Fingers Crossed

So... the test results we were waiting for indicated that the cancer had progressed. Still, my oncologist recommends waitin' and seein' for a few more weeks. It's a long shot and I'm not one to wear my hope on my sleeve -- but it'd be nice if this treatment would work for a while. Let's hold that thought for now, okay?

Here's the email exchange I had with the doctor. How's that for full disclosure?


To: Martha A Price
From: PWG MD
Subject: RE: Blood Test Results
Received: 2/15/06 8:18 AM

Ms. Price, I believe we discussed that I'd consider a CA 15-3 > 100
to be worrisome for progressive cancer that is refractory to the current
therapy. The result was 99. I'd favor continuing with the current
treatment, with a recheck of the CA 15-3 in early April, as we planned. Although
we believe that a falling CA 15-3 correlates with a shrinking tumor, and a
rising CA 15-3 correlates with an enlarging tumor, I don't want to abandon what
might still prove to be an effective hormone treatment too soon. In particular,
I'm mindful that effective hormone treatments can be associated with a hormone
"flair" phenomenon, with a temporary enlargement of tumors before they shrink;
it would be a shame to miss the possibility of a significant hormone response,
because we give up on hormone treatment too soon. Let me know, however, if
you want to consider moving on to chemotherapy now.

P.G. M.D.


From: PRICE,MARTHA A
Sent: 2/15/2006 8:47 AM
To: PG
Subject: RE: Blood Test Results

Dr. G -I'm reluctant to begin chemotherapy based on tumor marker results.
My question is: would scans at this point give us useful information? I
understand the tumor flair phenomenon, but if (for example) a bone scan showed
new hotspots, would that be "proof" of failure of the hormonal treatment?
I'm not at all anxious to start chemo, but at the same time I'm afraid that this
treatment is ineffective.

Thanks,

Martha Price


To: Martha A Price
From: PWG MD
Subject: RE: Blood Test Results
Received: 2/15/06 1:41 PM

Ms. Price: an excellent question! But the hormone flair phenomenon
applies to bone scans as well, so a "new" lesion on a bone scan (done shortly
after beginning an effective hormone treatment) may actually just be an old
lesion that was too small to detect that has now become visible because of the
hormone flair. As long as you're feeling reasonably well, I'd favor
continuing the current treatment, and making the assessment of
response/progression at the next visit.

PD M.D.