Thursday, February 25, 2010

Pokkin & ah Proddin & Genotypin

Just got the important post IL-2 scans scheduled.  CTs and MRI are scheduled for March 9th.  PET is scheduled for March10th.  Dr. Kaufman and I will meet right after the PET to determine whether the IL-2 had a positive impact or not.  If IL-2 is successful, I will head into four more series of IL-2 requiring four inpatient stays.  If not, we will see if my brain is clear of lesions.  If I am clear, I will again be eligible for some clinical trials which we will evaluate as well as chemo combo options.  

In the meantime, I finally secured my primary tumor from Evanston.  It is now in the hands of a lab at Rush for B-RAF testing.  If any of you saw the NYTimes Melanoma series I posted this week, you'll know why that mutation testing is critical.  I have a 40-50% chance of having the mutation which may make me eligible for a new Phase III trial using PLX-4032.  

I cannot emphasize the importance of patients keeping ownership of their tumors, should they face chronic illness.  The days of one stop shopping for treatment are over.  If you are lucky enough to survive, you may very well find yourself following the best research and the qualified expertise...which definitely moves around these days.  Of course, getting my second tumor block out of the National Cancer Institute is a lesson in patience and determination.

Thursday, February 11, 2010

Susan is a 5 Round Champ!  She rested better than ever last night due to the mix of  "cocktails" she imbibed in (of the medicinal nature)!  She just started the drug protocols that will help to eliminate the water weight gain and will hopefully be discharged late afternoon or early evening today.  No appetite, but the legs are strong for walking!

Wednesday, February 10, 2010

It is Wednesday night at 7 pm and Susan is now on Round 5.  Her blood pressure continues to be at normal levels and Dr. K is even considering a Round 6 (tbd Thursday at 5 am).  As expected, the itching is more problematic this go-around but Susan is managing with ice and benadryl.  She's even been able to catch a few winks off and on.   Thanks to everyone who continue to keep her in your thoughts and prayers! 

Tuesday, February 9, 2010

Rush Update and News

All is going well at Rush so far.  The 3rd dose of IL-2 is flowing now as I write this post.  Unlike the last series, Susan has not had blood pressure problems and therefore no additonal meds are needed to sustain it at reasonable levels.

And there is good news!  Susan's LDH levels are at a normal level for the first time in months! (LDH levels are a measure tumor activity. )  Dr. Kaufman is very happy about this level and other good indications of a positive reaction. Not only is he hoping Susan's t-cells respond to the IL-2, but also the modified cells that were given to her when she was at NCI.

He also discussed with us the rates of response to IL-2, which are higher than we have read about in the literature.  Every article sites a 6-11% response rate, but in actuality, a higher percentage of patients do respond:   
      6%  have complete regression
    10%  have partial response
    15%  are stabilized for 3-4 years
We are directing our hopes and thoughts to be on the right side of those odds!

Lest you think it is all business here, we have lapped this floor a million times, are in pursuit of Bruce and others and have solved many family, local and national problems!   Karen

Friday, February 5, 2010

Susan's Back Story: My 5 year Sword Play with Melanoma

It has been suggested to me that because this blog is growing so quickly (close to 500 visits in the first month), that not everyone knows how I morphed into this "Medical Tigress".  So for those of you interested in the gory details, here is my back story.

On January 8, 2008, the world’s largest and best-funded Melanoma Center released me.  After almost three years of treatment at the National Cancer Institute in Bethesda, Maryland, including three clinical trials, 40 platelet units and 60 blood units, hundreds of thousands of tax dollars, and the collective intelligence of some of the best and the brightest, Melanoma was defiantly consuming my liver and spleen.   A chemo called Temodar was prescribed.  This can be the kiss of death for Melanoma patients.   It is given when all hopes of survival are relinquished.  Temodar is only effective in 10% of Melanoma patients.  I was given 6 to 12 months to live.

As a mother given 6 to 12 months, I quickly set real clear goals.  I taught my sophomore son how to investigate colleges and interview the good profs…a year before any of his peers even had to say ACT.  I volunteered with my eighth grade daughter, at the Therapeutic Riding Organization of Tucson so she could learn the joy of marrying her love of horses with service.  I swallowed my pride as a “real” world traveler and booked that dream cruise my husband wanted even though it was the antithesis of global sensitivity.  I drilled into my small business staff that they were trusted, capable of taking initiative, and must help the company grow if I could not. Then I convinced an Olympic medalist to coach my patient advocate team to row crew for an 8 women boat, so they could get a much-needed mental break.  Nausea was defied when my advocate team convinced me to start training in the boat too, so that we could race the local high school girl’s crew team.  It was also critical to educate the public about the value and impact of platelet donations.  And just because I was still standing, I agreed to teach middle school kids how to take the lead in a village fundraiser by owning their message and staying on task.  Nope I wasn’t manically trying to fit the rest of my life into one year, no not me.

While frantically reaching for goals, I was still left with the reality of having to breathe and lead a normal life as the six and then twelve-month deadlines past.  I argued with myself in the shower about whether Obama was really the only one who had the audacity of hope.   Occasionally, I submitted myself to new clinical trial eligibility assessments only to be humiliated.  Sheepishly and with great frustration, one day I admitted to my advocate team that I was tiring mentally and physically.

On October 28, 2009, after twenty-two and a half months of chemo, lab tests indicated that the monster was running loose again.  Subsequent scans showed that not only was I out of remission but that Melanoma had the audacity to hit my brain.   There was only one problem.  It was clear to my local oncologist, palliative care doctor, advocate team, friends, family and even my mother, that I was still strong enough to fight, which meant that it was time to defrost hope…not an easy thing to do after some of the top research docs in the world had basically deep freezed that belief.

After wrangling with my fears for two days, I sat down and researched every clinical trial.  Only one stood out.  A company called Biovex had a new biologic that made it to Phase III.  The trial had a 30% response rate, with minimal side effects.  Furthermore, the Oconovex trial’s Head Researcher was Dr. Howard Kaufman, Rush’s Director of Cancer Programs, right here in Chicago.  I called Rush but no one knew Dr. Kaufman, nor was he showing up on Rush’s website.  Frustrated, I picked up the phone and called the CEO of Biovex in London.  Within one hour his Chief Medical Officer, based in Woburn MA, called me and explained that Dr. Kaufman was still directing Columbia University’s Melanoma Clinic and would be moving to Rush December 2nd.  He called Dr. Kaufman that day on my behalf.  On December 9, 2009, I was the first Melanoma patient Dr. Kaufman met at Rush.

I did not select Dr. Kaufman just because he was willing to see me.  In fact the day before meeting him, my advocacy team and I interviewed another Melanoma specialist at one of Chicago’s premier research hospitals.  I chose Dr. Kaufman because he sees a treatment plan with many options and believes he can keep me alive long enough to be on the receiving end of far more effective treatments.  For the first time since the onset of this disease, I am being offered better response rates than 6% or 11%.  My tumors are finally being genotyped so that treatments can be customized based on my own mutations.   Top researchers now believe that we are three years away from treatment combinations that will start offering cures.

Am I out of the woods?  Hell no.  On December 15, I had a crown screwed into my head.  Dr. Ross Abrams, Director of Rush’s Radiation Oncology, used radio surgery to eliminate two Melanoma lesions in my brain.  The noggin must remain cancer free for two months before I can qualify for any clinical trials.  On January 11, I became Rush’s first Interleukan-2 (IL-2) patient in six years.  The week was rough with the typical side effects of IL-2 including very low blood pressure, vomiting, extreme rash and hallucinations. On February 8th I will have a return engagement with IL-2 at Rush, and if my body allows, I will have more rounds while we wait for new drugs to come available.  It is all part of the formula for a cure.

Am I glad to be alive?  Hell yes.  I know that folks are facing terribly daunting challenges, especially now, and that my physical discomfort has been manageable.  I know that for whatever reason, I am still alive with a brain that works.  I know I am blessed with the opportunity to change how patients face Melanoma in Chicago.  I know that I have been paired with a doctor who shares my belief in the need for a new research paradigm. I know I am blessed to be associated with a group of advocates, family, friends and business associates that share the same vision.  I know that if I am brave enough a Melanoma Research Center could be developed at Rush that is at the forefront of finding cures for half the Melanomas in five years.  I know that I could help make sure you never walk in my shoes.


 

 

Tuesday, February 2, 2010

I Propose Rush develop Chicago's First Melanoma Research Center

A Melanoma Research Center for Rush

"get the latest advances coming out of research institutions into the patient with cancer."
-- Goal of Dr. Howard Kaufman, New Director of Rush Cancer Programs

Melanoma is the fastest growing cancer in the U.S. and Worldwide
  •  American Cancer Society estimates risk of developing invasive melanoma is 1 in 41 men and 1 in 61 women.
  •  Incidence of people under 30 developing melanoma increasing faster than any other demographic group, soaring by 50% in young women since 1980. 
  •   Melanoma is most common cancer for young adults 25 to 29 years old and second most common cancer in adolescents and young adults 15 to 29 years old.
  •   Midwest Melanoma patients often must seek treatment in Bethesda, Houston, New York, and Boston.
  •   Melanoma’s death rate is directly proportionate to the patient’s proximity to quality care


    Rush is a global medical hub capable of building a Melanoma Research Center in Chicago, which expedites advanced patient treatment like no other

    • Rush is committed to becoming Chicago’s premier Cancer Center with a full range of critical research and treatments that could approach melanoma in a new manner.
    • National Cancer Institute has overseen the bulk of melanoma research dollars, trial approvals, and actual trials but effective treatment remains beyond reach.
    •   Time for bolder paradigms that involve multiple medical disciplines, while combining and sequencing existing and new treatments.
    •  Dr. Kaufman exemplifies this approach, leading research in new classes of biologics, building expertise in sequencing treatment combinations, and fostering relationships with different research lines, pharmaceutical companies, academic institutes, insurance forums, and governmental entities including the National Institutes of Health and NCI.
    •  New resources could align to help make Rush’s Melanoma Research Center a reality, due in part to a tenacious Chicago recipient of 3 NCI Clinical Trials who has come to Rush because of Dr. Kaufman.
    • This patient’s shared vision of finding a cure has a team of advocates and business professionals anxious to collaborate on developing this Center via an abundance of new resources, talent, and determination.
    • Over a decade since the last melanoma drug was approved.  Today top researchers assert that within five years, more than half of all melanomas will be curable.  

      These cures should happen at Rush.