Re: his Team of Doctors:
Bruce has a very skilled multidisciplinary team working for him. His lung cancer doctor is Renato Martins MD, MPH Medical Director Thoracic/Head and Neck Oncology, who is located in the Seattle Cancer Care Alliance Clinic (SCCA). Dr. Martins is originally from Brazil, trained at Carney Hospital in Boston, resident at Gundersen Clinic in Wisconsin, Fellowships at Massachusetts General/Harvard Medical School, received a Masters in Public Health from Harvard and was Chief of Medical Oncology at the Brazilian National Cancer Institute.
His neurology team consists of Dr. Jason Rockhill, MD, PhD. a radiation oncologist, for his brain, and Dr. Maciej Mrugala, MD, PhD, MPH, a neuro-oncologist, for his spinal fluid. Both doctors are at the University of Washington Medical Center. (UWMC). Dr. Rockhill’s education is from the University of Illinois with a postgraduate residency at the UW Cancer Center. Dr. Mrugala graduated from medical school at the University of Warsaw and received his Ph.D. at Copernicus University in Poland.
Re: his Chest Tumors:
Bruce was seen by his chest oncologist (Dr. Martins) today who reiterated what we had learned from Dr Rockhill (his brain doctor) last week when we were able to compare his CT chest scan from last week with his CT scan from about a month ago. There was both good news and bad news. The bad news is that despite three different chemo “cocktails,” his chest tumors continue to grow in size and scope. The chemotherapy is having little effect on reducing or eliminating the 3 major tumors in his chest that Dr. Martins is tracking. Bruce doesn’t have many options for treatment remaining- at least treatments that have been show empirically to be effective.
Today, Dr. Martins gave Bruce the option of trying a drug given in pill form called Darceva. His doctor helped to bring this pill to market based on his own research. This is a pill that inhibits the growth of cancerous cells and has been most effective for people with lung cancer who have never smoked. Because of Bruce’s smoking history, this pill will probably be less effective in staving off the growth of cancer cells, but the doc did cite a couple of cases where patients with a smoking history have had success with the drug.
Bruce wants to try the drug and will start taking it as soon as his radiation treatment next week is complete (see below). The bad news about this new drug is that he will have to relive his teenage years and the curse of acne (a side effect along with diarrhea).
If this pill doesn’t work (we’ll need about 6 weeks and then run another CT scan to compare it to the CT scan taken last week) then probably the only recourse is to stop treatment of the chest tumors altogether or find a clinical trial with even greater risks for effectiveness.
The good news is that Bruce’s weight remains stable (a very good indicator) and his appetite remains strong (yes, he eats bacon, eggs and hash browns as often as he can!). He also can take care of his activities of daily living (bathing, dressing, etc.) He still has between 94 to 96% oxygen intake, even doing the stairs, and so currently will not be on oxygen. He has also had only 1 headache that was treatable with plain Tylenol (as opposed to Tylenol with codeine).
Re: his Brain Tumors:
The latest brain MRI shows the growth of 4 new lesions. Two of them are sitting on the edge of his 4th ventricle and have the greatest risk of having cancer cells enter his spinal fluid. This is something we definitely don’t want to have happen as it can lead to greater pain, incontinence, and maybe even paralysis. The doctors have suggested a procedure called Gamma Knife Radiation that has the best chance of getting rid of these tumors. It’s a short term solution (the cancer cells are likely to grow back given that he underwent full brain radiation just after his surgery and cancer cells have already grown back). The doctors think that his kind of treatment might help restore some of his balance and alleviate some of his double vision. In any event, it has the potential of making his visit to Salt Lake in June easier. (Yes, we are working on getting him in shape so he can travel!!!)
Last week Bruce had a spinal tap to see if there were any free flowing cancer cells in his spinal fluid. The great news is that they took a good sample and could not find any cancer cells. The cautionary news is that this test is not exact and may have reported a false negative. So Bruce may have another spinal tap in 6 weeks.
Re: his overall symptoms we are tracking
Bruce continues to have trouble with his balance and his double vision, and is experiencing some trouble with his hearing. He is very tired and climbing stairs can be exhausting.
He still visits grandma a couple of times a week and joins me when I take her for rides and to the park near her house to watch the ferries and other boats enter Elliot bay (where downtown Seattle is).
He would like to eat breakfast at every meal, but Barb and I can still take him into other foods.
Other Item/News
He loved getting the pictures from his nieces and nephews. They were such fun to look at. You guys were great to send them.
Where we go from here:
The doctors are optimistic about Bruce being able to travel to Salt Lake in June, especially if the gamma knife radiation procedure goes well. Keep your fingers crossed and keep him in your prayers. His goal is to get to see family and to get to see Jean so we are working hard to make this happen.
Love from all of us who are Sleepless in Seattle!!!
