Ox Fall Down

I have two meetings to cover: one on Monday, November 3rd with Demetri at DF; and another on Tuesday, November 4th at MGH with Delaney.

Monday/Demetri. Lettie walks over from Brigham and Womens and gets shanghai'd by the process. Demetri immediately relays the growth from the last cycle. July's scan showed an almost microscopic increase. This October scan shows a jump from 3.6 x 2.9 cm to 6.7 x 4.8 cm approximately. I got a D in math lower year but my Clint Mathis shows the tumor to be much bigger.

We expected growth. Maybe not that much growth.

Demetri is calm a la Tom Brady. He's got two drugs.

One, Doxil. Formerly known as Doxilrubicin. Previously it wasn't a good option. Very harsh. But after AIDS patients couldn't tolerate it the manufacturer had to repackage it. To make it more palatable they ended up wrapping it in fat. For reasons beyond me, healthy cells are smooth. Cancer cells are barbed. When this fat-encased drug is infused it bounces around the blood stream sliding off of healthy cells. Once it hits cancer cells it snags on the barbs and explodes, releasing the drug. Demetri calls it a "smart bomb." The beauty of the smart bomb is that it avoids the usual indiscriminate chemo targeting of healthy cells. We'll see. Keep it in mind.

Two, ET-743. Already did that. Ecteinascidin wasn't so hot. It'd be great to avoid that.

Then Demetri switches the talk to Delaney at MGH and the possibility of radiation. He's immediately enthusiastic. Radiation before chemo works well strategically. Delaney has seen the last scan and thinks he has three good portals (alley-ways to the tumor avoiding healthy tissue). He's ready to go. The catch: only 20 patient slots. He's the only doctor administering this outside of LA. So. does the timing work? Can he fit me in? Do I need to fly to LA/Yorba Linda? Finally, will the growth over the past three months change Delaney's mind?

We'll find out when I meet with Delaney at 14:00 on Tuesday, Novemeber 4th. For now I'm thrilled Demetri has options for me. And I'm grateful that he's pushing treatment outside of his hospital. It's nice to have a good head coach. Nice to have a BMW salesman pushing a Cadillac. Makes it clear the Caddy is a bargain.

It's getting late. I'm tired. I'll write more tomorrow about today's meeting with Delaney at MGH. For now, Di and I snuck on to the campus internet so hi-jinks will ensue.