Choosing a Chemotherapy Regimen

[From Ann]

Carla and Tony were precious to let me attend the doctor visit yesterday. Carla had just completed her third radiation treatment prior to this consultation. She has two more radiation treatments scheduled, for Wednesday and Friday of this week.

Dr. Stephanie Wagner confirmed that the biopsy from February 12, 2013 shows leiomyosarcoma with metastasis to the spine and clinical concern for spinal cord compression. I put a short summary about this kind of cancer below. Carla has a very rare cancer so the treatments are really still experimental.

The doctor reduced her steriod intake by half (one pill in the morning and one in the evening rather than two each time).

Radiation will not kill all the cells.

The activity of bone tumors are hard to evaluate because bone tissue takes a long time to reshape after invasion and distortion. PET scans will have to be relied on for evaluating the “success” of the treatments, but the problem with this is that dad and Carla’s cancer have never shown up well on PET scans. Not sure what this means. The doctors don’t seem to have an answer for this, because they ususally see active cancer sites “light up like Christmas trees.”

Dr. Wagner stated that leiomyosarcomas respond well to chemotherapy; this was new to us. She said that there are two main courses that could be pursued and that Carla and Tony will have to evaluate the side effects to make the decision on which course they would take. When Tony asked her which one she would recommend, she said that her preference is with the first course, but if one regime is not working then they would switch to the other one. Either treatment would be 12-16 weeks long (4-6 treatments spaced out every 3 weeks).

We have been kind of conditioned to think there is a “magic” pill for illnesses. We know, however, that chemotherapy is horrible. “Is it worth it?” is the question. We are thankful that strides have been made to make it more effective and more endurable.

[box] Our huge prayer need right now is wisdom for Carla, Tony, and the doctors.[/box]

These are the two treatment options:
1)  Doxorubicin. This drug would require surgery in order to install a port in the front shoulder area. The drug would be injected every three weeks and would result in hair loss.
2)  Gemcitabine and docetaxel (I think I got this one down right but I am iffy on the second drug). These drugs would be taken on a three-week cycle: one drug would be taken one week, the next drug the next week, and then there would be a break for one week. This regimen could produce swelling, nerve damage, and nausea.

The pelvic area seems to be the primary source of the cancer, although the doctor said there is no way to tell for sure.

The good news is that  the liver and lung spots that showed up on the latest MRI are not suspected to be cancerous. The prognosis is good because tumors confined to bone are not life threatening. (It is when cancer spreads to the organs that there life expectancy is severely reduced). That is one need for the chemothearapy: keep it out of the organs.

Let me know if you have any questions. Aunt Barbara just called. She is a prayer warrior!! Thank You, LORD!
In Christ,  Ann Ihms

Leimyosarcoma is a very rare cancer. It makes up 5-10% of soft tissue sarcomas, which are in themselves rare cancers. Here is some additional information, from this blog:

Leiomyosarcoma is a form of cancer that affects the smooth muscle of the body. It spreads through the blood stream and can affect the lungs, liver, blood vessels, or any other soft tissue in the body.

LMS is a type of sarcoma which is a neoplasm of smooth muscle. Smooth muscle cells make up the involuntary muscles, which are found in most parts of the body: in the uterus, stomach and intestines, walls of all blood vessels, and skin.Leiomyosarcoma is a very rare cancer.

It makes up 7% of soft tissue sarcomas; in all, LMS affects 4 out of 1,000,000 people.

Presently there is no cure. Remission can be attained, but this rare cancer can reappear at any time. Because of its rarity, few doctors know how to treat it and it attracts very little research.

One Reply to “Choosing a Chemotherapy Regimen”

  1. Carla’s last radiation was to have been this Friday but her neck hurt so bad that they decided to do a scan instead to see what is happening. They did radiate the lower tumors. She is schedueled for another treatment on Tuesday. Her right leg is swollen and they can’t figure out why – no blood clots showing up.
    Still trying to decide on what chemotherapy. That is the big prayer need.
    THANKS so much for all your prayers.

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