Christine's Second Surgery

First Chemotherapy

After an amazing logistical effort by the team, in particular Dr Blumenstein's clinical nurse Jancy John, Christine had her first infusion of the induction chemotherapy treatment today. This was a six hour session at MD Anderson downtown having what is known as the TPF regimen. This consists of the drugs docetaxel, and cisplatin, which were administered intravenously, and fluorouracil, which is administered as a continuous 24-hour infusion for 4 days. These drugs have been FDA approved for this type of cancer for quite some time, but are administered much more often now because the side affects can now be managed more effectively with other modern drugs. This process is repeated every three weeks, after which there will be a scan, and blood analysis to review progress. It is likely that Christine will need at least three, if not four of theses cycles, before we can even consider surgery. Andy and Christine have subsequently received training on how to flush her catheter which needs to be done on a daily basis. We are hoping that once everything becomes more routine, all of the treatments can be moved to the MD Anderson satellite hospital in Katy.
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Surgery Off

Christine received has just a call from Dr Pytynia to say that the tumor had grown so much that she felt that surgery was not the best way forward. She would have had to take half of Christine's face away, and still would not be certain in removing all of the cancer. The course of action now is to have an aggressive chemotherapy treatment, probably starting on Monday. This systemic approach will hopefully kill any cancer within Christine's body, and shrink the cancer in her face. Once this was happened, we will revisit the surgery route. I will keep you all updated as we hear more.

Immunotherapy Off

Christine and I spent the last two days at MDA downtown. It turns out that this was a complete waste of time, because, in their wisdom, the Ohio based leader of the immunotherapy program decided that Christine did not meet the necessary criteria. This, after four weeks of tests, approvals, consultations and boosting of expectations. We were not impressed.

What made it worse was the total lack of communication and empathy displayed by the program representative based in Houston. We were just about to go in to get the immunotherapy treatment, when she called for us go to another building, to meet with our oncologist. Despite calling her, emailing and paging her, she never even bothered to come and see us. She basically passed the buck. So unprofessional.

We waited another three hours before we finally go to meet with Dr. Blumenschein, who had unfortunately been backed up with other patients. He was equally as upset as we were, was very apologetic. He promised to take action to make sure that future program admission procedures would ensure that this does not happen again.
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Dr Pytynia showing Christine the bad news

The plan going forward is basically the same, but without the immunotherapy. Dr. Pytynia and her team will perform surgery on December 27th to remove the tumor. Once the tumor has been removed, Dr Garvey and his team will remove some soft tissue and capillaries from Christine’s arm, to fill in the void where the tumor was, and join everything back together again.

This will be followed by about a week’s recovery in hospital. At the end of January, Christine will start six weeks of radiation therapy, with the option to also have chemotherapy if the pathology warrants it. The good news about not having the immunotherapy treatment, is that the radiation/chemotherapy treatment can now be done in Katy.
Tom
Tom, in the house to give a lending hand

Thanks again for all of your kind words, and support. It means a lot to us.

Here We Go Again!

Well, we promised you an update in mid November and we thought it would be the last one. Unfortunately a lot has happened since our trip to UK, visiting parents, kids and grandkids. Sadly, the cancer has returned as a big lump on the left jaw line, close to the original surgery site.

After a series of consultations, CT and PET scans, the plan of attack is to have a series of seven immunotherapy infusions three weeks apart, starting on 17
th December, another extensive surgery on 27th December to remove the tumor, and radiation treatment once I have recovered from the surgery.
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Dr Blumenstein showing the imaging results

The immunotherapy treatment is a research trial for exactly this kind of cancer, and the oncologist thinks that this is the best option. There is the more conventional chemotherapy treatment that can be used alongside, if necessary. Check this
BBC article that explains the immunotherapy process very nicely.

So, we start the waiting game again, and see what happens. Physically, apart from feeling tired, I’m fine. I have no pain, just a huge hole in my face where the tumor is making an attempt to escape (better out than in, right?).

I have full 100% confidence in my most excellent medical team, and trust them to do their best for me. I’m trying to look for the positives in all of this, and I hope that it works for me and, just as importantly, the research results help many more people in the future.

I am quite at peace in my mind with it all, and won’t think about “what if’s”. We just take one day at a time, and try to carry on a normal life.

It's going to be another long haul, and we are both grateful for all of the support that we have received. Andy will update again after surgery.