Many options

I went to my doctor's appointment in Hamilton yesterday, anticipating information about and a recommendation between two cancer treatment choices. I expected to have (or be close to) a plan when I walked out of the Juravinski Cancer Centre, ready to move forward. Instead, Dr. H presented seven or eight different options for treatment. As a result, I left my doctor's appointment a little confused and with no definite path to follow - yet.

Since it was working, the first option would involve going back on the Regorafinib. However, I may have been off the drug for too long to continue on the clinical trial. In addition, Dr. H needs to talk to the drug company sponsor to determine if it's safe for me to continue taking this drug. It may have caused my duodenum perforation, and if that's the case, there's no way I could or would want to be on this drug anymore. But I saw the CT scans from the hospital compared to the ones taken just before I started the Regorafinib and I saw visible shrinkage in the size of the tumours after one three-week cycle, which is encouraging.

Dr. H will talk to the Bayer representatives to determine if I still qualify for the Regorafinib clinical trial and I should know by the end of the week. But I got the feeling this probably won't be an viable option because of the risk.

Okay, it's back to paclitaxel and carboplatin chemotherapy, I thought. But Dr. H presented several different options to consider - different combinations of chemotherapy, chemotherapy in conjunction with other drugs, etc. He went through them fairly quickly, so I have to admit I'm a little confused. But if the Regorafinib isn't an option, we'll discuss the other treatments - and which he recommends - in more detail.

From our discussion, I think my best choice may be to take the standard chemotherapy treatment of paclitaxel and carboplatin chemotherapy in conjunction with the clinical trial drug P53, which regulates the cell cycle and acts as a tumour suppressor, preventing cancer cells from repairing themselves. My tumour samples from my original surgery would need to be tested to ensure I have TP53 gene necessary for this drug to work. Approximately 60 per cent of people tested have the TP53 gene.

This clinical trial should be opening up within the next week or so in Hamilton (and may even be available in London), which is ideal because I don't want to wait around again to start treatment. I feel any delay is giving the cancer a chance to take over my body; my worst nightmare.

Some might question my willingness to be part of another clinical trial so soon after the last one may have caused serious medical complications, but I believe in the necessity of research to determine better treatment, diagnosis and a possibly a cure for ovarian cancer. That's also why I strongly support the Translational Ovarian Cancer Research Group at London Health Sciences Centre, which is the recipient of the funds raised by the Run for Ovarian Cancer.

Besides, it's been proven the remission time between every round of traditional chemotherapy becomes shorter and shorter before reoccurence. By taking another form of treatment, I could be increasing my window of time, giving me longer to live.

Dr. H also presented other options, including different chemotherapy combinations. Some involve IV drugs, while another is available in pill format. I've got information sheets on some of the different drugs, with their uses, precautions and side effects, but I'll need even more information before I can make a decision. I also need to hear what Dr. H thinks would provide my best chances to keep the disease at bay for as long as possible.

I also found it interesting to hear his hypotheses for my perforated duodeum: the Regorafinib, the Dexamethasone steroids, the pigtail poking a hole in the organ or possibly the shrinkage of the tumour surrounding the area, pulling a hole in the duodenum. Given that I didn't have a laparoscopy in the hospital to confirm the presence of a tumour in my stomach, we'll never know the exact cause. In a way, that's scary because I don't know how to prevent it from happening again (if I could).

So long story short, Dr. H needs to do talk to Bayer about the Regorafinib. He also has to determine if I meet the criteria for the other clinical trail presented. Then we'll talk. So no specific plan yet, but lots of information to mull over. Hopefully, in the next couple of weeks, I'll start treatment and begin battling this cancer yet again.

Tina