Sean Martella's Testicular Cancer Update Blog: Taxol/Gemzar Cycle 1 Treatment 3

Tuesday, November 3, 2009

Taxol/Gemzar Cycle 1 Treatment 3

Sean had his 3rd treatment of his first cycle last Friday, October 30. I wasn't able to be there with him but he said it basically went the same as the others. He didn't meet with Dr. Chandramouli that day or with Rick though. His white blood cell counts were up due to the neupogen shots he had had during the week and he was able to go out with Kathy (his mom) after his treatment and get lunch and visit. His platelet counts were low which causes him a good deal of fatigue but they weren't low enough for him to receive a blood transfusion.

Friday night he felt pretty sick and needed to take several doses of his medications to help him feel better enough to sleep. He was up for a bit during the night and I was able to get up with him and make sure he got his medications. He did really well on Saturday though. He was able to be out shopping with me and we went to the Utes game that night as well. Sunday he was back to not feeling too well and had to take his meds throughout the day then too. Yesterday was like Sunday--he was able to get things done but wasn't feeling the best. Today he's been very tired due to his platelets being low still and Dr. Chandramouli asked him to come in today for a CBC panel. His white blood cell counts are back down which means his immune system is compromised again and he has had a low grade fever of around 99.1-99.4. Dr. Chandramouli asked him to start taking his levaquin antibiotic today to help fight off his fever and any infection he may have, but he thinks Sean's fatigue is caused mainly by the chemo and being somewhat low on his red blood cell counts. The doctor told me to watch for any changes in Sean's breathing (especially with all of the flu viruses going around these days--although he did get his seasonal flu shot this week) and if anything gets worse we'll need to take him to the ER. Right now he's sleeping and stable so hopefully he'll be able to get some rest this evening. He is scheduled to see Dr. Miller on Thursday who is the pain/fatigue management specialist within Dr. Chandramouli's group so maybe he can help figure out how to get Sean through the next 5 cycles. Sean's off of chemo this week--it's his break week, but he will meet with Rick on Friday for a follow up office visit to see how he's doing.

I'm very grateful for the doctors and other medical providers that are working with Sean as well as for everyone's continued prayers and encouragement. It feels like we're dealing with a lot here and we are but we get through it one day at a time. I'll try and post again once I have enough to update everyone on but for now things seem to be under control. We'll see how this evening going and go from there I guess! Thanks again for all of the love and prayers. We really need it...

Karen

P.S. Sean's hair started to fall out on Sunday but he hasn't shaved his head yet. It's going to be extra hard to part with the curls he's had. :(

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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

Tuesday, November 3, 2009

Taxol/Gemzar Cycle 1 Treatment 3

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