4-14-10 - Day 23 of Radiation, Dr. Trang Meeting

Aunt Linda joined my dad and me for the meeting with Dr. Trang halfway through the process (when he likes to meet with his patients). We clarified some things and got some questions answered.

Good news!

• Dr. Trang said the tumor was way smaller – he said it looks like it has been reduced about 50% or more! He was very happy with the improvement in my dad’s general condition.
• My dad has gained some weight! He weighed in at 160 pounds. The increase in caloric intake (the 1.5 Cal instead of 1 Cal nutrition) and the Ensures between meals are helping!
• He can now breathe somewhat through his mouth!

General Information:

• There are two more rounds of chemotherapy scheduled for the next two Mondays, the next is early (7:00 a.m.) on the 19th. There will not be any more chemo thereafter.
• It is up to the radiation team when and whether or not to do the CT scan and re-mapping, although they just did one last week, they might do a more “fine-tuned” procedure again tomorrow.
• There will be at least 5 more radiation treatments and then Dr. Gorla will reassess what plan to follow from there on out. Two or so of these treatments will be a “boost” radiation by Dr. Desai, which spares more regular tissue. Sounds powerful!

Future Implications:

• Therapy could improve his speech eventually but because of the great damage to his tongue, it will never be the same.
• We hope to move towards a combination of “comfort food” through the mouth and supplementing that with the necessary nutrition through the feeding tube to promote weight gain.
• The trach tube will stay in until he can breathe well through his mouth. It is an easy in-office procedure to remove it and then the hole closes up over time.

In terms of heading home to Bishop soon, the trach suction will still be a necessary component, even if it is for the mouth eventually when the trach is taken out. There will be no need for the hospital bed. Many of the other materials, though, will still be necessary and Dr. Trang can order them so that we have a prescription to get them in Bishop.

My dad will have another meeting with Dr. Trang on Wednesday, May 12 at 9:00 and possibly another in June for follow-up. He will continue to see him every 2 months or so. Trang will remain his primary care doctor, even though he will be back in Bishop – he will come back to Bakersfield for the appointments. There will be no more chemo or radiation at this point, although the radiation will keep killing the cancer cells for about 6 weeks after the final treatment. 3 months after the last day of the radiation treatment, Trang will do a PET scan (and not a day earlier – he said no one else should do this), which is where they have radioactive dye go throughout the body to make sure that the cancer has not spread to other areas and to visually see the areas affected.

And on we go...