Happy: A Quest for Life After Death

Friday, March 27, 2009

Stable Bad

He made it. Despite nausea and misery every week for eight weeks -- long after most other people would have dropped out of the clinical trial, according to the oncology nurse -- Mat finished the clinical trial drug cycle.

Unfortunately, AV-412 didn't quite match Mat's level of commitment. He had a CT scan on Tuesday, and got the results Wednesday. The cancer was technically stable over the eight weeks, but according to Dr. Ryan, there's stable-good, and stable-bad.

The results showed stable-bad. Although most of Mat's tumors (lungs, liver, and lymph nodes) stayed about the same size, there was noticeable growth in one in particular (a bone tumor) that led Dr. Ryan to think Mat should be in the market for a new drug. Dr. Ryan is looking into other clinical trial options, or Mat may revisit a drug he tried in 2006.

That was a combination of two drugs: adriamycin and streptozocin. Infusions every day for five days, and then a week off. That treatment was hard to tolerate, but not as hard as AV-412. We have AV-412 to thank for redefining our expectations.

And as I often say, it's all about expectations.

Saturday, March 14, 2009

It's working!

Mat's body is a lot smarter than he is. After two weeks of nausea and hospital visits for hydration, Mat showed up at MGH for clinical trial week #5. He swallowed his dose of AV-412 (the catchy name for the chemo) ... and promptly threw up. Since the drug didn't "stick," he got an impromptu vacation from chemo for the week.

That combined with the two prior weeks of misery convinced his doctor to get an early CT scan to see if it was worth it to continue this fun-fest. The scan results showed that the cancer hasn't growth in the last four weeks, which is pretty good for being on the chemo such a short time.

Mat was able to spend the rest of his chemo vacation week resting, and week #6 has gone better. Despite being on six (count 'em) different drugs to control nausea, chemo day (Monday) was every bit as miserable as all the other chemo days. The improvement was on Tuesday, when he spent a day at MGH getting IV fluids and sleeping to make up for the day before. Mat was also scheduled for fluids on Thursday, but felt well enough to skip that appointment.

We do spend a lot of time thinking about the trade-off of quality of life for quantity of life, and have been very close to throwing in the towel on AV-412 several times in the last few weeks. But if the misery is mostly confined to Monday and Tuesday, well, it's still not a picnic in the park, but maybe we can have a little quality and quantity.

Some people are so hard to please.