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.