue.  He was advised to use soda bicarbonate as a mouth rinse.  He is to also add nystatin for this ulcer.   Return in 2 weeks for reassessment and a CEA.


Monday, October 5, 2015

Cycle #7.    Tolerated the last cycle reasonably well.   Mike did report that he did have around 8 episodes of diarrhea with some minor abdominal cramping the day after the last infusion which resolved without any intervention.  No blood or mucus in the stools and no nausea or vomiting.  No issues with fever or chills.  After starting the nystatin swish and swallow for mucositis, the lesions cleared after 2 days.    Cycle #7  was initiated.    Imodium  as needed for diarrhea if this becomes an issue.  Restart the mystatin should any further mouth sores develop.   A CEA was drawn at this visit to be reviewed at the next visit.


Monday, October 19, 2015

Cycle #8.   CEA 274.3.   No toxicity from treatment.   Performance status has improved.    Return in 2 weeks for  Cycle #9.


Monday, November 2, 2015


Cycle #9.  Some pus was extracted along the gumline.  There may be some periodontal disease along the left lower molar.  Given Penicillin VK 500 to take for the abscessed tooth.  If no improvement, Mike was instructed to seek a dental consult.  Continue the bicarbonate mouth rinse.  Given cycle #9.  Return in 2 weeks for Cycle #10.


Monday, November 16, 2015

Cycle #10.   Occasional mild, intermittent nausea.  No oral ulcers noted.  Abnormal molar loos improved.  Does have a follow up scheduled with the dentist.  Return in 2 weeks for cycle #11.


Monday, November 30, 2015

Cycle #11.  Since last visit, Mike developed an upper respiratory infection with postnasal drip, sore throat, right ear pressure, and rhinorrhea over the past 4 days.  Mike has been taking Vitamin C to help resolve the infection.  He has been to the dentist where he was told his gingiva has receded and have become very sensitive.  Nasal mucous positive for erythema and congestion.  Oral mucus clear.  No lesions or ulcers.  Gingiva of the anterior teeth of the lower jaw noted to be receded - no bone visualized.  

Proceed with Folfiri cycle 11.  The Avastin is withheld from the infusion due to the gingival recession and tenderness in the mouth.  Osteonecrosis of the jaw is a concern with Avastin.  However this was not noted on his exam today.   Mike was advised that manipulation of the gums while on chemotherapy is contraindicated.   Symptomatic care was encouraged.  Mike was also informed that large amounts of vitamin C can interfere with chemotherapy mechanism of action and possibly decrease effectiveness.  Mike was instructed not t take more than 500 ng daily of vitamin C.  He was to contact the office if he developed progressive respiratory symptoms or fever.  He is return in 2 weeks for a complete blood count, chemistry profile, and hepatic function test prior to reassessment for cycle #12.


Monday, December 14, 2015

Cycle #12.  No ulcers noted.  Sinus infection improved with a Z-pak.    Irritation of the gumline noted in the anterior jaw in the area of the incisors.  Recommended that Mike use biotin mouth rinse.  The Avastin is still held.  Proceed with #12 FOLFIRI at 30% dose reduction.  Return in 2 weeks for potential FOLFIRI.  CEA and a CT scan of the chest, abdoment, and pelvis to be done to reassess his disease.



Monday, December 21, 2015       CT SCAN


Multiple bilateral pulmonary nodule consistent with metastatic disease.   However, there has been a               definite decrease in size of the numerous lower lobe nodules compared to the prior exam.  Multiple hepatic lesions present consistent with metastatic disease.  These are also decreased in size compared to the previous study.No new suspicious signs of metastatic disease currently identified.


Monday, December 28, 2015

Cycle #13.  Scans indicated good partial response and CEA is also improved. Continue biotin mouth rinse,  Hold further Avastin because of the gum recession and lower jaw pain. Proceed with Cycle #13 at 30% dose reduction because of prior toxicity.  After 3 further cycles, repeat CEA will be done.

ONCOLOGY VISITS AFTER TRIP TO EMERGENCY ROOM JULY 13, 2015 - AUGUST 24, 2015

Monday, July 13, 2015

Mike had another CEA test done on July 8th following his visit to the Emergency Room.   This showed his level to now be at 4635.8 which has increased since the last time this was done.   Mike return to the cancer center for reassessment.  The doctor stated he was showing scleral icterus which is when the normally white area (sclera) of the eye is yellow because the patient has jaundice, and he had dark urine.  He was also experiencing itching over his body and was complaining of right upper quadrant pain.

Due to this, Mike has decided to reinitiate chemotherapy. Because of Mike's mild jaundice and his bilirubin of 3, the doctor decided to reduce the chemotherapy by 25-30%.  He was started on cycle #1 of palliative FOLFIRI plus Avastin.   He was advised to take his Phenergan every 6 hours a needed for nausea.

The doctor told Mike that his prognosis was extremely poor, and the chemotherapy was palliative once again.  He also said that if this was ineffective or if he developed complications, he would likely require hospice treatment.  He is to follow up in 2 weeks for reassessment.  We will wait to see how he responds to this.


Monday, July 27, 2015

Cycle #2.  The doctor noted that Mike's jaundice and itching has improved.   He stated, clinically, he had a response to cycle #1 of this chemotherapy.  Therefore, he recommended that Mike continue with cycle #2 at the same dosing.   He is to return in 2 weeks for cycle #3.


Monday, August 10, 2015

Mike returned for cycle #3 of the FOLFIRI plus Avastin.  Mike denied any fever or chills or pain.  He was experiencing some mild nausea from the treatment which was expected.

Since Mike was responding to this treatment, it was decided that Mike would proceed with cycle #3 of the FOLFIRI plus bevacizumab at a reduced dose,

Mike was advised to continue his routine medications and activity.  He was advised to avoid direct sun exposure.  The doctor stated his liver enzymes were improving.   He is to return in 2 weeks for cycle #4.


Monday, August 24, 2016

Cycle #4.  Per doctor, Mike is responding nicely,  He stated Mike had no significant toxicity and was adequately palliated.  Return in 2 weeks for cycle #5.

RESULTS OF LAST ONCOLOGY VISIT AND RECENT STATUS

Saturday, July 4th, 2015

Happy Fourth of July!  

Well........Mike's CEA level as of June were disappointing.  With everything that Mike has been doing to try to hollisticaly treat his cancer himself, his CEA level rose to 3534.  His liver profile levels have risen as well.    At that time, Mike still did not want to give into chemotherapy.   He wanted to give it another month to see if he could knock that number down himself without taking on the damaging chemotherapy.  Mike is scheduled to return for a repeat blood test on July 15th and a follow up on July 22nd with his oncologist, however, Mike has resigned to the decision that he is going to have to do chemo again to get that number down.  He has said that the only thing that will get him through this round of chemo would be knowing that he has the opportunity of returning to Germany.  So we are going to try to do our best to save as much as we can and do some fund raising to get the money for him to go to see Dr. Weber.  However, Mike has a call to his oncologist who is on vacation this week so that he can get things going to start the process to start the chemo.

About 3 weeks ago, Mike was having pain in his side that he thought was probably coming from his liver cancer.   At that time, he decided it was best to go to the Emergency Room at our local hospital. We checked in, but unfortunately after waiting 4 hours in the waiting room, Mike decided he could not wait any longer.  We left without him being seen so he could go home and lie down.  

This past week on Monday, Mike started having pain again in his stomach area.  He developed sweats but at the same time was freezing.   He sweated so much that he had to change his clothing.   As the week went on, he felt better.    Last evening after dinner, Mike decided to lie down and take a nap.  Once again, he woke up with pain in the stomach and was soaked, but yet could not get warm.    He went to bed, got up this morning with all the same symptoms and decided he needed to go back to the Emergency Room.   Luckily this time, he was taken back to the treating area right away.    He was started on fluids, had blood drawn, and a CT scan was ordered.    The doctor came in after reviewing the test results and talked to us. He said the CT scan showed the liver nodules were a little bigger and that they were probably stretching the capsule around the liver,   He said that was probably causing the pain and also causing the itching.   He said there was some fluid in his stomach which was due to some inflammation.   He said that could cause the fever.   He is discharging Mike with a pain medication and told him to take some Benadryl for the itching at night as it makes him fall asleep..  During the day, he is to take Tagamet,  Pepsid, or Zantac  which will act as an antihistamine to help his itching.    He also told Mike to call his oncologist on Monday and have him look at the scan and get things going for treatment.

I know the thought of what Mike will go through during the chemo has him dreading the upcoming days, weeks, and months as he knows how he will suffer through it.  It just breaks my heart as well knowing how much this will take out of him and watching him go through this.  My prayer is that he is able to tolerate this as best he can without too many difficulties.  I send prayers and well wishes to everyone else who is going through this awful disease.

"I can do all things through Christ, which strengthens me."   PHP 4:13

FOLLOW UP WITH ONCOLOGIST FOR CEA TESTING RESULTS

Sunday, April 26, 2015

Mike had his follow up appointment with his oncologist last Monday, April 20th.  I did not go to the appointment with him.   Mike stated the doctor came into the exam and and asked him if he was there for chemo.  Mike told him that he was not, and the doctor said he did not think he was.   He did his normal exam on Mike by listening to his lungs, having him lay back on the exam bed and palpating his neck, under his arms, and his stomach.

He relayed the result of his CEA (which we already knew) and just said that it was lower than it had been in January.    He told Mike that he looked good  and told him to keep doing what he has been doing.

Mike has been eating apricot seeds every day.  He eats a total of 24 every day.  Laetrile can be found in the apricot seeds.

Laetrile (i.e. amygdalin or Vitamin B17) therapy is one of the most popular and best known alternative cancer treatments. It is very simple to use and is very effective if used in high enough doses and if the product is of high quality and if it is combined with an effective cancer diet and key supplements.  Laetrile works by targeting and killing cancer cells and building the immune system to fend off future outbreaks of cancer. It uses two different methods for killing cancer cells. It involves a strict diet (as do all cancer treatments) and several supplements.   

The FDA has made the purchase of laetrile supplements almost impossible to obtain, even though it is a perfectly natural and safe supplement. In order for a doctor to use laetrile supplements, they or their patient must “confess” to the FDA that the doctor is using laetrile in their practice. In other words, laetrile supplements are effectively illegal because no doctor wants to admit they are using laetrile.  Fortunately they are available over the Internet either as apricot kernelsor pills and in some cases in liquid form.

Most people take laetrile in the form of apricot kernels. In the middle of a peach or apricot is a hard shell. If you break open the hard shell with a “nut cracker,” pliers or hammer, you will find a small seed/kernel in the middle that looks like an almond. However, it is much softer than an almond and certainly does not taste like an almond. It is this seed that is rich in natural laetrile.

Read Morehttp://www.cancertutor.com/laetrile/

Mike is also using Cellect- which is a multi-mineral, multiamino acid, multi-vitamin supplement, with anti-cancer products added in.Cellect is created by biochemist Fred Eichhorn who himself had "terminal" pancreatic cancer in 1976. Fred is alive today and the current president of the National Cancer Research Foundation. It has been reported that the powder Cellect shown excellent results with all forms of cancer.

National Cancer Research Foundation
www.ncrf.org, 30 Aug 2014

The cause is the result of the nutritional deficiency altering the environmental source, which, upon re-establishing the correct nutritional levels in the body, the environment would be corrected for normal body functions and no longer be provisional to the cancer's survival, the cancer will soon die as a result. Due to genetics, each person has different vulnerabilities to different deficiencies, therefore, genetics will determine the type of cancer vulnerability. 


A follow up CEA blood testing has been scheduled for June 3rd. Mike's follow up appointment with the oncologist has been scheduled for June 10th.  Hopefully at that time we will not see an increase in Mike's CEA level.

BRINGING EVERYONE UP TO DATE ON WHERE MIKE STANDS IN HIS FIGHT

Sunday, April  5, 2015

Mike and I would like to wish everyone a Happy Easter.  Easter has a special meaning this year as Mike has come to know and accept the Lord as his Savior.   We started going to a local church the week before Thanksgiving and became official members in January.  Mike was also re-baptized in February. His faith and spirituality have added to his well being in fighting his cancer.

It has been awhile since I have written any updates on this blog.  I have had other things that needed tended to, so my posting got pushed to the bottom of my to do list.   I myself have been struggling with some "winter blues/depression" due to our long and cold winter as well as stress from my job, taking care of things here at home, and living with our life of Mike fighting his cancer.   I have felt that Mike's cancer is defining our existence again with so much emphasis being placed on the things that Mike is doing in his fight.  I will go into that in more detail further into this post.

Mike arrived for his first FOLFIRI chemo treatment on Monday, January 26th.  This drug made him sick even before he finished receiving it and leaving the cancer treatment center that day.  Mike went to his workplace and got things ready to go for his next day at work.   He got up the next morning, January 27th, and went to work as usual.  However, he only was able to tolerate working until around 10:00 that morning.  He had to come home because he felt sick and tired.   He did not experience being this sick and tired with the FOLFOX.   As Mike progressed through the rest of the week, he slowly felt better.    His anti-nausea medicine really did not do anything to help him.   Mike then had his 2nd chemo treatment on Monday, February 9th.  He again experienced the same sickness and tiredness as he did following the 1st treatment,   He ended up coming home from work mid-morning the next day.   It was very hard for me seeing Mike not feeling well and knowing that there was nothing I could do to make things any easier for him.  His employer (and great friends) have been really good to both Mike and I.   He said that he was not going to allow Mike to continue working the day of and the day following his treatments, especially due to Mike feeling so tired that he was having trouble staying awake while doing his job.  

Mike had scheduled a follow up appointment for his 3rd chemo treatment for February 23rd. However, at this point, Mike decided that he was no longer going to do any further chemo treatments so he decided to cancel that appointment.    I called the oncologist to see if we could come in and talk to the him because I wanted to keep an open relationship with him in case Mike needed him for further care.   They also wanted to have this documented in Mike's records so that if anything further was needed down the line and needed to be approved by his insurance, they would have information.  That appointment was scheduled for February 25th.  When the oncologist came in, he asked what Mike wanted from him..  Mike told him that he did not want to do any more of the chemo treatments because he wanted to try some things on his own. The oncologist stated he wished Mike would have done a total of 4 treatments and then had testing to see if the cancer was responding to this drug. He was not happy that Mike was once again deciding to take matters into his own hands as far as his cancer was concerned.

 We asked the oncologist about his surprise that Sloan Kettering had not wanted to do clinical trials on Mike because he was not symptomatic.   He stated that Sloan would not want to accept Mike into their program if he would not follow through with that program in it's entirety.  He stated that would throw off all of their results.  Mike told the oncologist that he was hoping to go to Germany in April.    Mike had some new things he wanted to try.

That leads me to the things Mike has changed in his fight.  His day is consumed with taking supplements, getting things prepared for his meals for the day, shopping for those items and supplements, doing coffee enemas, and doing some sort of heat therapy.  One such heat therapy is the infra red sauna he uses and the other is the BioMat which is something new he has started using.  

Mike ordered the Amethyst Richway Biomat.  The following is taken from their site: http://www.biomat.com

The core of the Richway BioMat technology is a combination of far infrared rays, negative ion effects and the conductive properties of amethyst channels. These three powerful health stimulators are combined in a single, easy-to-use product with remarkable healing properties. The amethyst BioMat delivers soothing, deep-penetrating heat while stimulating the regeneration of damaged cells in your body. It’s a safe and natural way to achieve optimal health now and maintain a stronger, more resilient body in the future. This highly effective therapy is now available to medical professionals and home consumers who want to improve health and well-being with products based on Nobel prize-winning scientific research pioneered by NASA and developed using pure, natural materials.

The following video will explain the purpose of the Bio-Mat.




Mike has been using this mat since approximately the beginning of March.  He uses it for an hour in the evening at 158 degrees.  He also uses  it at 109 degrees when during the night when he sleeps.  Mike's local alternative doctor was so impressed with the information about this BioMat that he ordered it for use in his clinic.

Mike has also switched to eating only raw vegetables such as cauliflower, broccoli, green beans, green peppers, as well as ingredients used in making salads.  He does not eat cooked vegetables because when they are cooked above 105 degrees, they lose all their beneficial nutrients.  He is allowed to eat fresh caught salmon or organic chicken (the size of a deck of cards) once a week.  He rarely eats any of these two items.  He is also juicing using swiss chard, collard greens, a green apple, ginger, romaine lettuce, squash, cucumbers, carrots, green peppers, cabbage, and a lemon.  He has given up carbohydrates, and dairy products.   He does do the Budwig procotol diet of Flaxseed oil and Quark/Cottage cheese.  

Quark and cottage cheese are rich in sulphurated proteins. When these proteins are mixed with fat, the fat becomes water soluble and no longer needs the liver’s help to be absorbed into the body’s cells. Dr. Budwig’s method saturates the body with omega 3 anti-inflammatory fatty acids, a process which oxidizes the cells and restores health at a cellular level.  (from Organic Lifestyle Magazine).

Mike had a new CEA blood test done on Monday, March 30th.   His CEA level is down to 255.4 from 626.3.   I was so excited and thrilled.   When I relayed the results to Mike, his expression was nonemotional.  His feeling on this is that we really do not know if the results are due to what Mike has been doing himself or if it is mainly from the two chemo sessions that he had done, but the last one chemo treatment was 7 weeks before this test.  I am hoping that his results are due to all the effort and discipline that Mike is putting into fighting this disease.  Mike had to reschedule his follow up doctor appointment with the oncologist, so he will not find out his response to this result until April 20th.  Mike feels that the oncologist will say that it is all due to the two chemo treatments.  We will have to wait and see how that turns out and what else he may have to say about Mike's decision to do no further chemo.

Mike has two other things he wants to add to his regiment of treatment.  I will go into detail in future blogs as they become available to him and he starts using them.  Everyone has to decide and do what is best for their personal fight against cancer.   What works for some, may not work for others,  Find out what the thing is for you can go with it.  Mike just knows that chemo is not a right fit for him.

MIKE NOT FEELING WELL JANUARY 18, 2015

Sunday, January 18, 2015

Mike started experiencing chills and then sweats on Wednesday night.   Mike does run a lower temperature than most.    When I took his temperature when he went to bed, it was 98.7 so that was up for him.   He was also starting a cough and had a headache.  The next morning he just sat on the side of the bed which is unusual for him.  When I asked what was wrong, he stated he did not feel well.  But, of course, he went into work.   I informed his employer that he did not feel well so he could ask him how he felt.  In Mike's usual fashion, he told his employer that he was feeling better.  I tried to tell Mike to call his family doctor.  This was how his pneumonia started  prior to his very 1st chemo treatment.

As he headed into the weekend, his cough was becoming worse.  It must have bothered him enough in that he called our family doctor on his cell phone to let him know what he was experiencing and that he was to start chemo on the 26th.   A prescription for Biaxin was called in for Mike to start taking.   

Mike is taking all of his supplements and was able to get time in infra red sauna which should help with the immune system.   We have to get him pumped up before he would start any more chemo.

CEA LEVEL 01/13/2915

Friday, January 15, 2015


I was able to obtain Mike's CEA level which is 626.3.  Mike thought it would surely be into the 1000s or 2000s by this time.    We will have to wait until his follow up appointment as to what Dr, Wyshock says and what Mike decides to do at that time.

I will let you know when that time rolls around.

FOLLOW UP WITH 2ND OPINION RESULTS 01/13/15

Wednesday, January 13, 2015

After returning from Sloan Kettering Memorial Hospital, I called Mike's oncologist's office the day following Mike's appointment at Sloan to make them aware that he had had the 2nd opinion and to be watching for the findings to come through.  I did not want this to slip through the cracks and not hear anything regarding this.  They gave me an appointment date of January 26th.    However, Mike called their office the following Monday and obtained an appointment for today.

The doctor came in and asked how we made out.  I am not sure if he had any correspondence from Sloan yet or not.   Mike told the doctor that I had notes. He then asked me what we were told.  I went through the list of the options that Dr, Veach had given to Mike.   When Mike mentioned the KRAS testing, Dr. Wyshock said he thought he had written for any biopsy tissue that the hospital had be checked for this and it had been checked.  This revealed that Mike did not have the KRAS mutation negative gene. His was mutated so the Erbitux drug would not work for Mike.

Mike asked about having another CEA test to see where his level was being that he had not had any chemo treatment since August before he went to Germany for the 2nd time,  The doctor agreed to doing this.  The blood was drawn at this appointment.   A follow up appointment has been scheduled for 2 weeks which will be January 26th.   They did go ahead and also scheduled Mike to begin the Folfiri. This would be given every other week like he had his previous chemo infusions.

FOL	= Leucovorin Calcium (Folinic Acid)
F	= Fluorouracil
IRI	= Irinotecan Hydrochloride

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways. A chemotherapy regimen consisting of leucovorin calcium (calcium folinate), 5-fluorouracil, and irinotecan is used in the treatment of advanced-stage and metastatic colorectal cancer.   This would be given along with Avastin which is a blood vessel strangulator.  It strangles the new blood vessels that the tumor makes and sends to spread the cancer.   Mike had this drug in his previous chemo treatments.

Dr, Wyshock stated this was the most aggressive treatment.  He said he would use this to try to shrink the tumors.  If it would not work, then they would try something else.    

He mentioned the drug Stivarga which would be used after all other options have been exhausted.


Stivarga (Regorafenib) which is approved to treat:

Colorectal cancer that has metastasized (spread to other parts of the body).  It is used in patients who have not gotten better with other treatments. So now we wait to see where Mike's CEA level is at.   Mike wanted to leave his options open as he would like to try to return to Germany in April if we can come up with the funds to return there for immune building treatment.

SLOAN KETTERING MEMORIAL HOSPITAL APPOINTMENT FOR A 2ND OPINION

Wednesday, January 7, 2015

Well Mike and I made it safely into New York City with out any difficulties.   We left after work last night.   We arrived in the city around 9:30, found a parking garage located right under our hotel, checked into Doubletree  Hotel, and were both in bed by 10:00.   We thought we would venture around the city a little bit in the morning before Mike's appointment.  The room was very nice and the beds so comfortable.   The weather that night and the next day were predicted to be very cold,   I guess due to us both working all day, the three hour drive, the comfortable bed, warmth of the room, the room darkening curtains, and not being on a too busy street, we were able to have a good, sound sleep. Mike is one to not sleep in.  On the weekends he is up anywhere between 3:00 & 5:00 AM.   However,  he did not wake up until 8:50 AM.   His appointment was at 10:00 AM.    We rushed to get around and, therefore, were unable to site see before his appointment.

We walked the two blocks from the hotel to the hospital.   This outpatient center does not stand out as a regular hospital.   We were standing on the street trying to locate the address when I turned around to ask a gentleman for help and discover the hospital's logo on his jacket.  We were standing right in front of the entrance.   We went inside and took the elevator to the 5th floor where we were greeted by a very friendly receptionist.  She gave us paperwork to complete.  While I was completing the paperwork, They took Mike to get his temperature, blood pressure, height, and weight.  We were then taken to an examination room about an hour later.   Dr, Veach same into the room and stated he had reviewed Mike's records, but wanted to hear Mike's telling of his journey thus far.  He then did a brief exam and did some strength testing.  He told us he heard a drop in Mike's heart beat which he called atrial arthymia.   After that, he asked Mike - "what is it that you want from me". Mike told him that his oncologist suggested seeing an oncologist who specialized in the type of cancer that Mike has.

Here are the options that he gave to Mike:

1)  He could continue with the Folfox that he has already had  (two rounds).  He stated the pro for this treatment would be that Mike would know what to expect from it.  The con was that the tumors have already experienced this drug so the response to this "cocktail" of drugs goes down to a 30% chance of working.  This treatment would also have an accumulative toxicity.

2)  He could try Irinatecan (AKA Camptosa).  This drug is classified as a plant alkaloid.   The pro to this would be that the cancer has not experienced this drug.  He stated it would be the most aggressive with the best chance of working for him and that there was no dose limiting toxicity.   The con to this drug is that it can cause diarrhea.   This occurs in less than 30% of patients who receive it.  This drug is given by infusion over 90 minutes.

3) KRAS testing.  This is done using tissue from the liver biopsy.  It can tell you what to use.  I still do not quite understand this so I will explain it using information I obtained off the internet.
 
     This test detects specific mutations in the KRAS gene in the DNA of cancer cells & tissue.  The presence of mutations may indicate that certain drugs may not be effective in treatment the
cancer.

  With this testing, Dr. Veach suggested a drug, Erbitux, which has been approved for treatment of patients whose colorectal cancer has spread to other parts of the body,  Only patients whose tumors have a KRAS mutation negative gene (commonly known as "wild type" and whose tumors have a protein called Epidermal Growth Factor Receptor (EGFR) should receive this.  The con to this drug is that is causes skin problems such as an acne like rash, skin drying and cracking. The acne/rash would then have to be treated with steroids.

4)  Experimental treatment.

     They could take a new biopsy of the liver to test for mutations to see what the tumors need to grow.  They would then somehow stop giving the tumor what it needs.  They would look for molecular abnormalities.

     Immunotheraphy which is not a treatment of cancer itself,   This use the body's own immune system to help fight the cancer,  It stimulates the body's own  immune system to work harder to attack the cancer cells..  It "takes the breaks off the immune system and lets it loose on the cancer while shutting off immune support".  The immune system is reved up.    It can also attack the good cells and make antibodies against itself.  If this would happen, then they would stop the drug that is boosting the immune system and give the patient steroids.  This would have to be done at Sloan Kettering.

Since Mike is "asymptomatic", Dr. Veach stated he would not recommend any experimental treatment.

Dr. Veach then sent Mike up to the 7th floor to have an EKG to document what he heard when listening to his heart.  By this time it was 11:45.   The transporter told us that the EKG was scheduled for 1:00 but he would take us up there and have us check in. He said that maybe they could get him in earlier.  We checked in and they told us to have a seat.  They came right out for Mike and took him back for this testing.  Before I could send an email to my and Mike's coworkers, Mike was back with the print out in his hand to take back down to Dr, Veach.    The doctor said it show the "drop" and gave Mike the print out to bring home to have it to compare to any previous EKGs that Mike may have had done for prior surgeries.  He stated it was not really anything to be concerned about nor something for which he would need medication.  It was just something our family doctor could watch.

So we left Sloan Kettering with this information.   I knew Mike was anxious about getting out of New York City before there was any major traffic.  I asked him if he wanted to eat lunch there or drive out of the city and get something to eat along the way.  He decided to eat there.  We did not, however, take time to find a different or special place to eat in the city.   We saw a guy walking carrying a Subway bag so we asked him if there was one close by.  We went there for lunch and then headed back to the hotel to pick up our bags that we had put in storage.   We called ahead to the parking garage so they could get our car ready to be picked up.  We had the parking validated by the hotel and we started our journey home from 51st Street around 1:00 PM.

Mike concentrated on the driving while I kept an eye on our directions and obstacles up ahead in our lane.  We followed the GPS and headed out of New York City unscathed and without any problems. We encounterd a couple of snow squalls on Interstate 80 on the way home.  There have been some recent major accidents on this interstate due to snow squalls,  I told Mike that if it got bad, we were going to pull over and not try to continue in that.  Luckily we did not have to do that.  We drove straight to our dog groomer's house who had kept our 3 dogs while we were away and made it back home around 5:30 PM.

It was a quick trip in and out of New York City.  We did what we went there for and will bring that information back to Mike's oncologist and decide on how to proceed from here.