Monday, August 23, 2010

Charles River and the PARP Inhibitor Trial

As the old saying goes we've got good news and bad news.

First the bad news.

I might as well get it out of the way. Kay’s cancer is trying to come back. Since her fifth course of chemotherapy her CA-125, the primary biologic marker of her ovarian cancer, has been very low. The range had been all <10 until about 6 weeks ago. At that time her level was found to be 27 on her routine follow up visit, and when rechecked a week later was 30. This was of concern because it likely signaled that her cancer was not cured by her initial chemotherapy, and had started to grow again. She had extensive imaging done, including an MRI of her abdomen, and CT scans of her pelvis and chest, and no single site of cancer large enough to be seen on these techniques was found. Still we were told, and know, that it is likely recurring in multiple tiny areas too small to see on imaging tests. She waited a month, and on testing again the CA-125 was 42, more evidence that the cancer is growing.
We have been researching her options, praying, and talking a lot. Thanks to her connections with Rob McCroskey, her primary oncologist, she has been able to get accepted into a study of a new and promising type of anti-cancer drug called a PARP inhibitor. See my post on DrPullen.com today about PARP inhibitors. She was admitted to the Charles River research site in Tacoma as one of 8 persons nationwide to be enrolled in this study. She is literally under lockup for 6 days and 5 nights to complete the first phase of this study. She will receive the drug as a radio-labeled infusion, and they will be doing pharmacokinetic studies for the next 5 days. Then she’ll return in 5 more days for an overnight stay.
After that she will have access to this PARP inhibitor to use as an adjunct to chemotherapy for as long as the cancer stays responsive, i.e. does not show signs of progression. We pray, and ask you to pray, that this will be a very effective drug for Kay, and that her cancer will be cured or induced into a long remission.

Now the good news.

Kay is an exceptional advocate for getting what she needs. Anyone who knows Kay knows that she is not one to be shy about asking for what she wants. We have had a trip planned to visit Maine and then go on to Italy in September for some time. She has arranged to get this initial PARP study done just before we leave, to go on our trip, and to start her chemo after we return. She has also arranged to have the timing of the cycles of treatment work out so that our Thanksgiving trip to So Cal will fit between courses, and not require a “drug holiday.” In addition she has managed to get into this PARP inhibitor study, at least a couple of years prior to this promising drug being available in any other way.
So how can you all help. First pray hard and often. During Kay’s initial battle with this cancer, we could physically feel the power of prayers of support from our friends and family. It was awesome, and we want you to ramp it up again. This is going to be a long haul, so hunker down with us for the long term. Second, please treat us as normally as possible. Kay feels not just good but great right now. We are really trying to maintain a semblance of our normal lives, which are blessed and very good. We don’t need a lot of help right now, but may at some time in the future. We’ll not be hesitant to ask for your help when we need it. Right now we are just waiting to see how all this works out. Kay is going to be really busy tomorrow and the next day with this study. E-mail is probably the best way to send your best wishes and support. She can’t have many visitors, and she will invite anyone she is able to see, but cannot have drop in visitors at least for a couple of days.
So far Kay has tolerated every type of treatment like the incredibly strong woman she is, and we anticipate more of the same with this course. Still her energy level is likely to drop, and I’ll try to keep you all informed through this blog. Thanks in advance for your prayers.
Ed

Saturday, April 24, 2010

Kay Remains Well

No news on this site is good news. Kay remains free of cancer as far as anyone can tell. Her tests so far, including follow up CA-125 and mammogram recently all are good. Her CA-125 remains less than 10 and she feels great.

This weekend Kay is in Los Angeles visiting Jean who is there on assignment from her Ernest and Young Portland office. Jean has a hotel downtown, the weekend off, and so Kay, Mary - Kay's sister, and Fay - Kay's mom are joining her for a girls weekend on the city. Girls just gotta have fun.

Kay is back to running, up to about 6-9 miles a week, and is doing a "Core and More" class at the YMCA, a really intense class. She is feeling pretty fit, and I'd say is just doing normally.

I continue to enjoy life after being medical director at Sound Family Medicine, and am having fun blogging as DrPullen.com

We continue to praise God for Kay's health, and pray for lots more of the same.

Enjoy the spring and summer.

Ed

Friday, February 19, 2010

Olympics

Some of you may not know that Kay is an Olympic fanatic. For 3 weekends and two weeks every other year she stays up late watching the games, and now with our DVR watches at breakfast, lunch, dinner and every spare moment. I'm a much more casual fan, and catch a little now and then. That said, we are excited about the weekend. We are leaving mid-afternoon today to head for Bellingham, picking Brett up from Seattle University on the way. We'll stay with Ron and Linda Bahr tonight, and get up early to go to Vancouver tomorrow.

We primarily want to check out the Olympic venue and get a feel for being at an Olympic games. We have tickets to a women's curling preliminary event at 2 PM, but mostly plan to put in a big day of experiencing and seeing the Olympic village and venue.

It is really good to see Kay essentially back to her normal energy level. She is doing great. Her port came out a week ago today, and she is now hardware free. No signs of cancer, and lots of signs of Kay. Tomorrow is supposed to be sunny and beautiful, so pray for safe journey, and think of Kay when you see the games Saturday.

Ed

Sunday, February 7, 2010

Lots of friends and relatives

Yesterday Fay Colmar, Kay Mom, had her 80th birthday party. All 5 children, all but one grandchild, and an incredibly interesting and adoring group of friends converged at Fay's home in Fullerton,CA. We had a lovefest worthy of the occation. Fay had the house decorated in high style, with a red, white, and black theme. Guests dressed to match the theme, and we all got a chance to wish Fay a happy 80th, as well as to renew old acquaintances, make new ones, and have a great day.

Kay is really essentially back to normal. She has a cute short hairdo, is really getting fit again, running up to 3 miles and working out 5-6 times a week, and feeling good. She is going to get her port out this week. It is the last piece of foreign material still reminding her daily of Cecil, and she looks forward to having it gone. She is quite thin, and it is noticible and a bit uncomfortable below her right collarbone.

Jean and Marc (boyfriend) were able to come down to the party. Jean has been in the midst of her first "busy season" as an accountant, and is working long hours, learning lots, and doing great.

Brett is thriving as a University of Seattle junior English major, and could not make the party, as he is in mid-terms.

I continue to love my post-medical director status as a family physician. I am enjoying my new blog drpullen.com, and Kay and I continue to have lots of fun.

Enjoy the Super Bowl today, and give prayers of thanks for Kay's continued health.

Sunday, January 31, 2010

Continued good news

Kay saw Dr. McCroskey last week for her monthly checkup. All continues great. We got her CA-125 (the tumor marker) results back this week and they remain nice and low at 7. She worries that it is up from 6 the last two times, but 6 & 7 are really the same result in this type of thing, i.e. nice and low.

Kay's blood count keeps creeping back toward normal as her bone marrow slowly recovers from the 8 courses of chemotherapy. In a more visible reminder she is recovering she has a full head of hair, short hair, but looks really cute.

We are headed to So. Cal this week to celebrate Fay Colmar's (Kay's mom)birthday. Most of the family is going to be there. Brett is the exception, he has mid-terms the next week and needs to stay at school and work.

I continue to enjoy my medical blog http://drpullen.com It gives me a creative outlet, and has been a blast.

Keep up the prayers of thanks for Kay's continued health, and enjoy the rest of the winter.

Ed

Saturday, January 9, 2010

Low odds, high stakes, we win!

We have been anxiously awaiting the results of the test for the BRCA2 mutation that Kay has that led to her ovarian cancer in our children. We got the results for Jean some time ago, thankfully NO MUTATION in big print on the top of the results sheet. Then yesterday we got the results for Brett. I had been sweating this, because it seemed like the results were taking longer to come back. As a physician I sometimes see that when abnormal results are pending, as often additional time is required to confirm the information. As I opened the envelope my heart was sinking, but i nearly leaped in joy when the same NO MUTATION was on the top of the results page. I took care to confirm that the correct mutation was tested for on both results reports, and then called Brett, Kay and Jean to let them know.

This is really great news, and we feel blessed. As you may recall the odds of each child having the mutation was 50%, so the odds of winning this coin flip twice was only only 25%, not the type of odds you want when facing a concern of this importance. We are happy that in our immediate family this mutation stops here.

On a side note, I am really enjoying my medical blog DrPullen.com. Some of you have been following me there, and I have been having fun.
Prayers of great thanks are in order.
Ed