Sean Martella's Testicular Cancer Update Blog: Latest Update From Karen

Monday, February 11, 2008

Latest Update From Karen

Sean started his 2nd chemotherapy cycle on Monday, Feb 4, and it went all week long. He was his same old self until Wednesday, and then things went kind of sour. The doctors told us in the beginning of his treatment that the chemo drugs would have a cumulative effect on the way that he feels so it was not surprise to see him get sick faster this week.

Kathy and I took Sean to the ER at St. Mark's Hospital on Wednesday night. He was extremely nauseous and none of his medication was working for him. He vomited several times over the span of 2 hours and was very dehydrated. The staff at the ER gave him 3 liters of IV fluid (mostly saline solution) and 3 dosages of anti-nausea medications. We were finally able to take him home around 4:30 am.

When Dr. Chandramouli heard about his night in the ER, he set Sean up on Homecare. They delivered a bunch of medical supplies and sent out a nurse to show me how to give him IV injections of anti-nausea through his PORT (the same drugs they give him in the hospital).

Thursday was a good day overall, but Friday was more like Wednesday. The dosage of IV Zofran that they had said that I could give him wasn't cutting it and Kathy and I had to take him into the ER for the second time Friday evening for extreme nausea and slight dehydration and stayed there with him until 1:30 am. After this trip to the ER we realized that Sean responds much better to the anti-nausea medication when he is hydrated and it is easiest for him to stay hydrated through IV fluids. SO on Saturday, the Homecare delivered IV fluids to us and sent out another nurse to show me how to set him up on an IV drip. They also said that I could increase the dosage of IV anti-nausea medication that I was giving him from 8 mg every 8 hours to 8 mg every 6 hours.

Since then he's been a little bit up and down but we feel like we have things mostly under control, for now at least. He sleeps a lot, takes his meds, eats and drinks as much as he can handle, and keeps in good spirits by playing xbox and watching the new Planet Earth (discovery channel) dvd set that he bought.

We're hopeful that the next two weeks will be much better for him and that he'll be feeling much better. We're looking forward to Jeff's visit next week too, and to be a couple more weeks closer to the end of this treatment.

-Karen

2 comments:

Anonymous said...: Karen, YOU AND KATHY are Seans ANGELS and I KNOW Jeff is hurting and wishing so MUCH to know he's not there physically to help you both take care of his Seany Boy...THANK YOU so much for updating us. Sean is being well taken care of by you 2 and I KNOW he appreciates EVERYTHING YOU DO FOR HIM....Kathy AND Karen, this has to be SO HARD for you to go through...I can only imagine...WE LOVE YOU ALL....Aunt Laura, and the ENTIRE MARTELLA FAMILY..Please tell Sean we love him too and our thoughts and prayers are with him AND ALL FO YOU....THANK YOU AGAIN FOR ALL OF YOUR HELP.....; February 11, 2008 at 9:44 AM
Mel said...: Karen you really are an angel. Thank you for taking care of Sean and being such a great influence on him. You will be blessed!! Hope things start looking up for both of you and that this will all be over soon. Lots of Love, Melanie; February 11, 2008 at 4:32 PM

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The Rundown

Okay, so here is how it all started and where we are at now (short version):

Throughout 2007, I had lower back pain. The back pain got worse and worse. Finally, a doctor ordered bloodwork, which showed that I was anemic. A CT scan was ordered that showed widespread cancer that had originated in my right testicle. There were small metastases in the lungs and large tumors in the abdomen.

In January of 2008 I had a right orchiechtomy surgery done (right testicle removal). A biopsy was done that showed a nonseminoma/seminoma mixture. I was diagnosed as stage 3 high risk. I went on a BEP regimen (Bleomycin,Etoposide, and Cisplatin) of chemotherapy that lasted 12 weeks. All this was done at home in Salt Lake City under the direction of Dr. Nitin Chandramouli. After it was done, a CT scan showed that all cancer was inactive except for the largest tumor in my abdomen. Circa June '08.

In August of 2008 I underwent an RPLND (Retroperitoneal Lymph Node Dissection) in SLC. The surgery appeared successful but a subsequent CT scan showed the cancer had spread to my liver in a couple spots. In September of '08 I was taken to Indiana where Dr. Einhorn (inventor of platinum based chemo and recognized testicular cancer specialist) practices. Under his direction, I received three weeks of salvage chemotherapy. After the salvage, I underwent two rounds of high dose chemotherapy (5x strength Carboplatin and Etoposide). Before undergoing treatment, my stem cells were harvested so that they could be given to my severely weakened body after treatment. I achieved a complete remission in December of '08

As part of maintenance, I took a VP-16 etoposide pill until April of 2009. I remained in remission until July when my blood markers began elevating again. A PET scan revealed a localized tumor in my abdominal cavity, near the vena cava. I was taken to Indiana again, where Dr. Beck performed a second RPLND. The surgery was difficult but successful. At the cost of half a kidney, a bowel obstruction, a possible blood clot, and several weeks in the hospital I was in remission again.

In October of 2009 I relapsed again. I began a regimen containing Taxol and Gemcitabine. At the time there were small metastases in my liver, lungs, and abdomen. Taxol/Gemzar failed in early 2010

In late January of 2010, after having several months of normal blood tests, the AFP marker began to rise again. Tumors in my abdomen, lungs, and liver began appearing again.

In March 2010, I went to Sloan Kettering Memorial Cancer Hospital in New York and began a clinical trial under the guidance of Dr. Darren Feldman. The ARQ-197 pill looked like a good side-effect free choice to try and fight the cancer.

In April 2010, the trial was determined not to be effective for me. New tumors appeared and disease progression showed no signs of slowing. A tumor on my spine threatening paralysis was of particular danger. Fearing that consequence, I underwent a short course of radiation on that tumor and another in my hip.

I have multiple lesions in my lungs, liver, and other areas that continue to grow. Currently, I am in the process of having my tumor profiled on a molecular level by TGen. TGen is a company that is based out of Arizona. They look at tumor's case by case, on a genetic level, to determine new and unused courses of treatment that will be as effective as possible for that individual.

Because that process takes a while, and the treatment itself may not be covered by insurance, I just started a regimen of Oxaliplatin as well. Oxali is effecive in 20% of people in my situation. The regimen often comes with a lot of neuropathy and cold sensitivity. I started this regimen on 5/12/10 and am still waiting to here about how it's working.

Sean Martella's Testicular Cancer Update Blog

Monday, February 11, 2008

Latest Update From Karen

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