[stanford_status] Monday, Dec 4th - Current Status

[John R Larsen]

Hello Everyone,

Stanford has had a somewhat difficult 36 hours.  Sunday morning he 
started needing oxycodone for breakthrough pain again.  He didn't 
sleep very well last night and was up about every three hours.  On 
Sunday he very much wanted to attend Church services, which we 
always do.  It made him quite tired and he came home to rest after a 
couple of hours.  However, it was uplifting to be with our church 
"family" and feel their love and support.

Stanford had an appointment with Dr. James O'Shea today at 4:00 PM.  
Joyce and I were with him.  He noticed that Stanford's hair is 
starting to grow back.  Also the acne looking rash from the Erbitux 
is starting to go away.  

This morning blood was drawn for lab work.  His hemoglobin number 
was down to 8.8 compared with a week ago when it was 9.4.  Another 
blood draw will be done this Thursday.  Dr. O'Shea didn't think that 
Stanford was in need of another transfusion yet.  We've been taking 
his pulse and blood pressure.  His pulse is in the 97 to 116 range 
depending on activity.  His blood pressure is always in a good 
normal range.  His temperature is normal or slightly above 99.0.

A dosage change starts this evening.  Stanford will now receive 60 
mg of oxycontin twice a day.  This is up from 40 mg twice a day.  It 
is expected that this higher level will allow him to sleep better at 
night and control the break through pain.  Dr. O'Shea said he has 
had patients on as high as 400 mg per day.  If these levels are 
reached then there are other alternatives such as a patch delivery 
system.  

We asked about the itching that Stanford experiences from the oxy 
drugs.  Stanford said is wasn't too bad, but Dr. O'Shea said if this 
becomes more of a problem that Stanford could switch over to 
morphine based drugs.  He said that since his brain is now used to 
narcotics that the switch probably wouldn't have the same effect as 
when Stanford was on morphine in June after the surgery.  That made 
him very tired and loopy.  Stanford doesn't like taking any drugs, 
but he would rather do that than experience pain.

Sources of pain. Dr. O'Shea explained that the liver is in a 
capsule.  When the tumors grow or bleed it can cause pressure on 
this capsule which causes pain.  Another source of pain is when 
blood gets in the abdominal cavity and irritates the lining of the 
abdomen.

Dr. O'Shea was very open with us.  He explained that Stanford has 
already gone through three different "cocktails" of very powerful 
chemo drugs and they haven't had any effect on the cancer.  The 
probability of gemcitabine having any effect is in the 0 to 5% 
range.  Stanford said he wasn't feeling up to having chemo today or 
maybe even this week.  Dr. O'Shea said if Stanford starts feeling 
better in a couple of days with the new level of oxycontin and wants 
to try chemo later this week that it can be arranged.  It is all up 
to Stanford and what he wants to do.  The side effects of 
gemcitabine are supposed to be less than those of the other drugs he 
has already been on.  There is always the worry that in his weakened 
condition that it could make him deteriorate more quickly.

We asked about clinical trials.  The difficulty in Stanford's 
situation is that his cancer is of "unknown origin".  The four 
pathology labs that tested the small bowel tumor in June and July 
were unable to determine what type of cancer he has.  Clinical 
trials are performed in very controlled conditions in order to 
measure the effectiveness of the drug.  Stanford isn't a candidate.

Another area of trials is alpha trials.  These are trials of drugs 
that have only been tested in the petri dish and in animals.  These 
types of trials have a very low success rate, in the 0 to 5% range.  
The side effects can be very traumatic.  These trials are always 
done in research hospitals.  Dr. O'Shea wouldn't recommend any kind 
of alpha trial for Stanford because of all the negatives.

Dr. O'Shea asked Stanford if he was getting as many visitors as he 
wanted and if he was able to see his family and friends.  Stanford 
said he has been able to see lots of them, but that it has dropped 
off lately.  Joyce's parents are here and will return to Utah this 
Wednesday morning.  Stanford's Aunt Lori (John's sister) is arriving 
this Tuesday evening and will be here until returning home Saturday 
morning.

We asked about diet and nutrition.  At this point it is more 
important that Stanford get calories of any kind rather than be 
picky.  For example, if he wants a chocolate milk shake instead of a 
vegetable fruit smoothy then go for the chocolate milkshake.  
Whatever he wants to eat and enjoy is the way to go.  Dr. O'Shea 
said scientists are still trying to determine the link between 
cancer and nutrition.

Dr. O'Shea asked Stanford how he was doing with his faith and 
spirituality.  With conviction Stanford said his faith was strong 
and fine.  Stanford has a very strong belief in God and Jesus 
Christ.  He knows that the Lord is mindful of his condition and he 
trusts in the Lord.  Stanford met with his Bishop this Sunday 
discussing spiritual matters and had a good session with him.

Several people have asked us why a transplant can't be done.  We 
asked Dr. O'Shea about that.  He explained that transplants are done 
in a situation when a dosage of chemotherapy required to kill the 
cancer also kills an organ.  This is done in cases where the chemo 
has been shown to be effective, but not completely at the doses 
being used.  For example, in the case of bone marrow, good bone 
marrow is set aside in storage and then the body is blasted with 
chemo that kills all the bone marrow.  Then the good bone marrow is 
put back in the body.  In Stanford's case the chemo he has received 
hasn't been effective so a transplant isn't an option.  In 
Stanford's condition he wouldn't survive the seriousness and trauma 
of a liver transplant and even if he did, the tumors would simply 
grow back because the chemo can't kill it.

So, family and friends of Stanford, we still pray and hope.  We need 
Stanford to get stronger so that he can even attempt the chemo.  
Let's be specific in our pleadings with the Lord and if it is His 
will, give Stanford life.

Thanks for all your support,

John

_______________________________________________________
John R Larsen <john at larsen-family.us>
http://larsen-family.us