PET Results The Fight Goes on...

It is time for us all to stand and cheer for the doer, the achiever -- the one who recognizes the challenges and does something about it- Vince Lombardi
Aappropriatete quote for the week after the Super Bowl.

Well, the PET was not a ray of hope.
The good news: one node on his trachea is gone-the other two have shrank again! The neck, arm and some back potential melanoma hot spots are gone.
The other bad news: three spots on his left thigh, a swollen node near his kidney and some superficial spots on his back in his muscle or deep tissue.

Dr. Wyzinski is annoyed because the IL2 showed potential. Usually 9% of melanoma patients see good results and 1% get mixed. Karl is in the 1%. Dr. Wyzinski thinks that the IL2 was not as effective as they hoped, and Karl's heart took a beating (haha) on the last round, his LVEF (left ventricle ejection flow rate) is low. They don't want to cause permanent damage to his heart. So we are going back to the original treatment he had when he was first diagnosed with melanoma- which if you all remember killed the disease and kicked him in remission for 6 months. We were like "HURRAH" because:

1)Karl goes in to get the chemo at the center and can still work- he use to go into work after being infused in the morning. He also can work via computer during infusion so hurrah for VZ! His quality of life is better, he's able to do more and stay healthy.
2)It's a walk in the park compared to the IL2 and we know it works.Hehe was clean last time after 3 months.
3)My caregiver role is diminished so I can work more and do more with Anika and Karl.

So after the brain surgeries, Karl with start radiation and chemotherapy in March. He can do both together as the radiation is at the center and takes 10-15min to do. He will probably be taking Temedol via tablet at home along with 2 weeks of 5 days of infusion of chemotherapy drugs (DTIC), two weeks of supporting fluids and repeat the cycle. This will be done for at least 5 months. His side effects are manageable including fatigue, mouth sores and loss of appetite. We talked and feel that he's going to have a better time this round because we know what to expect and can manage his nutrition and health issues before they happen. The juicing works and we have a good idea what he likes and doesn't like when it comes to veggie juices! He is also walking every day to try to build up muscles and his stamina.

Oh also we are looking at clinical trials out there for melanoma and trying to get Karl on one locally or at MD Anderson.

Here's a link to one article on Temedol and it's effectiveness: http://www.looksmartcosmetic.com/p/articles/mi_m0PDG/is_1_2/ai_110152644

Thalidomide and temozolomide in the treatment of metastatic melanoma - Skin Cancer Foundation UpdateJournal of Drugs in Dermatology, Jan, 2003 by Wen-Jen Hwu
Melanoma is the third most common cancer to metastasize to the brain. Due to the extremely poor prognosis (median survival is often less than 6 months) and lack of effective therapy, patients are often excluded from clinical trials. However, melanoma is a highly vascularized tumor, suggesting a possible role for an antiangiogenic agent in combating metastasis. Thalidomide has been shown to possess antiangiogenic properties. Preliminary research indicates that the combination of thalidomide and temozolomide--an oral congener of dacarbazine (DTIC)--may offer improved therapy for advanced melanoma.