Results of Recent Tests - Update on Robin as of 01/02/2008

It has been almost two months since the last update was posted, and life has gone on. Robin has been through three 3-week cycles of the oral chemotherapy, Xeloda. The back pain has been constant, but manageable with Vicodin. Her vision has not improved since the radiation therapy, and might have gotten slightly worse. She has had two bone treatments by infusion of Zometa (zoledronic acid). The side effects are similar to a bad case of the flu, and last about two-three days. With all that going on, we survived Christmas, including our adoption of a small family (two children and a Mom (actually, probably, their Grandmom) who spoke no English). Shopping was difficult for Robin, with the back pain exacerbated by standing or walking for long, so she tried the "shopping scooter" at Target. It wasn't pretty! After taking out a rack of boy's coats with the scooter, she decided she would stay in the main aisle, and let me fetch things she wanted to see closer. Anyway, John came down from College Station, and spent a few days, we all went to Midnight Mass, and we celebrated Christmas with our Texas family, the Couvillions. It was a very nice holiday.

On the Friday after Christmas, Robin had new CT and bone scans performed. The appointment was at 6:30 AM, and we got home about 3:30 PM. What a way to spend your vacation!!! Today (January 2nd), we received the reports. The CT scan looked good, with nothing remarkable showing in the chest or abdomen. The bone scan was a different matter, though. The T11 vertebra still showed signs of cancer, and the cancer appears to have spread into several posterior ribs about at T9 and T10 on the left, and T10 on the right side. Additionally, there appears to be some activity in the T10 vertebra and possibly one or two other ribs, although this was not conclusive. Even without this additional involvement, the rapidity of the spreading indicated that a change in Robin's treatment is necessary, since Xeloda does not seem to be working.

We went to Robin's appointment with Dr. McClure this afternoon, armed with the results of the report, and we discussed the next steps we needed to take. She suggested (and we agreed) that more aggressive chemotherapy was needed. She told us about a newly approved chemo called "Ixabepilone" (or Ixempra™) that has been shown to be effective in treating aggressive cancers that have been "refractory" ("resistant" --- see, we learned a new word) to other standard treatments. So the plan is this:

1. Get a port-a-cath (Port) installed (again). This is fairly minor surgery.
2. Start infusions of Ixabepilone once every three weeks as soon as possible after port installation.
3. Obtain additional CAT scans focused on the area where the disease is indicated.

In the meantime, Dr. McClure prescribed slightly stronger pain medication, since there has been some additional pain experienced in the last couple of weeks. The first step is to add Ibuprofin to the Vicodin, and if that doesn't work, increase the Hydrocodone. Robin will need to play it by ear to find the right level that works.

The good news is that the cancer appears to be limited to the bone, and cancer in the bone is not lethal. Also, the new chemo, Ixabepilone, has been recently been approved for use in cases like Robin's, and it has been shown to be effective in treating aggressive cancers. The bad news is that the cancer has spread quickly, and cancer in the bone can be very painful. Furthermore, cancer in the bone indicates the spreading is by way of the blood, so other organs could be affected in the future. We will need to be vigilant and respond quickly if there are additional complications or if the Ixabepilone does not appear to be working.

Other minor news:

• John was accepted at Texas A&M. He'll start next week. We are officially an "Aggie" family.
  
• Larry received an "Employee of the Month" award for December. The Shuttle program has been keeping him busy and (generally) out of trouble.

Well, that’s about it. To sum it up, Christmas was great. The oral chemo did not seem to work, and the cancer has apparently spread to several ribs and possibly other vertebra. Robin will be prepared to start chemo infusions with a new drug, Ixabepilone soon. Robin's eyesight is not good, but we still hope for improvement. John's an Aggie, and Larry is… well, Larry.

As before, we ask you to keep the prayers and good thoughts going. At this point, the prayers are more important than ever before.

We send our love to you all,

                  Larry and Robin (and John)