day 1 at Duke

today we met Dr. Henry Friedman, one of the 3 brain cancer doctors here at duke and we met his PA Yung Kim.

after reviewing our history they wanted karen to do the Avastin with CPT - 11 option through their clinical trail (this means the avastin $11000.00 a pop would be free). then after looking over karen's last MRI, they came back and said they found blood on her brain which would cancel out the avastin.

this disturbs me 2 ways: first, at emory we were going to continue the avastin with the CPT - 11 added based on the same MRI they looked at today. emory either missed the blood which could have been fatal or duke's doctors are reading something into the MRI that emory doctors don't agree with. second, the avastin was to me one of the last straws that we had to fall back on. i am not sure if this disqualifies it all together, or if we can come back to it later if needed, but right now all we have are clinical trials.

so, the duke doctors want to start karen on a clinical trial involving the drugs DASATINIB and ERLOTINIB (wow they are as hard to type as to say). this is a phase one trail and as i read the information about it (http://clinicaltrials.gov/ct2/show/NCT000609999) i see it is a trail where there is no placebo and that has been going on since jan 2008 and has a possible end date of Jan 2010. it also shows that as this study goes on new people to enter will get the knowledge learned to this point considered into their dosages. they have given us a consent to participate (17 pages) form to read over tonight, and tomorrow at her appointment she needs to have decided to do it or look into other options. they said there may be other options but this looks to be the best to start with at this time.

what i do know is that these are 2 pills that are taken everyday at the same time about 2 hours apart. one can be with or without food and the other should be 1 to 2 hours after a meal. this sounds to me like the first should be taken before or after breakfast and then the next 2 hours later. there are several POSSIBLE side effects which include what seems to be the standards - nausea, weakness, diarrhea, rashes, and various others...they never tell you the chances or percentages of these happening. MRI's will come every 4 weeks for the first 3 months and then 8 weeks after that. we find out more tomorrow when we talk to the clinical trial dude here at duke.

tonight, we might try dinner and a movie, she deserves it!