Complexity Arises

This week, Ed is back on 5FU, partly because he had a small brush with foot and hand rash with the Xeloda, and partly because it's cheaper for Medicare.  Medicare didn't request this act of thrift, however.

And so, this past Tuesday we went to Bellingham for the 4 hour infusion session, which is not as much as the 6-hour ones that last spring included, but more than the 1 hour one that Ed has had with just the Avastin this past fall and winter.

Also, during the past month, Ed has been mulling the possibility of liver surgery.  A former colleague from RAND had suggested the possibility after talking with a surgical oncologist down there.  Ed has been procuring digital files of CT scans for the UCLA doc to look at, as well as docs at U.W., and in Chicago, where a former colleague of mine offered some counsel.  With so many lesions (5) and in more than one lobe of the liver, resection is, as one might wish not to say, a kind of cutting edge thing.  The surgeons, of course, like to tempt you with phrases like 'potentially curative,' but that is probably not true.  These cancer cells have a free ticket to ride about in the body once they hit the lymph nodes and removing actual tumors from the liver doesn't have any impact on tumors--too small yet to see on ct scans--with box seats in some location other than the liver and even, I suppose, in the liver itself.

If the liver tumors are causing trouble immediately, then having them not there might be a good thing, although having them extracted might be troublesome, at best, all things considered.

It's easier to "go with what's working" (i.e., just do what you are already doing) when the CEA numbers aren't rising faster, as they did by a full 4 points this past 3-week period, up to 12.3.  So, we are both thinking.  We are reading research; we are researching research.

The numbers tell you something, but not what you want to hear.