This is convoluted, so I apologize in advance. First, yesterday's scan shows stable disease to mild improvement. My oncologist is taking all the scans to his favorite radiologist to review. If they decide that there is continued decrease in tumor size the choices would be:
1) Continue the current therapy
2) Stop the Carbo/Taxol and continue with Avastin alone
3) Stop the current therapy and switch to Tarceva
I think he is leaning toward #3. Tarceva is a pill with much fewer side effects than the intravenous chemotherapy and it's what they would have done first for me if my liver hadn't had a heart attack. They would obviously watch very closely and frequently to make sure that the tumor is not progressing on the Tarceva. Because I have not developed resistance to the Carbo/Taxol/Avastin they could always go back to that if the Tarceva doesn't work. Tarceva offers me the chance to grow my hair back and feel stronger without all the bone and joint pain and, because I'm a never-smoker, is actually more likely out of the box to produce a response than the Carbo/Taxol/Avastin was. I actually think this is what he's going to recommend. Which makes me really, really happy.
Probably he will want a PET scan soon after I get back from the cruise to determine how much active tumor is really left. We could be looking at scar tissue everywhere. That wouldn't change anything except that he's still thinking it might make sense to go after the largest liver lesion with cyberknife while it's small enough for the cyberknife guys to be willing to do it.
My shoulder went crazy again over the weekend to the point of ice, oxycodone, PT for phonophoresis/electrical stim, and tears on my part. It is much better than it was Monday, but I will probably see if the orthopod will inject it tomorrow to give me the best chance of not being miserable on the cruise.
I had a little fever yesterday so they drew blood cultures and labs today just to make sure I don't need antibiotics. I have to doctor myself while on the cruise if I get a fever, since no culture facilities will be available.
So I'm making reservations for NM in Christmas because all indications are that I will be around and feisty.