We have decided to go with the FOLFOX chemotherapy treatment, consisting of 5FU, Oxaliplatin and Avastin.
Lowell will be on this chemo regimen for about three months, at which time they will stop the Oxaliplatin, as it causes neuropathy (numbness) if left too long. Lowell will then continue with just the 5FU and Avastin for three more months (six months total chemo), barring additional info which would make them change the regimen (i.e. treatment not working). We also asked Dr. Whisenant about Avastin, as one of the oncologists in Jeff’s hospital (University of Virginia) voiced some concerns with it. Avastin patients have been known to have a very slight increased risk of stroke and heart attack, as well as an increased risk of GI perforations (1 in every 200 patients). 95% of patients have no side effects from taking Avastin and one of the positive reasons for its use is a 15 to 20 % increase in tumor shrinkage. The doctor said he would go with this treatment if he were in Lowell’s position. If this treatment doesn’t work or we want to pursue the debulking/heated intraperitoneal therapy, Dr. Whisenant recommends we go to see Dr. Andy Lowy in San Diego, who specializes in this. (Hmm, San Diego.) Here is the schedule for the next few weeks:
· Lowell will have a PET scan on Monday to use as a baseline, although Dr Whisenant isn’t sure the cancers are large enough to show up on the scan yet
· Tuesday we are signed up to attend a Chemo class
· Wednesday they will call with a time to come in for the port insertion surgery
· Thursday we will go in to have the port implanted. The port-a-cath is placed under the skin on the chest. The catheter is then inserted into the superior vena cava vessel at entrance of the right atrium of the heart. It is approximately a one-hour procedure. The port-a-cath can be felt under the skin and the nurse can find the entrance by locating the edges of the port and inserting a special needle (called a Huber needle) into the soft middle section. Medications can be given through the port-a-cath and blood can be drawn from it eliminating the need for a blood draw from the arm. The use of a portable pump and port-a-cath allows the medication to be given over several days in a home setting rather than as a patient in the hospital. There are no dressing changes required but there is some maintenance involved
· We start chemo on Tuesday, March 2