[stanford_status] Distressing news

John R Larsen john at larsen-family.us
Wed Sep 27 10:53:07 EDT 2006

Hello Everyone,

Joyce and Stanford when up to Dartmouth Hitchcock Medical Center (DHMC) yesterday for a CT scan.  
This morning Dr. Kim called.  The scan shows that the tumors are bigger.  Actually there is more tumor 
than liver at this point.  

Options are very limited.  Radiation is not an option.  Neither is surgery because there is not enough liver 
left.  They want Stanford to come up to DHMC tomorrow while the regular nursing staff is there.  They are 
working on getting insurance pre authorizations.  It will be a same day trip arriving in the morning and 
returning in the afternoon.  Home nurses will come to set up everything.  The infusion treatment lasts 48 
hours.  There are not the same bladder and kidney issues with these drugs as with the previous drugs so 
IV fluids aren't needed.  The only new side affect is possible diarrhea the following week.  Dr. Kim doesn't 
anticipate this will happen.   

Dr. Kim says the same approach would be done this time as the last.  A round of treatment would be 
followed by scans to see the results.  She said it will take time for the treatment to do its work, but the 
initial scan should show that the tumors haven't grown.  If they haven't grown then continued treatment 
should make them shrink.  

These are the chemo agents that will be used:  5FU, irinotecan (can cause diarrhea), leucovorin, and 
Avastin.  The Avastin is a newer drug that shrinks blood vessels to the tumor in order to starve it.  This 
drug requires insurance pre authorization. 

Yesterday evening Stanford started having lots of pain where his liver is.  He had to take oxycodone in 
order to sleep.  He is still in a lot of pain.

We're all scared at this point, even Stanford.  Please keep us in your thoughts and prayers.  

John R Larsen <john at larsen-family.us>

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