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No More Chemo (for now)<br />
Tuesday, June 28, 2011<br />
Today, I had my appointment <strong>with</strong> Dr. Flam. Fortunately, I had the report of my CT scan<br />
<strong>with</strong> me, as the office claimed not to have received it. He read the report, and did not ask<br />
to look at the images, which I offered, as I had the CD <strong>with</strong> me. He said that the<br />
chemotherapy had accomplished its objectives, and it was time to clean up the residual<br />
tumor cells <strong>with</strong> radiation. Dr. John, the radiation oncologist was in the hall, and I brought<br />
him up to date on my case. I think he did not recognize hairless me at first, but I have an<br />
appointment for tomorrow at 9:30 AM for simulation and planning.<br />
<strong>My</strong> labs are good. WBC is 5900, platelets are up to 182,000 and hemoglobin back up to<br />
11.2.<br />
<strong>My</strong> port was flushed and I have an appointment to see Dr. Flam in 1 month.<br />
Additional discussion <strong>with</strong> Dr. Flam included the question of what might be available<br />
should the tumor come back. He said that he had additional chemotherapeutic regimens<br />
which might be effective.<br />
I feel good. The side effects of hearing loss, bad speaker tinnitus and taste loss <strong>with</strong> dry<br />
mouth are still <strong>with</strong> me. I think I have largely avoided "chemo brain". I hope these side<br />
effects go away, although the hearing loss is irreversible.<br />
I am delighted to avoid the expected additional chemotherapy, and I hope to be able to<br />
travel in another 6 or 7 weeks.<br />
On the downside, I spoke <strong>with</strong> Dr. Nghiem yesterday. He was not particularly<br />
encouraging about the good response to chemotherapy. He suggested that this is the<br />
usual result, but there are most likely cancer cells in my body which would not show up<br />
on a circulating <strong>Merkel</strong> cell assay, and the remission induced by chemotherapy is unlikely<br />
to be a cure. He did say that should that be the case, there are experimental protocols for<br />
which I would be a good candidate. One using immunotherapy would be particularly<br />
promising for me.<br />
In the meantime, I know of 3 cases of <strong>Merkel</strong> call carcinoma cancer-free after<br />
chemotherapy. Audi, Scott Hammond and an additional unnamed patient of Dr. Hackett<br />
who is a 10 year surviver.<br />
If you know of others, please post the information.<br />
Posted by David Shuster at 02:57PM (-07:00)<br />
Or Was That a Premature Celebration<br />
Wednesday, June 29, 2011<br />
Dr. John, the Radiation Oncologist who will be giving me the treatment for my residual<br />
tumor next to the lower esophagus and perhaps extending into the esophagus wants me<br />
to have additional chemotherapy to enhance the effect of the radiation.<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong><br />
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