Today's PET scan showed that the cancer is growing again. Not aggressively, but definitely growing in the areas where it's been seen before, including one spot again in Lisa's hip. Her white blood cell counts were low so the doctor wants to wait another week before any treatment.
As far as treatment goes, there are three different options that were discussed that we are researching and praying about. The doctor's first recommendation is to use Tarceva pills for some period of time (probably two to four months) as a cancer "suppressant". In most patients that respond to Tarceva, it doesn't kill cancer, but it does keep it from growing. However, though this is the doctor's first choice, he only gave it a 15%-20% chance of working. If it does work, this would provide some "buffer time" for Lisa away from traditional chemotherapy, and especially give her body more time away from the Gemzar which we used successfully previously. Since cancer cells are usually "smart" and adapt to chemotherapy, having more time before reintroducing a chemo which was effective in killing at least some of the cancer is usually helpful. When Tarceva stops working, Lisa would go back on the Gemzar/Navelbine combination.
The doctor's next choice is to start using a completely different chemo combination, with Cisplatin as the primary component. Cisplatin is a platinum-based chemo, and though Lisa's cancer did not respond to Carboplatin as a first-line treatment two years ago, there is a chance that it would respond to the Cisplatin. However, Cisplatin has much more severe side effects than the more modern Carboplatin.
Another option is to go back to the Gemzar/Navelbine combination right away, but probably at a 20% lower dose so that it lessens the side effects. Although it's the oncologist's last choice, he's "ok with it" if that's what we decide to do. It wasn't his first choice in September either, when we had to deal with aggressive cancer growth after Lisa being taken off chemo after being declared as being in "partial remission", but it worked very well.
As far as treatment goes, there are three different options that were discussed that we are researching and praying about. The doctor's first recommendation is to use Tarceva pills for some period of time (probably two to four months) as a cancer "suppressant". In most patients that respond to Tarceva, it doesn't kill cancer, but it does keep it from growing. However, though this is the doctor's first choice, he only gave it a 15%-20% chance of working. If it does work, this would provide some "buffer time" for Lisa away from traditional chemotherapy, and especially give her body more time away from the Gemzar which we used successfully previously. Since cancer cells are usually "smart" and adapt to chemotherapy, having more time before reintroducing a chemo which was effective in killing at least some of the cancer is usually helpful. When Tarceva stops working, Lisa would go back on the Gemzar/Navelbine combination.
The doctor's next choice is to start using a completely different chemo combination, with Cisplatin as the primary component. Cisplatin is a platinum-based chemo, and though Lisa's cancer did not respond to Carboplatin as a first-line treatment two years ago, there is a chance that it would respond to the Cisplatin. However, Cisplatin has much more severe side effects than the more modern Carboplatin.
Another option is to go back to the Gemzar/Navelbine combination right away, but probably at a 20% lower dose so that it lessens the side effects. Although it's the oncologist's last choice, he's "ok with it" if that's what we decide to do. It wasn't his first choice in September either, when we had to deal with aggressive cancer growth after Lisa being taken off chemo after being declared as being in "partial remission", but it worked very well.
