Nickie - Re: avastan/gereteek (erbitux) or GW572016

[Guest guest]

Hi Nickie,

Nickie Wrote:

> I started researching information for " peritoneal

> carcinamotosis (sp?) " and for " malignant ascites "

> since it was indicated that my Dad has these

> intraabdominal mets in addition to his lung mets. The

> statistics do not look very promising, even on Dr.

> Sugerbaker's site indicated that most people do not

> survive past 3 years.

>

You know, I was at a local support group meeting (Wellness Community

here in Indianapolis), and I met the wife of a stage IV survivor who

lived for 4 years on chemo alone, NO surgery! And I don't think he

even had access to Oxaliplatin and/or Xeloda. I also don't think he

was even on " continuous chemo " . Instead, he took each chemo " for

awhile " until going into remission (for a number of months) where he

had a GOOD quality of life. Isn't that the important thing?

So many different stories...everyone is SOOO different....

What I'm trying to say is, please don't focus too much on Sugarbaker

or other Statistics - 'cause you have NO IDEA how these apply to your

Dad! The fact that he has had " slow progression: is a very good

sign, and I would keep my attention on that.

Nickie Wrote:

> Is there a difference (or better prognosis) for

> patients like my Dad whose abdominal mets are in the

> " subcutaneous tissues " or abdominal walls/muscle or

> rectovisceral pouch, instead of mets being inside the

> intestines, which could more likely lead to intestinal

> obstruction?

Impossible to say...it depends on what new stuff (if any) comes up

cancerwise - hopefully NOTHING for your Dad. Clearly, much better

off if obstruction can be avoided. And why not? Let's keep our

fingers crossed!

Nickie Wrote:

> What are the symptoms of intestinal obstructions (ie,

> is it constipation, bleeding, or pain)? Would doctors

> perform surgery or radiation for palliative reasons or

> would they just give my Dad pain medication?

The complete or partial stoppage of bowels resulting in extreme

abdominal pain is generally the reason for treatment of bowel

obstruction. The other symptoms are of course possible, but

generally don't causing problems severe enough for intervention

(unless bleeding is so bad it is causing anemia, etc). The treatment

is considered " palliative " (meaning " non-curative " ).

Surgeons seem reluctant to get into TREATING obstruction until the

bowels actually STOP working and the patient becomes very ill - the

idea is apparently to treat the symptoms at the time they MUST be

treated " or else " . I guess doctors don't like to do any more surgery

than absolutely necessary (surgery itself can cause adhesions which

can result in obstruction!). That makes sense, doesn't it?

From reading the recent stories here, it does sound like they will

perform surgeries to reroute the bowel around tumors (if possible, or

perform an " ostomy " (reroute colon to " bag " )to restore as

much " normal " function as possible. This is critical for obstructed

patients, as without bowel function you cannot eat or drink and

cannot live long.

Nickie Wrote:

> When Avastin/Erbitux are approved, will patients like

> my Dad, who received prior chemo and failed, be able

> to get both? I heard that Avastin is for " first line "

> therapy only and that Erbitux is " second/third line " .

> Will Avastin be available to my Dad as well?

Once the FDA approves ANY drug, it will be available in what is

called OFF LABEL USE for ANY patient.

What that means is, it doesn't matter if the drug is " offically "

approved for first or second line therapy - the oncologist can use it

at ANY time. Of course, there could be other issues regarding

payment for chemos...the insurance company or HMO MIGHT try to wiggle

out of paying for " off label " use....

I heard Erbitux is supposed to be available in Switzerland, although

have not seen any reports on the Internet from US patients getting

it. Might be possible though!

http://www.cancerguide.org/offprotocol.html

http://www.commentwire.com/commwire_story.asp?commentwire_ID=5045

http://pb.merck.de/servlet/PB/menu/1277540/

Nickie Wrote:

> It's

> realy disheartening to read these reports but I it

> does appear that my Dad's cancer is slow growing for

> these past 2 years.

Focus on the GOOD NEWS of slow cancer growth!!!

Nickie Wrote:

> Right now, I just pray that Dr. Alan Venook at UCSF

> will be willing to give us more aggressive options,

> instead of just waiting for Avastin or Erbitux to be

> approved

Keep the faith, friend! I'm sure he will give you some good ideas.

Please let us know how the appt goes and what he says!

Hope this helps!

Best Wishes,